CPT Code for a compression bra - help?

TwoForOneSpecial

This sounds so ridiculous... I have lymphedema in my breast and a prescription for compression bras. I called my insurance company to find out about coverage, and they say they can find a "CPT code" only for compression sleeves, not bras, I should ask the doctor. The doctor's office gave me a code, but I googled it and it is for "compression garments for upper arm and forearm", not for bras.

Does anyone happen to know what code they use for bras? This feels very wrong that they are leaving it to me to figure out... I really can't have this run into next calendar year when it will hit my deductible (again).

Thanks for any help you can offer.

Rachel

DebAL

hi 2 for 1, I'm probably way off here but will give you my thoughts. My son is a CPT Coder and he really wasn't sure. CPT stands for current procedural terminology. My understanding is that CPT is tied more to diagnostics or a surgical procedure. I'm sure there is a code you need but maybe it's another type of code? Silly idea but I wonder if Medical supply companies could guide you. You would think the garment code should pass. Sorry I'm of no help lol. Keep us posted and yes not fair that u need to do all the leg work

MinusTwo

Yes, I believe there is a code that the doc would write on a prescription. I'm a long way out but I'll see if I can find it.

EDitted to add - sorry, I'm pretty sure I had a "number" at one time when I went to Nordstroms, but that was 2012 & I can't find it. I did find written prescriptions from two different doctors that respectively say: "Bellisse Mastectomy Bra, use as directed, 3 refills authorized", and "Compression Bras - dispense four". Both are on official prescription pads & signed by the doctors.

Maybe Nordstroms would know the number?

Or maybe there's one number that covers compression garments - bras, sleeves, gloves?

SpecialK

My garments have always been billed to insurance with HCPCS codes rather than CPT codes. I have linked an explanation for why that seems to be, and the link also lists a bunch of codes for lymphedema related garments and equipment. I think you will likely have to use a generic code as there doesn't seem to be a specific one for "compression bra" or bra of any kind, like one of the L Codes.

http://www.lymphactivist.org/hcpcs_level2.php