Cryotherapy and Compression Devices for Home Use

Coverage decision: Not covered

Cryotherapy and compression devices, such as Game Ready™ system, are considered personal appliances and are not authorized per WAC 296-20-1102.

Game Ready™ system and other similar devices are used to reduce pain and swelling after knee or shoulder surgery. The devices may pump cold water through a sleeve around the affected limb and provides intermittent compression by inflating and deflating the sleeve. The devices are classified by the Food and Drug Administration as a massager and cold water cooling system. These devices are not approved for marketing or use as a pneumatic compression device to treat or prevent deep vein thrombosis.

L&I does not cover Game Ready™ system or similar devices for home use because the evidence of effectiveness is insufficient and the evidence of cost-effectiveness is unfavorable compared to the standard of care: rest, ice, compression and elevation (RICE). The coverage decision applies to other cooling devices with or without pneumatic compression, including but not limited to:

  • ArticFlow Cold Therapy System
  • AutoChill® system
  • Cryo/cuff™
  • Cryotherapy Cold Water Therapy System by Artic® Ice
  • Iceman Cold Therapy unit
  • OPTI-ICE™ Cold Therapy System
  • Polar Care Cub
  • Polar Care 500, Polar Care 300
  • Versa-Cool™ Portable Cold Therapy Unit
  • VitalWrap™ System

Billing codes

HCPCS codes: E0218 and E0236
Note: Cryotherapy and compression devices used in a clinical setting are not payable separately. These modalities are considered to be bundled into existing physical medicine services billable under CPT® 97010. HCPCS E1399 is not appropriate for use of cryotherapy and compression devices in any setting.

Technology assessment and references

 

Regulatory authority and related information

 

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