For physicians, nurse practitioners, PAs and wound care teams
Compression is the foundation of treatment for many chronic swelling and venous conditions, but patients often go years without it. Early referral can prevent progression, skin changes, wounds and infections.
Conditions that often benefit from compression
Lymphedema, including after cancer surgery or radiation, or primary lymphedema
Chronic venous insufficiency, with varicose veins, edema or skin changes
Venous leg ulcers, during healing and to prevent recurrence
Lipedema and lipo-lymphedema
Post-thrombotic syndrome after a DVT
After vein procedures such as ablation or sclerotherapy
Chronic edema from reduced mobility, once cardiac and renal causes are managed
Signs it's time to refer
Swelling that persists despite elevation and activity
Swelling in one limb, or swelling that's getting worse over time
A positive Stemmer sign (can't pinch a fold of skin at the base of the second toe or finger)
Skin thickening, hardening, discoloration or weeping
Recurrent cellulitis in the same limb
A history of lymph node removal or radiation with new heaviness or swelling
A healed venous ulcer, to prevent it from coming back
Before prescribing compression
Check arterial circulation in patients with risk factors for peripheral artery disease, such as diabetes, smoking or absent pulses. An ankle-brachial index (ABI) helps determine whether compression is safe and at what level. Rule out acute DVT, active infection and uncontrolled heart failure as causes of new swelling.
What to include in a referral
Diagnosis and ICD-10 code
Affected limb or limbs
Compression level, or a referral for a lymphedema therapist to evaluate
Recent notes, and ABI results if done
Any relevant history, such as cancer treatment, DVT or ulcers
For lymphedema, we recommend referral to a certified lymphedema therapist for complete decongestive therapy before custom garments are ordered.
How Midwest Compression can help
We handle benefits checks, documentation and fitting, and we keep you updated. Orders can be sent through Parachute Health or by fax. Email customersupport@midwestcompression.com or call 800-883-1549.
Need forms? Find every measurement form, sizing guide and order form on our Measurement & Sizing Forms page, and manufacturer charts on our Size Charts page.
This article is general information for healthcare professionals and is not a substitute for clinical judgment.
