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Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism Prophylaxis

Postsurgical home use of limb compression devices for venous thromboembolism (VTE) prophylaxis is considered investigational in all other situations, including but not limited to:
After major orthopedic surgery (total hip arthroplasty, total knee arthroplasty, hip fracture surgery) in patients without a contraindication for anticoagulation; OR

After major nonorthopedic surgery or other orthopedic procedures in patients without a contraindication for anticoagulation who are at moderate or high risk of VTE (see Policy Guidelines).

Postsurgical home use of limb compression devices for VTE prophylaxis may be considered medically necessary in patients with a contraindication to pharmacologic agents (see Policy Guidelines), in the following situations:

After major orthopedic surgery (total hip arthroplasty, total knee arthroplasty, hip fracture surgery); OR

After major nonorthopedic surgery or other orthopedic procedures in patients who are at moderate or high risk of VTE (see Policy Guidelines).

Postsurgical home use of limb compression devices for VTE prophylaxis for periods longer than 30 days postsurgery is not medically necessary.

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