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CommercialBilling CodesMedium impact

Garments

Blue Cross & Blue Shield of Mississippi·MS · Plastic Surgery, Wound Care, General Surgery +2 more·Medical Policy
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS Mississippi updated their Garments policy (L.1.04.400) with new HCPCS codes effective April 1, 2025, and April 1, 2026. The policy covers burn garments, compression stockings, and prosthetic garments with specific medical necessity criteria and quantity limits.

Action Required

Action needed
By April 1, 2025: Billing team must update billing system to include new HCPCS codes A6515, A6516, A6517, A6518, A6519, and A6611 for gradient compression garments. Verify medical necessity documentation requirements are met: burn garments require physician prescription for 3rd degree burns, deep 2nd degree burns, or skin grafts; compression stockings require at least 25mm Hg pressure and specific conditions like lymphedema or venous insufficiency. Note quantity limits: 4 pairs compression stockings per 12 months, 7 prosthetic sheaths/socks per year.

Affected Billing Codes

A4490
A4495
A4500
A4510
A6501
A6502
A6503
A6504
A6505
A6506
A6507
A6508
A6509
A6510
A6511
A6512
A6513
A6515
A6516
A6517
A6518
A6519
A6520
A6521
A6522
A6523
A6524
A6525
A6526
A6527
A6528
A6529
A6531
A6532
A6545
A6548
A6552
A6553
A6554
A6555
A6556
A6557
A6558
A6559
A6560
A6561
A6562
A6563
A6564
A6565
A6566
A6567
A6568
A6569
A6570
A6571
A6572
A6573
A6574
A6575
A6576
A6577
A6578
A6579
A6580
A6581
A6582
A6583
A6584
A6585
A6586
A6587
A6588
A6589
A6593
A6594
A6595
A6596
A6597
A6598
A6599
A6600
A6601
A6602
A6603
A6604
A6605
A6606
A6607
A6608
A6609
A6610
A6611
E0677
E0678
E0679
E0682
L8030
L8031
L8032
L8033
L8035
L8039
S8460