Providers · Vascular & vein surgery
Compression for venous insufficiency and lymphedema: vascular referrals
From chronic venous insufficiency and varicose veins to compression after ablation, sclerotherapy or bypass — we fit, deliver and follow up so your patients actually wear it. Long-standing venous insufficiency can also overload the lymphatic system, and ilio-femoral bypass is a recognized cause of secondary lymphedema.
Chronic venous disease: CEAP clinical classes
2020 revision, with the compression we typically fit at each stage
Pathway
Clinical classes
| Class | Clinical sign | Compression we typically fit* |
|---|---|---|
| C0 | No visible or palpable signs of venous disease (symptoms may be present) | 15–20 mmHg for symptoms, travel or standing work |
| C1 | Telangiectasias or reticular veins (spider veins) | 15–20 mmHg |
| C2 / C2r | Varicose veins — C2r: recurrent after treatment | 20–30 mmHg; after ablation or sclerotherapy as directed |
| C3 | Edema of venous origin | 20–30 or 30–40 mmHg; wraps if stockings aren’t tolerated |
| C4a–c | Skin changes: C4a pigmentation or eczema · C4b lipodermatosclerosis or atrophie blanche · C4c corona phlebectatica | 30–40 mmHg stockings or adjustable wraps |
| C5 | Healed venous ulcer | 30–40 mmHg long term to help prevent recurrence |
| C6 / C6r | Active venous ulcer — C6r: recurrent | Wraps or ulcer kits under wound care; stockings once healed |
When CVI and lymphedema overlap
Edema that persists despite stockings and elevation, or spreads to the foot and toes, may reflect lymphatic involvement. Pneumatic compression (E0651 / E0652) may be considered when lymphedema documentation criteria are met. Pump documentation →What to send us
- Signed Rx: garment, mmHg, length, quantity
- Diagnosis with ICD-10 code and CEAP class if documented
- Recent note; ABI if arterial disease is a concern
- Face sheet and insurance card
Patients we help
Who we see
- Chronic venous insufficiency (CVI), venous edema and varicose veins
- After vein procedures — ablation, sclerotherapy, phlebectomy
- Post-thrombotic syndrome after DVT
- Venous ulcers — wraps during healing, stockings after
- Lymphedema after vascular surgery, including ilio-femoral bypass
- Combined venous and lymphatic swelling that hasn’t responded to stockings alone
What we provide
- Medical compression stockings 15–20, 20–30 and 30–40 mmHg — knee, thigh and waist high
- Adjustable compression wraps (CircAid, Juzo, Solaris)
- Custom flat knit for hard-to-fit legs
- Pneumatic compression pumps (E0651 / E0652) when lymphedema criteria are met
- JOBST, Juzo, medi, Sigvaris and L&R
Related pages
What we handle for your office
- Benefits check and prior authorization, and we tell your office right away if anything is missing
- Fitting by certified compression fitters, with in-stock garments, wraps and custom flat knit
- Pumps (E0651 / E0652) delivered and set up, with follow-up
- Updates to your office through Parachute Health or by fax
- A cash-pay option for patients without coverage, through our online shop
← All specialties · Garment documentation · Pump documentation
Sources: Lymphedema Advocacy Group and Lymphedema Education & Awareness Project fact sheets (LymphedemaAdvocacyGroup.org, LymphedemaProject.org), citing J Clin Oncol 2009;27(3):390-7; Cancer 2010;116:5138-49; J Am Coll Cardiol 2008;52(10):799-806; Vasc Med 1998;3:145-156; Clin Genet 2010;77:438-452. This page is referral information for clinicians, not medical advice.