Medical Policy Updates

Table Of Contents

Notification of Policy Revisions Effective August 27, 2013 (Posted May 28, 2013)

Medical Policy Revision
Outpatient Use of Limb Pneumatic Compression Devices for Venous Thromboembolism Prophylaxis "Notification" New policy adopted. Outpatient use of limb pneumatic compression devices after major orthopedic surgery is considered medically necessary in patients with a contraindication to pharmacological agents i.e., at high-risk for bleeding. Outpatient use is considered medically necessary after major non-orthopedic surgery in patients who are at moderate or high risk of venous thromboembolism with a contraindication to pharmacological agents. Other outpatient uses are investigational and outpatient use beyond 30 days post-surgery is not medically necessary. Senior Medical Director review. Notification given 5/28/13 for policy effective date 8/27/13.