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    v1.0.31
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a6525-gradient-compression-garment-lower-leg-foot-nighttime-custom
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    HCPCS Level II A6525: Gradient Compression Garment, Lower Leg and Foot, Nighttime

    HCPCS Level II code A6525 describes a custom, padded gradient compression garment for the lower leg and foot intended for nighttime use; the service is a durable medical equipment supply of a custom-fitted lower-leg/foot compression garment provided typically in outpatient durable medical equipment settings or fitted in a clinic for home/nighttime therapy.

    For related coverage guidance, see recent payer policy updates: Diabetic Supplies, Radiofrequency Ablation for Thyroid Nodules, Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only).

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    Clinical & Coding Specifications

    Clinical Context

    A patient with chronic venous insufficiency and persistent lower‑leg edema is prescribed a custom, padded gradient compression garment for the lower leg and foot intended for nighttime use. The typical patient is an adult with venous stasis changes, lymphedema, or post‑procedural edema who requires off‑loading and sustained graduated compression during sleep to reduce ambulatory discomfort and overnight fluid accumulation. The device is custom‑measured by a certified orthotist or durable medical equipment (DME) supplier at an outpatient DME clinic, vascular medicine clinic, wound care center, or home health visit when neuromuscular or mobility limitations prevent independent fitting.

    Clinical workflow:

    • Referral: The treating clinician (vascular surgeon, wound care specialist, or primary care physician) documents medical necessity and orders a custom nighttime gradient compression garment A6525.

    • Evaluation and measurements: A certified fitter (orthotist/DME supplier) obtains limb measurements, documents skin integrity, stage of lymphedema or venous disease, and captures photos if required by the payor.

    • Fabrication: The supplier manufactures the padded, custom gradient garment per specifications for lower leg and foot, intended for nighttime use.

    • Delivery and training: Device is delivered in the outpatient DME clinic or at home; the supplier provides fitting confirmation, donning/doffing education, and written instructions. The supplier documents the final fit and provides an itemized invoice matching A6525.

    • Follow‑up: The prescriber documents clinical response at follow‑up visits (reduction in edema, improved wound healing when applicable) and authorizes replacement intervals per payor policy.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    94640Pressurized chest physiotherapy; per sessionMay be used in patients with lymphedema requiring additional decongestive therapy in coordination with compression garments.
    97110Therapeutic exercises to develop strength and endurance, range of motion and flexibilityPerformed by physical therapists who may assess limb mobility and provide donning/doffing training for custom garments.
    97530Therapeutic activities, direct (one‑on‑one) patient contactUsed for functional training related to device use, particularly for patients with limited mobility.
    99070Supplies and materials provided by the physician over and above those usually included with the office visitMay be reported when additional non‑standard supplies are provided during fitting or education.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    332B00000X
    207L00000X
    193200000X
    207VC0200X
    246XC2901X
    163WP0000X
    2470A2800X
    261QA0005X

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Diabetic SuppliesCigna2026-10-15
    Radiofrequency Ablation for Thyroid NodulesCigna2026-10-15
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)UnitedHealthcare2026-10-01
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Indiana Only)UnitedHealthcare2026-10-01
    Tzield (teplizumab-mzwv) CoverageUnitedHealthcare2026-10-01
    Medical Necessity Guidelines Insulin PumpsMass General Brigham Health Plan2026-10-01
    Medical Necessity Guidelines: Continuous Glucose MonitorsMass General Brigham Health Plan2026-10-01
    Continuous Glucose MonitoringAmbetter Nevada2026-10-01
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01

    Related Codes

    HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

    HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

    HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

    HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

    HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

    HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

    HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

    HCPCS Level II A4210: Needle-free Injection Device, Each

    HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

    HCPCS Level II A4211: Supplies for Self-Administered Injections

    HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

    HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

    HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

    HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

    HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

    HCPCS Level II A4215: Needle, Sterile, Any Size

    HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

    HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

    Showing 1–10 of 633

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    99080
    Special reports such as insurance forms, medical record; completion of forms
    Used for documentation tasks required by payors when prior authorization or detailed justification for A6525 is submitted.