Pneumatic Pumps for Lymphedema

Although pneumatic pumps have been used for many years to treat lymphedema, studies have conflicted on their effectiveness. For example, the 2009 McMaster University Evidence-based Practice Centre (building on an earlier study in 1998 by the Blue Cross Blue Shield Technology Evaluation Center) comparing the efficacy of different types of pneumatic extremity pumps found there was ” insufficient evidence to permit conclusions regarding whether the efficacy of lymphedema pumps varied across pump type.” More recent studies suggest that they can be useful in treating lymphedema, chronic venous stasis ulcers/associated venous insufficiency (Cervantes, 2010), (Adams, 2010).  Medicare wrote: “Our current policy covers the use of pneumatic compression pumps for patients with refractory edema from chronic venous insufficiency with significant ulceration of the lower extremities that have received standard therapy but have failed to heal after 6 months of continuous treatment. After review of all available published literature, we have found sufficient evidence to show that standard care for the treatment of chronic venous insufficiency, which results in ulceration, can be successfully treated by elevation, exercise and compression therapy.” However, this coverage decision is not specific to Pneumatic Pumps and is not binding on other entities and many insurers are not covering this service, insisting on manual massage, or on leasing rather than purchasing a pump.

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