Summary & Overview
HCPCS S8426: Gradient Pressure Glove, Custom Made, Heavy Weight
HCPCS Level II code S8426 defines a custom-made, heavy-weight gradient pressure glove used for sustained compression therapy of the hand and fingers. Nationally, this code represents specialized durable medical equipment prescribed for conditions such as lymphedema and chronic edema where individualized fit and graduated pressure are clinically important. The availability and coverage of custom compression garments influence access to conservative, noninvasive management options for swelling-related conditions.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise view of what S8426 represents, the typical service setting, and the practical clinical context for its use. The publication outlines benchmarking and reimbursement considerations at a high level, summarizes common modifiers (provided separately), and highlights areas where policy clarification or documentation may affect claims adjudication. This resource is intended to orient clinicians, billing staff, and administrators to the code’s clinical purpose and payer landscape so they can locate applicable coverage policies and billing guidance.
Billing Code Overview
HCPCS Level II code S8426 describes a gradient pressure aid (glove), custom made, heavy weight. This item is a custom-fabricated compression glove designed to provide graduated pressure to the hand and fingers, typically used to manage lymphedema, chronic swelling, or other conditions requiring sustained compression therapy.
Service type: Durable Medical Equipment / Compression Garment (custom-made)
Typical site of service: Outpatient clinics, specialty durable medical equipment suppliers, home health settings for use in the home
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic lymphedema, post-burn scarring, or chronic venous insufficiency causing significant hand or forearm edema and fibrosis. The patient is referred by a vascular surgeon, physiatrist, or certified lymphedema therapist after conservative measures (manual lymphatic drainage, compression bandaging, topical care) provide insufficient control of swelling, pain, or functional limitation. A certified orthotist or prosthetist performs a custom measurement session to capture hand and forearm dimensions and identify areas requiring graduated compression. The device fabricated is a heavy-weight, custom-made gradient pressure glove designed to provide therapeutic compression to reduce edema and improve range of motion and function. The clinical workflow includes evaluation and documentation of diagnosis, prior conservative treatments, functional impairment, measurement and fitting visit, fabrication order with specifications, delivery and fit verification, patient education on wear schedule and garment care, and follow-up visits to assess response and adjust or replace the device as needed. Typical sites of service are outpatient durable medical equipment (DME) supplier clinics, outpatient rehabilitation or orthotics offices, and home health visits for patients unable to attend clinic.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the custom glove is fabricated for the left hand/forearm |