CurrentProvidence Health PlanPolicy 145

Pneumatic Compression Devices

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Medical policy governing coverage criteria for pneumatic compression devices and related accessories for Providence Health Plan commercial members; describes when devices are considered medically necessary or not.

Policy Summary

PayerProvidence Health Plan

PolicyPneumatic Compression Devices

Policy CodePolicy 145

Change TypeNo material changes

Effective DateJul 1, 2026

Last ReviewJul 1, 2026

Next Review DateJun 1, 2027

Key ActionDocument a conservative therapy trial (duration per indication) and required evaluation/signoff in the medical record before prescribing any PCD.

SourceLink

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CurrentProvidence Health PlanPolicy 145

Pneumatic Compression Devices

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Policy Summary

PayerProvidence Health Plan

PolicyPneumatic Compression Devices

Policy CodePolicy 145

Change TypeNo material changes

Effective DateJul 1, 2026

Last ReviewJul 1, 2026

Next Review DateJun 1, 2027

Key ActionDocument a conservative therapy trial (duration per indication) and required evaluation/signoff in the medical record before prescribing any PCD.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Multiple (E0650–E0676)HCPCS referenced

4 weeksLymphedema trial

6 monthsCVI trial

30 mmHgMinimum distal pressure

Home onlyPlace of service

POS 24 denyFacility billing

Coverage Criteria for Pneumatic Compression Devices

Lymphedema of the arm caused by breast cancer-related surgery

Covered when ANY of the following are met

Arm lymphedema post-breast surgery: Use of a pneumatic compression device (PCD) to treat lymphedema of the arm caused by a breast cancer-related surgery is considered medically necessary (additional criteria below are not applied).

Other lymphedema not extending to chest/trunk/abdomen (E0650, E0651)

Covered when ALL of the following are met

Primary coverage conditions: A. Diagnosis of lymphedema (defined in Policy Guidelines); B. Persistence of chronic and severe lymphedema demonstrated by at least one clinical finding (1-5: marked hyperkeratosis; papillomatosis cutis lymphostatica; deformity of elephantiasis; skin breakdown with persisting lymphorrhea; or detailed measurements over time confirming persistence with history evidencing likely etiology);

Conservative therapy trial: C. The lymphedema is unresponsive to conservative therapy over the course of a 4-week trial, which must include: 1) regular and compliant use of an appropriate compression bandage system or compression garment to provide adequate graduated compression; 2) regular exercise; 3) elevation of the limb; and 4) manual lymphatic drainage (where available) and medication as appropriate (or documentation why tried/ruled out).4 weeks

Conservative components must all be tried

Lymphedema extending to chest/trunk/abdomen (E0652)

Covered when ALL of the following are met

Base conditions: A. The patient has lymphedema of an extremity; and B. The patient meets criteria II (other lymphedema not extending to chest/trunk/abdomen); and C. The lymphedema extends onto the chest, trunk, and/or abdomen past the limits of a standard compression sleeve; and D. The chest/trunk/abdominal lymphedema has failed to improve with a 4-week trial of a non-segmented PCD (E0650) or a segmented PCD without calibrated gradient pressure (E0651).

All A–D required

Required elements of the 4-week trial for E0652: Trial must include: 1) >=4 weeks regular daily multiple-hour home usage after careful in-person fitting, training, and supervision by a skilled technician; 2) compliant use of an appropriate compression bandage system or compression garment to provide adequate graduated compression; 3) regular exercise; 4) elevation where appropriate; 5) manual and/or self-manual lymphatic drainage for at least 20 minutes per day; 6) evaluation of diet and implementation of necessary changes; 7) medications as appropriate; and 8) correction of anemia and/or hypoproteinemia where possible.>= 4 weeks

All listed elements required during trial

Chronic venous insufficiency (CVI) with venous stasis ulcers (E0650, E0651)

Covered when ALL of the following are met

CVI with venous stasis ulcer criteria: A. Patient has edema in the affected lower extremity; and B. One or more venous stasis ulcer(s); and C. The ulcer(s) have failed to heal after a 6-month trial of conservative therapy directed by the treating practitioner that includes: compliant use of an appropriate compression bandage system or compression garment to provide adequate graduated compression; medications as appropriate; regular exercise; elevation of the limb; and appropriate wound care (including sharp debridement where appropriate).6 months

All listed conservative elements required during trial

DVT prevention (E0676)

Covered when ALL of the following are met

DVT prevention conditions: A. The patient is unable to ambulate for a prolonged period of time (e.g., >2 weeks) due to trauma, orthopedic surgery, neurosurgery, or other acute circumstances; and B. The patient has a contraindication to standard short-term anticoagulation.

Both criteria required

Conservative therapy and device performance requirements

Coverage considered when specified conservative therapy trials and device performance requirements are met

Adequate compression: Garment (prefabricated or custom) must provide adequate graduated compression starting with a minimum of 30 mmHg distally; compression must be sufficient to cause fluid movement and across a gradient to move fluid from distal to proximal without creating a tourniquet effect.minimum 30 mmHg

from Adequate Compression Requirements

Conservative therapy - general: A documented trial of conservative therapy must be in the medical record before prescribing any type of PCD. Assessment may be performed by the treating practitioner or an LCMP with no financial relationship to the DME supplier; if LCMP evaluates, treating practitioner must review, sign and date the report and state concurrence or disagreement on or before the prescription date.documented trial before prescription

from Conservative Therapy Trials

Lymphedema (not involving chest/trunk/abdomen):

PCDs for PAD / arterial insufficiency

Evidence statement regarding PAD/arterial insufficiency

PAD/arterial insufficiency evidence: Evidence supporting the use of intermittent pneumatic compression devices (PCDs) for peripheral arterial disease (PAD) or arterial insufficiency is limited and insufficient to establish safety and efficacy or to determine the impact on net health outcomes.

Studies small, heterogeneous, often use surrogate outcomes; limited data on wound healing, limb salvage, functional improvement.

The policy states that a segmental PCD with calibrated gradient pressure (HCPCS E0652) is not medically necessary when the lymphedema does not extend onto the chest, trunk, or abdomen. E0652 is reserved for cases meeting the criteria for lymphedema that extends past the limits of a standard sleeve; if that extension is not present, E0652 should not be used or reimbursed.

The policy clarifies that edema from causes other than lymphedema is not considered lymphedema for reimbursement of PCDs (HCPCS E0650–E0652). Before classifying a condition as lymphedema for coverage purposes, other causes of edema must be ruled out and documented; PCD coverage requires a documented diagnosis of lymphedema per the policy criteria.

Use of pneumatic compression devices in a facility setting (for example, during an ambulatory surgery in POS 24) is bundled into the facility fee and is not eligible for separate reimbursement. All claims for PCDs billed with POS 24 will be denied; reimbursement applies to home/outpatient settings only.

When a PCD is determined to be non-covered under this policy, all related appliances and accessories (HCPCS E0655–E0673) are also considered non-covered and therefore not eligible for reimbursement. Accessories are only covered when the related base PCD meets applicable coverage criteria.

A PCD is not medically necessary when the documented clinical criteria for the specific indication are not met. Examples include failure to document a diagnosis of lymphedema or required clinical findings, failure to complete required conservative therapy trials of specified duration, or requesting devices for excluded indications (such as arterial insufficiency HCPCS E0675). Accessories are likewise not medically necessary when the base device criteria are unmet.

If the beneficiary demonstrates significant improvement during the required conservative therapy trial (for example, improvement during the 4‑week lymphedema trials or the 6‑month CVI trial), reimbursement for a PCD is not justified. In such cases the policy directs continuation of conservative therapy with ongoing reassessments rather than PCD placement.

The policy finds that evidence for use of intermittent pneumatic compression devices in peripheral arterial disease (PAD) or arterial insufficiency is limited and insufficient to establish safety and efficacy. As a result, PCD use for PAD/arterial insufficiency (HCPCS E0675) is not supported by the available evidence and is considered not medically necessary.

HCPCS and Coding Details

Referenced HCPCS codesHCPCS

E0650	Non-segmental pneumatic compression device
E0651	Segmental pneumatic compression device without calibrated gradient pressure
E0652	Segmental PCD with calibrated gradient pressure
E0655-E0673	PCD-related accessories
E0675	Arterial insufficiency PCD
E0676	PCD for DVT prevention

Referenced HCPCS CodesHCPCS

E0650-E0652

Pneumatic compression device codes referenced for Medicare reimbursement context

HCPCS codes mentionedHCPCS

E0650	Pneumatic compressor, non-segmental home model
E0651	Pneumatic compressor, segmental home model without calibrated gradient
E0652	Pneumatic compressor, segmental home model with calibrated gradient
E0655	Non-segmental pneumatic appliance for use with pneumatic compressor, half arm
E0656	Segmental pneumatic appliance for use with pneumatic compressor, trunk
E0657	Segmental pneumatic appliance for use with pneumatic compressor, chest
E0658	Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest
E0659	Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest
E0660	Non-segmental pneumatic appliance for use with pneumatic compressor, full leg
E0665	Non-segmental pneumatic appliance for use with pneumatic compressor, full arm

1–10 of 20

1/2

inv-18: Minimum graduated compression distal pressure — >= 30 mmHg

Minimum distal graduated compression>= 30 mmHg

Graduated compression requirementCompression must be graduated, starting distally and producing a pressure gradient to move fluid from distal to proximal

No tourniquet effectCompression must not create a tourniquet effect at any point

Prescribing, Prior Authorization, and Step Requirements

Prior Authorization

Prior authorization: verify HCPCS meets device- and indication-specific criteria

Prior authorization should confirm that the specific HCPCS code requested (e.g., E0650, E0651, E0652, E0676, related accessories) corresponds to the device type and indication and meets the policy’s medical necessity criteria (including required conservative therapy trials and device-specific elements).

Ensure code maps to the indicated device type (E0650/E0651 for most lymphedema/CVI; E0652 only when chest/trunk/abdomen involvement criteria met).
Confirm documented conservative therapy trial and device performance (e.g., adequate graduated compression ≥30 mmHg where required).

Prior Authorization

Conservative therapy trial required and documented before prescribing a PCD

Document a trial of conservative therapy in the medical record before prescribing any PCD; the trial must include the required components (compression bandage/garment, exercise, elevation, MLD where available) and the treating practitioner’s evaluation and signoff or an LCMP assessment with practitioner concurrence.

Medical Necessity Requirements

DME medical necessity

Device-specific medical necessity criteria mirror the coverage criteria sets above and must be met for the requested equipment type.

E0650/E0651 for non-chest/trunk lymphedema: Diagnosis of lymphedema; persistence of chronic/severe lymphedema (one clinical finding); failure of 4-week conservative therapy (bandage/garment, exercise, elevation, MLD/medication).4 weeks

E0652 for chest/trunk/abdomen involvement: All II criteria plus extension onto chest/trunk/abdomen beyond sleeve limits and failed >=4-week trial of E0650/E0651 with specified elements including daily multiple-hour use after fitting, MLD >=20 min/day, dietary and medical optimization.4 weeks

E0650/E0651 for CVI with ulcers: Edema in lower extremity; venous stasis ulcer(s); failed 6-month conservative therapy including compression, medications, exercise, elevation, wound care.

Rental, Purchase, and Accessory Rules

Accessory HCPCS	Description / Use	Coverage Condition
E0655–E0673
PCD-related accessories (appliances, liners, connectors, integrated systems)
Covered only when the appropriate related base PCD (E0650, E0651, E0652, or E0675) meets the applicable coverage criteria; not covered when that base device does not meet criteria.

HCPCS Code	Device description	Indications / Notes
E0650
Non-segmental pneumatic compression device (home model)
Used for lymphedema or CVI when medical necessity criteria and required conservative therapy trials are met; edema from non-lymphedema causes must be excluded.

Rule	Details	Coverage implication
Rental vs Purchase
Policy applies to PCDs as DME in the home setting; facility-supplied devices (e.g., during ambulatory surgery; POS 24) are not separately reimbursable.
Claims billed with POS 24 will be denied; coverage for purchase or rental requires that home-use DME criteria and medical necessity are met for the base device and any accessories.

Documentation Requirements and Signatures

Documentation Required

Document device type, diagnosis/history, conservative therapy trials and consistent measurements

Include the device type requested; diagnosis and history (length, severity, symptoms); documentation of conservative therapy trials and outcomes; and consistent pre/during/post measurements with reference to the same anatomic landmarks in the medical record.

Record bilateral comparisons where appropriate and the specific device characteristics (segmental/non-segmental, calibrated/non-calibrated).

Documentation Required

Treating practitioner signoff required when LCMP performs assessment

If an LCMP performs the assessment, the assessment report must be in the medical record and the treating practitioner must receive, review, sign and date the report and state concurrence or disagreement on or before the prescription date.

The LCMP must have no financial relationship with the DME supplier providing the device.

Definitions

inv-34: Adequate graduated compression — definition and performance note

Definition of adequate graduated compressionSufficient pressure at the lowest pressure point to cause fluid movement and sufficient gradient to move fluid from distal to proximal without creating a tourniquet effect

Minimum starting pressureGarment must provide graduated compression starting with a minimum of 30 mmHg distally

Garment typesMay be prefabricated or custom-fabricated, but must meet the graduated compression requirements

Device relationApplies to pneumatic compression garments/appliances used with PCD pumps that inflate/deflate to predetermined pressures and cycle times

inv-35: Edema — definition and distinction from lymphedema

Edema definitionAccumulation of fluid in tissue, most often in the extremities

Not Covered Services

Not covered under this policy are PCDs for arterial insufficiency (HCPCS E0675), and any PCDs or accessories when the applicable base-device coverage criteria are not met. Additionally, a segmental calibrated-gradient device (HCPCS E0652) is not covered when the lymphedema does not extend onto the chest, trunk, or abdomen. Accessories (E0655–E0673) are dependent on a covered base PCD and are excluded when the base device is non-covered.

Use of intermittent pneumatic compression devices for treatment of peripheral arterial disease (PAD) or arterial insufficiency is not supported by sufficient evidence to establish safety and efficacy. Therefore, the policy does not provide coverage for PCDs when the indication is PAD/arterial insufficiency.

PCD use provided in a facility setting (for example, during ambulatory surgery — POS 24) is included in the facility procedure fee and is not separately reimbursable. All claims for PCDs billed with POS 24 will be denied.

Background

Pneumatic compression devices (PCDs) are durable medical equipment consisting of an electrical pneumatic pump and inflatable, body-part‑specific appliances that alternately inflate and deflate to predetermined pressures and cycle times. They are used to treat lymphedema, manage chronic venous insufficiency with venous stasis ulcers, and to prevent DVT in selected immobilized patients with contraindications to anticoagulation. The policy aligns device-type selection and coverage with specific clinical indications and conservative therapy requirements, and references CMS guidance and minimum device performance parameters where applicable.

Policy Summary and Quick Coding Overview

2026-07-01Effective date

2026-07-01Last review

4 weeksTypical minimum lymphedema conservative trial

6 monthsCVI conservative trial

Home onlyPlace of service eligible

Policy Summary

PayerProvidence Health Plan

PolicyPneumatic Compression Devices

Policy CodePolicy 145

Change TypeNo material changes

Effective DateJul 1, 2026

Last ReviewJul 1, 2026

Next Review DateJun 1, 2027

Key ActionDocument a conservative therapy trial (duration per indication) and required evaluation/signoff in the medical record before prescribing any PCD.

SourceLink

On This Page

After a four-week trial, if no significant improvement in the most recent four weeks and other coverage criteria are met, PCD coverage may be considered; if improvement occurs, continue conservative therapy and reassess at least weekly.

from Trial for Lymphedema Not Extending Onto the Chest, Trunk, and/or Abdomen

Lymphedema (extending onto chest/trunk/abdomen): After a four-week trial, if no significant improvement in the most recent four weeks and other coverage criteria are met, E0652 is eligible for reimbursement; if improvement occurs, continue conservative therapy and reassess at least weekly.4-week trial

from Trial for Lymphedema Extending Onto the Chest, Trunk and/or Abdomen

Chronic venous insufficiency (CVI): A continuous period of six months with no significant improvement is required before PCD use for CVI is eligible for reimbursement; if improvement occurs, continue conservative therapy with reassessments.6 months

from Trial for Chronic Venous Insufficiency

Trial must be recorded in the beneficiary’s medical record prior to prescription.

If assessed by an LCMP, the treating practitioner must receive, review, sign and date the report and state concurrence or disagreement on or before the prescription date.

Prior Authorization

Prior authorization recommended for unlisted HCPCS submissions

For any unlisted HCPCS code submitted for services potentially covered under this policy, obtain prior authorization to avoid post-service denial; unlisted codes are reviewed at claim level for medical necessity, coding, and pricing.

If an unlisted code is submitted for a non-covered service in this policy it will be denied.
Prior authorization is recommended for unlisted codes for potentially covered services to prevent post-service denials.

Step Therapy

Required device step: trial of E0650 or E0651 before E0652

Before requesting a calibrated, segmented PCD (E0652) for lymphedema extending onto the chest/trunk/abdomen, document a failed 4‑week trial of a non-segmented PCD (E0650) or a segmented non‑calibrated PCD (E0651) that met all trial elements (daily multiple-hour home use after in-person fitting/training, compression garment compliance, exercise, elevation, MLD ≥20 minutes/day, diet/medication optimization, correction of anemia/hypoproteinemia where possible).

Trial must include at least 4 weeks of regular daily multiple-hour home usage after careful in-person fitting/training by a skilled technician.
All listed conservative elements (compression, exercise, elevation, MLD/self-MLD ≥20 min/day, diet evaluation, medications, correction of anemia/hypoproteinemia) must be documented during the trial.

Step Therapy

Conservative therapy step: complete required trial and show lack of significant improvement

Complete the indicated conservative therapy trial of the duration required for the indication and document lack of significant improvement before PCD coverage is considered (4 weeks for lymphedema scenarios; 6 months for CVI).

Lymphedema not involving chest/trunk/abdomen: 4‑week documented trial; if improvement occurred, continue conservative therapy and reassess weekly.
Lymphedema extending onto chest/trunk/abdomen: 4‑week documented trial of E0650/E0651 before E0652 considered; if improvement occurred, continue conservative therapy and reassess weekly.
CVI with venous stasis ulcers: 6‑month documented trial including compression, medications, exercise, elevation, and appropriate wound care.

Documentation Required

Required documentation: device type, diagnosis/history, and conservative therapy outcomes

Maintain medical record documentation that includes the type of PCD requested, the diagnosis and clinical history, and detailed records of conservative therapy trials and their outcomes to support medical necessity.

Record device type requested (segmental vs non-segmental, calibrated vs non-calibrated).
Document diagnosis, history (length, severity, symptoms), conservative therapies tried, and outcomes.

Documentation Required

Conservative therapy trial documentation: performed by treating practitioner or LCMP with practitioner signoff

Ensure the conservative therapy trial is documented in the medical record and performed by the treating practitioner or an LCMP directly involved in treatment; if an LCMP performs the assessment, the treating practitioner must review, sign, date, and state concurrence or disagreement on or before the prescription date.

LCMP must have no financial relationship with the DME supplier.
Treating practitioner signature date must be on or before the prescription date.

Documentation Required

Measurement and reassessment requirements: consistent, landmark‑based measurements

Re-assessments must include detailed limb measurements obtained in the same manner and using the same anatomic landmarks, with bilateral comparisons where appropriate, and recorded prior to, during, and after trials.

Measurements must be consistently obtained and referenced to the same anatomic landmarks each time.
Include bilateral comparisons where appropriate and document measurements before and at the conclusion of trials.

Note

Unlisted code review: prior authorization recommended and claim‑level review

All unlisted HCPCS codes submitted for services addressed by this policy will be reviewed for medical necessity, coding, and pricing at the claim level; obtain prior authorization for unlisted submissions when the service may be covered to avoid post-service denial.

Unlisted codes submitted for non-covered services in this policy will be denied as not covered.
Prior authorization is recommended for unlisted codes for potentially covered services.

Denial Risk

Denial triggers: missing indication- or device-specific criteria

Requests may be denied when the required criteria for the requested device type or indication are not met, including use of devices for non-covered indications (e.g., E0675 for arterial insufficiency or E0652 when chest/trunk/abdomen criteria are unmet).

Denials can occur if conservative therapy trials, device‑type criteria, or indication-specific requirements are not satisfied.
E0675 (arterial insufficiency) is considered not medically necessary and will be denied.

Denial Risk

Denial risk: lack of documented conservative therapy trial

Failure to document a trial of conservative therapy in the beneficiary’s medical record prior to prescribing any PCD may result in denial of the request.

The trial must be recorded before the prescription date and include required conservative elements.

Denial Risk

Denial risk: missing duration or documented improvement during conservative therapy

If the required conservative therapy duration is not documented or the record shows clinical improvement during the trial (4 weeks for lymphedema scenarios; 6 months for CVI), reimbursement for a PCD is not supported.

Lymphedema trials: 4‑week minimum; improvement during the trial precludes PCD reimbursement.
CVI with ulcers: continuous 6‑month trial required; documented improvement during that period precludes reimbursement.

Billing Rule

Billing rule: PCDs supplied for facility use (POS 24) will be denied

Do not bill for PCDs as separate DME when supplied for use in a facility (e.g., ambulatory surgery — POS 24); all claims for PCDs billed with POS 24 will be denied because the service is included in the facility fee.

PCD reimbursement is applicable to the home setting; facility use is not separately reimbursable.
Claims billed with POS 24 will be denied whether billed by the ASC or a DME supplier.

Denial Risk

Denial risk: unlisted codes for non-covered services will be denied

Unlisted codes submitted for services that are non-covered under this policy will be denied as not covered.

All unlisted codes are reviewed at claim level; if submitted for non-covered services in this policy, they will be denied.

E0676 for DVT prevention: Prolonged inability to ambulate (>~2 weeks) and contraindication to standard short-term anticoagulation.

DME medical necessity

Requires device performance characteristics and completion of specified conservative therapy trials

Device performance: Garment must provide graduated compression starting at minimum 30 mmHg distally and produce sufficient pressure gradients to move fluid without tourniquet effect.

Conservative therapy trial: Documented trial of conservative therapy of appropriate duration (4 weeks for lymphedema scenarios; 6 months for CVI) with measurements showing lack of significant improvement prior to PCD coverage.

Device-type and indication mapping

Coverage depends on indication and device type; evidence insufficient for PAD/arterial insufficiency and limited coverage applies to certain codes

Code-based indication guidance: A PCD coded as E0650 or E0651 is used for lymphedema or CVI; E0652 is for segmented, calibrated gradient devices and has limited coverage; E0675 is used only for peripheral artery disease (PAD); E0676 is used only for prevention of venous thrombosis.

Appropriate HCPCS coding is based on indication and device type.

Documentation Required

Consistent measurement documentation required for reassessments

Re-assessments must include detailed measurements obtained in the same manner and with reference to the same anatomic landmarks, and should include bilateral comparisons where appropriate to document change (or lack thereof).

Measurements must be taken prior to and at the conclusion of trials and therapies using consistent landmarks.

Prior Authorization

Recommend prior authorization for unlisted HCPCS submissions

Prior authorization is recommended for submissions using unlisted HCPCS codes because all unlisted codes are reviewed for medical necessity, correct coding, and pricing at the claim level; prior authorization helps avoid post-service denial.

Unlisted codes for non-covered services will be denied; use prior authorization for potentially covered unlisted submissions.

Etiology clarificationLymphedema is one cause of edema arising from lymphatic system disorders; other systemic or local causes must be ruled out

Reimbursement implicationEdema from causes other than lymphedema is not classified as lymphedema for Medicare reimbursement of PCDs (E0650–E0652)

inv-36: Primary lymphedema — definition examples

Primary lymphedema definitionAn inherited disorder of the lymphatic system that occurs on its own (uncommon)

ExamplesCongenital lymphedema due to lymphatic aplasia/hypoplasia; Milroy's disease; lymphedema praecox; lymphedema tarda

inv-37: Secondary lymphedema — definition and typical causes

Secondary lymphedema definitionDisorder of lymphatic flow caused by another disease or condition (more common than primary)

Typical causesSurgery (especially lymph node dissection), radiation therapy, trauma, tumor obstruction, lymphatic filariasis; may also result from CVI-related leakage

inv-38: Chronic Venous Insufficiency (CVI) — definition and signs

CVI definitionCondition caused by abnormalities of the venous wall and valves leading to obstruction or reflux of venous blood flow

Common signsHyperpigmentation, stasis dermatitis, chronic edema, and venous ulcers

Relation to lymphedemaCVI can cause lymphedema when fluid leaks into interstitial tissues from the venous system

inv-39: Peripheral Arterial Disease (PAD) — definition

PAD definitionCirculatory problem where narrowed arteries reduce blood flow to limbs, compromising distal tissue oxygenation

Clinical implicationPAD may impair distal tissue perfusion and is the specific indication for HCPCS E0675 when used

inv-40: Pneumatic compression device (PCD) — equipment definition

PCD equipment definitionAn electrical pneumatic pump and an inflatable appliance that alternately inflates and deflates to predetermined pressures and cycle times

System componentsPump fills the appliance with compressed air and intermittently alternates inflation and deflation; pressures and cycles vary and may be user-adjustable

Body-part-specific appliancesUsed with body-part-specific inflatable appliances that enclose the applicable body part