Lymphedema - Diagnosis and Treatment - Medicare Advantage

This Humana Medicare Advantage medical coverage policy addresses diagnosis and treatment of lymphedema and defers to applicable Medicare NCDs/LCDs. It explicitly covers bioimpedance spectroscopy (CPT 93702) under specified criteria (history of axillary/pelvic lymph node removal/damage/irradiation plus development of lymphedema or risk factors or breast cancer treatment with stated frequency limits), and it references CMS NCD 280.6 and the Medicare Benefit Policy Manual for coverage of pneumatic pumps and compression garments. The policy lists multiple exclusions (including certain surgeries, nonpneumatic devices/controllers, head/neck pump use, and chest/head/neck/trunk garments) and requires documentation demonstrating prior node removal/irradiation, diagnosis or risk factors, and measurements/clinical records supporting medical necessity.

"Services that are reasonable and necessary for the diagnosis and treatment of lymphedema consistent with Medicare requirements and applicable NCDs/LCDs (Humana follows any applicable NCD/LCD/LCA fo..."