The Lymphedema Advocacy Group (LAG) and the Lymphedema Education & Awareness Project (LEAP) publish a one-page handout called 6 Things You Should Know About Lymphedema. It's a good one to keep in the clinic and hand to patients, families and referring offices. Here is a summary for therapists and providers, plus what it means for ordering compression.
1. What lymphedema is
Lymphedema is chronic swelling caused by a buildup of protein-rich lymphatic fluid. It happens when the lymphatic system is faulty from birth or has been damaged, so fluid can't drain normally.
2. It is more common than most people think
An estimated 3 to 5 million Americans live with lymphedema. LAG notes that this is more than ALS, cystic fibrosis, multiple sclerosis, muscular dystrophy and Parkinson's disease combined. In breast cancer, about 2 in 5 patients develop lymphedema within 5 years of surgery (Journal of Clinical Oncology, 2009).
3. Many patients are missed
Lack of awareness means many patients go undiagnosed or are misdiagnosed. The handout's rule of thumb: swelling that lasts 3 months or more should be evaluated for lymphedema by a provider who knows the condition. Early referral to a certified lymphedema therapist (CLT) makes treatment easier and outcomes better.
4. No cure, but it can be treated, and compression is central
There is no cure, but lymphedema can be managed. Compression therapy is the most important part of treatment. Without it, patients face a higher risk of infection (cellulitis), skin changes, loss of function and disability.
5. Leading causes
Lymph node removal during cancer treatment
Injury to lymphatic vessels from trauma or infection
Venous insufficiency that overloads the lymphatic vessels (phlebolymphedema)
Congenital malformation of the lymphatics (primary lymphedema)
6. The Lymphedema Treatment Act
Congress passed the Lymphedema Treatment Act in December 2022. Starting January 1, 2024, Medicare covers medically necessary lymphedema compression garments and supplies: daytime garments, nighttime garments, wraps, bandaging supplies and accessories, with set replacement schedules. LAG notes that the law also sets a precedent for Medicaid and private plans, and that advocacy continues so every patient can get treatment.
What this means when you refer to Midwest Compression
Write the diagnosis clearly. Use the lymphedema ICD-10 code (for example I89.0, I97.2 or Q82.0) and note the affected body area.
Order day and night compression. Medicare and many other plans now cover both, plus wraps and bandaging supplies.
Let us handle measuring. We measure for ready-to-wear and custom flat-knit garments, or use your CLT's measurements on our measurement forms.
Need a pump? If a patient still has swelling after a trial of compression and home care, a pneumatic compression pump may be appropriate. See Pumps: Evidence & How to Choose.
Questions or a referral? Call (800) 883-1549, text (517) 657-5223, or order on Parachute Health.
Source: "6 Things You Should Know About Lymphedema," Lymphedema Advocacy Group and Lymphedema Education & Awareness Project. Learn more at LymphedemaAdvocacyGroup.org and LymphedemaProject.org.
