Compression Devices - (0354)

Cigna covers home-use standard pneumatic compression devices (E0650, E0651) for intractable lymphedema after failure of a 4‑week trial of conservative measures and for chronic venous insufficiency with venous stasis ulcers after ≥24 weeks of medically‑supervised wound care without improvement; calibrated-gradient devices (E0652) are covered only after meeting those standard-device criteria plus documented failure of the standard device or need for localized specified pressure, while non‑pneumatic systems (E0677–E0683), home intermittent limb compression (E0676), arterial devices (E0675), home cooling systems (e.g., Game Ready) and other unspecified codes are experimental or not covered. Coverage requires documentation of the required conservative-treatment trials (lymphedema: 4 weeks of home exercise, elevation, and compression; CVI: ≥24 weeks of supervised wound care and lack of ulcer improvement), continued use requires adherence and documented clinical improvement, and claims must use the policy’s listed HCPCS and ICD‑10 codes.