A6552 Grad com stocking bk 30-40Gradient compression stocking, below knee, 30-40 mmhg, each
Status X: statutory exclusion, not paid under the PFS.
A6552 appears in 7 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Complex Regional Pain Syndrome (CRPS): Treatments (0447) Ketamine metabolite (2R,6R)-hydroxynorketamine, metformin, topical ketamine, Topical dimethyl sulfoxide, Anakinra, Sarilumab - | not covered (range A6552-A6565) | Jul 16, 2026 | payer document |
| Aetna | Compression Garments for the Legs (0482) | covered if criteria are met (range A6552-A6564) | Jul 29, 2026 | payer document |
| Aetna | Lymphedema (0069) | listed, no stance (range A6552-A6564) | Feb 25, 2026 | payer document |
| Anthem | Lower Extremity Pressure Gradient Compression Stockings (CG-DME-57) | covered if criteria are met | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Garments (L.1.04.400) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Prosthetics (L.1.04.401) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Compression Garments_Stockings | covered if criteria are met | Apr 1, 2026 | payer document |
Prior authorization required or conditional in MA, MS, NY, OH, VA.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.