Medicare Order Process – Venous Leg Ulcers

To initiate a Medicare order for a product to treat venous leg ulcers, fax a copy of the patient’s medical record face sheet to Tactile Medical at 866.435.3949. After we have verified that Medicare is the patient’s primary insurance, a Medicare Specialist will contact you to discuss which pneumatic compression device is appropriate for the patient based upon Medicare’s coverage criteria outlined below. We will work with you to complete any necessary forms and documentation.

The patient’s medical records must include the following to meet criteria:

ACTitouchAdaptive Compression Therapy System (HCPCS E0651)

  • Documented diagnosis of chronic venous leg ulcers
  • Objective findings that establish the severity of the nonhealing ulcers
  • Record of conservative therapies used consistently for at least the previous six months and that ulcers remain unhealed despite compliance with treatments
  • Physician oversight of all treatment, including a reason for ordering a pump

Flexitouch® System (HCPCS E0652)

  • Meets criteria for basic pump, plus:
  • Clear evidence that use of the basic noncalibrated pressure pump (HCPCS E0651) was ineffective in treating the patient’s condition
  • The patient’s unique characteristics that prevent satisfactory treatment with basic pump
  • Justification for why an advanced (HCPCS E0652) pump is needed to meet the patient’s needs

Download the Medicare Coverage Criteria for Chronic Venous Ulcers guide >