Clinical Context
A patient with a history of lymphedema of the upper extremity following breast cancer treatment is fitted for a custom, padded, nighttime gradient compression arm garment (A6523). The typical workflow begins in an outpatient lymphedema clinic, physical medicine and rehabilitation office, or durable medical equipment (DME) supplier after referral from the patient’s oncologist, surgeon, or primary care provider. The patient receives a clinical assessment documenting limb measurements, degree of edema, skin integrity, and functional limitations. A certified lymphedema therapist or trained clinician performs serial circumferential measurements and documents objective improvement goals. A prescription/order authorizing a custom, padded, nighttime gradient compression garment is written by an authorized prescriber and includes laterality (RT or LT), size, and clinical justification (e.g., persistent stage II lymphedema, nocturnal fluid redistribution). The DME supplier takes custom molding or measurements and fabricates the garment to provide graduated compression intended for overnight use to maintain limb reduction achieved by daytime therapy. The patient returns for fitting, education on donning/doffing, skin care, and documentation of wear tolerance. Follow-up visits assess fit, skin changes, and therapy response; replacement or adjustments are ordered as clinically indicated. Typical sites of service include outpatient clinics, DME supplier locations, and the patient’s home for delivery and fitting.