Summary & Overview
HCPCS A6559: Gradient Compression Stocking, Full Length/Chap, 18-30 mmHg
HCPCS Level II code A6559 represents a custom-fitted, full-length (chap style) gradient compression stocking delivering 18–30 mmHg of graduated compression. These garments are used to manage venous insufficiency, lymphedema adjunct therapy, post-thrombotic syndrome, and other conditions requiring sustained compression. As a custom durable medical equipment item, A6559 is clinically significant for outpatient vascular care and wound management and can influence durable medical equipment utilization nationally.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical use and service setting, typical payer coverage patterns, and what to expect in terms of billing context for custom compression garments. The publication summarizes benchmarking points, common documentation requirements, and coding considerations relevant to outpatient DME suppliers and vascular/wound care clinicians.
This summary is intended to provide a national perspective on HCPCS Level II code A6559, covering clinical context, likely sites of service, and the payer landscape. Data not available in the input is noted where applicable in the detailed sections.
Billing Code Overview
HCPCS Level II code A6559 describes a gradient compression stocking, full length/chap style, 18-30 mmHg, custom, each. This item is a custom-fitted, knee-to-thigh (full length/chap) medical compression garment designed to provide therapeutic graduated compression in the 18–30 mmHg range for conditions requiring sustained venous support.
Service type: Custom therapeutic compression garment
Typical site of service: Outpatient durable medical equipment suppliers, specialty medical supply clinics, and outpatient vascular or wound care settings
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic venous insufficiency, symptomatic varicose veins, post-thrombotic syndrome, or lymphedema who requires a custom full-length (chap style) gradient compression stocking providing 18–30 mmHg of compression. The clinical workflow begins with a vascular medicine, wound care, or lymphedema-certified clinician evaluation documenting the diagnosis, limb measurements for a custom garment, and medical necessity for custom rather than off-the-shelf compression. The supplier obtains a valid prescription or order specifying A6559, size, laterality, compression level, and clinical indication. The clinician documents prior conservative measures (elevation, exercise, OTC stockings) and rationale for custom stocking. The patient is measured in clinic or by a certified fitter; a custom stocking is fabricated and delivered with fitting verification and patient education on wear schedule and skin care. Follow-up visit documents efficacy, fit issues, or complications. Billing uses A6559 per each stocking supplied, with applicable modifiers to indicate unusual complexity, bilateral provision, rental versus purchase status, or supplier/vendor identity as required by payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |