12 commercial payer policies list E0657. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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12 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of E0657 |
|---|---|---|
| Compression Pumps for Treatment of Lymphedema and Venous Ulcers | Jan 1, 2026 | Covered |
| Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis | Sep 1, 2026 | Covered |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Compression Pumps for Treatment of Lymphedema and Venous Ulcers | Jan 1, 2026 | Covered |
| Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis | Sep 1, 2026 | Covered |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Compression Pumps for Treatment of Lymphedema and Venous Ulcers | Jan 1, 2026 | Covered |
| Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis | Sep 1, 2026 | Covered |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Compression Pumps for Treatment of Lymphedema and Venous Ulcers | Jan 1, 2026 | Covered |
| Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis | Sep 1, 2026 | Covered |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Compression Devices for Lymphedema | Jan 6, 2026 | Covered |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Compression Devices | May 15, 2026 | Covered |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of E0657 |
|---|---|---|
| Postsurgical Home Use of Limb Compression Devices | Feb 1, 2026 | Covered |