What is the Insurance Reimbursement code for Purple Wrap  ?

 2011 HCPCS A6449

Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard

• Added on Thursday, January 01, 2004
  
• BETOS Classification: Medical/Surgical Supplies
• Medicare coverage status: Carrier judgment

Do Private health insurers and  Medicare  reimburse  Purple Wrap  Treatment ?  

Purple wrap is a light compression device and a variety of insurers reimburse light compression therapy . You have to check with your health  plan .

What is the Science Behind  Compression Therapy?

The calf muscle is the driving force to return the blood from the legs back to the heart in its journey up the deep veins, through the abdominal cavity, and back to the heart chambers. Historically, the calf muscle has been called the “peripheral heart.” When the calf muscle contracts, it expands and squeezes the deep veins shut, driving the blood content upwards. When the calf muscle is wrapped in a short stretch or non-stretch wrap, the calf muscle expands against the rigid bandage causing a huge increase in pressure and greatly increases the output of venous blood from the calf. And when the calf muscle relaxes, as when you are carrying your leg through to the next step, the pressure in the deep veins falls far more than normal; this has a huge effect on drawing fluid out from the tissues and into the veins. This negative phase of the calf pump is the most important function to concentrate on if we are to rid the edema or lymphedema. When patients put on our wrap, and walk for a minute, they can feel their leg is lighter and stronger….because the wrap boosts their calf muscle action. Any elastic component opposes this action. So, in order to get the most out of the purple wrap, you should apply the wrap so that it is “comfortably snug.” And since the wrap only works when you are walking and working your calf muscle, it doesn’t work when you are sitting or lying down. You should remove the wrap at bed time and re-wrap first thing in the morning. It is best to walk for 20 minutes three times a day for moderate calf action. 

Three potential areas for difficulty, and how to resolve them:

1.      Older patient who is unable to wrap self, 

2.    Painful skin lesion that prevents proper wrapping, 

3.    Painful knee, ankle or foot that inhibits walking.

If the patient is unable to wrap himself/herself, then she should be wrapped by a helper first thing in the morning. 

If there is a painful ulcer on the leg, then this will require the application of Xylocaine liquid to a cotton ball for about 20 minutes before wrapping. Then put a dry cover on the lesion and then wrap normally. When the patient walks for a while, the inflammatory edema will be removed and the ulcer pain should go away.

If the patient is elderly and unstable, or can’t walk well, they can shift their weight from one leg to the other and back again, while holding onto the back of a tall chair or something firm. This action simulates walking especially if they put their weight on the front of their feet. 

Older patients tend to collect edema in their ankles because they are physically inactive for much of the day. But if they wear the purple wrap, their legs will feel stronger and they can walk enough to rid the edema