Summary & Overview
HCPCS A6558: Gradient Thigh-Length Compression Stocking, Custom, ≥40 mmHg
HCPCS Level II code A6558 designates a custom thigh-length gradient compression stocking delivering 40 mmHg or greater compression, used to manage advanced venous and lymphatic conditions. Nationally, availability and coverage of high-compression custom garments affect care pathways for patients with severe venous disease, post-thrombotic syndrome, and lymphedema where off-the-shelf options are insufficient.
Key payers in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication presents payer coverage patterns, billing considerations, and the clinical context for prescribing custom high-compression thigh garments. Readers will find benchmarks on utilization where available, common billing and documentation elements, and an explanation of clinical indications that typically justify custom 40 mmHg thigh-length stockings.
The content addresses practical coding identification and service classification for suppliers and billing staff, plus policy-relevant points for purchasers and payers. Data not available in the input will be noted where applicable; the focus is on clarifying what A6558 represents, typical settings for service delivery, and the policy and billing implications of providing custom, high-compression thigh stockings at a national level.
Billing Code Overview
HCPCS Level II code A6558 describes a gradient compression stocking, thigh length, 40 mmHg or greater, custom, each. This item is a custom-fitted, medical compression garment designed to provide thigh-length, graduated compression of at least 40 mmHg to support venous return and manage conditions such as severe chronic venous insufficiency, post-thrombotic syndrome, lymphedema, or other circulatory disorders.
Service Type: Durable Medical Equipment (DME) / Compression Garment
Typical Site of Service: Outpatient clinical settings, specialty prosthetics/orthotics suppliers, home health supply delivery
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with chronic venous insufficiency or post-thrombotic syndrome is fitted for a custom thigh-length gradient compression stocking (A6558, 40 mmHg or greater, custom, each) to manage severe edema, venous stasis ulcers, or symptoms after deep vein thrombosis. Typical patient: a 68-year-old ambulatory woman with persistent unilateral lower-extremity edema and recurrent stasis dermatitis despite conservative measures. The clinical workflow: a vascular medicine or wound care clinician documents the medical necessity, obtains precise limb measurements, writes a custom garment order specifying thigh-length and graduated compression ≥40 mmHg, and communicates payer requirements (e.g., face-to-face visit, trial of off-the-shelf if required). A certified fitter or orthotic technician fabricates the custom stocking to measurements. Follow-up visits assess fit, skin integrity, symptom improvement, and replacement timing. Typical site of service: outpatient specialty clinic (vascular medicine, wound clinic), durable medical equipment supplier, or home health visit for measurement and fitting when mobility-limited.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the custom stocking is for the left lower extremity |