Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Blue Cross & Blue Shield of MississippiCommercial · Coverage · Medical Policy · Wound Care, Physical Therapy, OncologyMedium impact

Compression Pumps for Treatment of Lymphedema and Venous Ulcers

Effective date
Not stated in the notice
Identified
Sep 29, 2026

Summary

BCBSMS may consider single-compartment or multi-chamber non-programmable pneumatic compression pumps applied to the limbs medically necessary for lymphedema that has failed conservative measures, and programmable pumps when specified conditions are met. The 04/07/2026 revision added criteria for pumps applied to the chest or trunk in addition to the limbs, and for programmable wearable non-pneumatic pumps such as the Koya Dayspring applied to the limbs. Single-compartment or multichamber pumps applied to the head or neck, and pneumatic or non-pneumatic compression pumps used to treat venous ulcers, are considered investigational.

Get alerts when payers change rules like this one

We check Blue Cross & Blue Shield of Mississippi and other payers every day and email you when a change matches your specialty and state.

Get Blue Cross & Blue Shield of Mississippi alertsPolicy Monitoring is free. No card required.

What to do

Action · 7 steps
01Billing team must confirm the documentation in the record before billing these pumps.
02For a non-programmable pneumatic pump applied to the limbs, the lymphedema must have failed to respond to conservative measures such as limb elevation and use of compression garments.
03For a programmable pneumatic pump applied to the limbs, the individual must be otherwise eligible for a non-programmable pump, and the record must document unique characteristics such as significant scarring or recent surgery that prevent satisfactory compression with a non-programmable pump, or an inadequate response to an initial course of treatment with a non-programmable pneumatic pump applied to the limbs.
04For a pump applied to the chest or trunk in addition to the limbs, the lymphedema must have failed to adequately respond to both conservative measures and non-programmable pneumatic compression to the limbs only, and the programmable pump criteria for unique characteristics or inadequate response apply.
05For a programmable wearable non-pneumatic pump applied to the limbs, the individual must be otherwise eligible for a programmable pneumatic pump, and the record must document lifestyle considerations or mobility requirements where compliance with a traditional programmable pneumatic system is expected to be insufficient.
06For segmented devices, E0651 applies when manual control is not needed, and E0652 is covered only when unique characteristics, such as significant sensitive skin, scars, contracture or pain, prevent satisfactory pneumatic treatment with a less costly device.
07Pneumatic compression devices prescribed for surgery to prevent DVT or PE should be included in the surgical facility's claim, may not be billed separately, and must not be billed to the patient.

Codes mentioned

E0658E0659E0678E0679E0680E0681E0682E0683

Original notice

Compression Pumps for Treatment of Lymphedema and Venous Ulcers
bcbsms.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross & Blue Shield of Mississippi changes →
Pneumatic Compression Pumps for Treatment of Lymphedema and Venous UlcersMediumNo effective date · Medical PolicyBrowse every Blue Cross & Blue Shield of Mississippi change in the policy list

Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesWound CarePhysical TherapyOncologyCode E0658Code E0659Code E0678Code E0679Code E0680Code E0681Code E0682Code E0683

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account