We’re updating our coverage of limb compression devices and accessories, starting April 1

Blue Cross Blue Shield of Michigan and Blue Care Network are changing our reimbursement policy for intermittent limb compression devices and accessories.

Beginning April 1, 2025, limb compression devices and accessories will no longer be eligible for reimbursement when a durable medical equipment supplier provides them for use in an ambulatory surgical center. Coverage will be limited to devices and accessories delivered to the patient’s home.  

There’s no change to the requirement for members to meet the clinical criteria in our medical policies.

Patients use limb compression devices for venous thromboembolism prophylaxis after they’ve had surgery and are recovering at home. To qualify for coverage of those devices, one of these criteria must be met:

• The patient has a high risk for bleeding after a major orthopedic procedure.
• The patient has a moderate or high risk of venous thromboembolism with a high risk for bleeding after a major non-orthopedic or other orthopedic procedure.
• The patient has an extremely high risk for venous thromboembolism after a major orthopedic or major non-orthopedic procedure. The devices serve as an adjunct to anticoagulant or antiplatelet therapy.

Review these policies to determine if your patient meets the clinical requirements:

• Postsurgical home use of limb compression devices for venous thromboembolism prophylaxis
• Pneumatic compression pumps and appliances for venous ulcers
• Pneumatic compression pumps and appliances for lymphedema (for example, Flexitouch System)

You can find these policies using the Medical Policy Router Search.