Medical Compression Garments

RAP Schedule no.

AR22

(Refer to the RAP Schedule)

Definition

Medical compression garments include but are not limited to the following:

Compression stockings

• to manage chronic venous disease and oedema, including varicosities, venous eczema and  ulceration
• to reduce the risk of deep vein thrombosis

 Lymphoedema garments

• to manage lymphatic insufficiency

Medical dynamic compression garments

• for adjunct management of
  • hypertonicity in spastic muscles e.g. post stroke or head injury.
  • involuntary muscle contractions in dystonic movement disorders
  • low muscle tone disorders by providing  proprioceptive feedback

Compression gloves

• for the management of
  • hand osteoarthritis or rheumatoid arthritis
  • hand oedema post stroke

Medical compression garments may also be prescribed for the management of burns scars.

DVA does not fund generic sports and athletic training and recovery compression garments.

Eligibility

The DVA client must have an assessed clinical need and a:

• Gold Card; or

• White Card with an accepted condition, where the item is reasonably necessary for appropriate clinical treatment of the condition.

Prescribing

Suitably qualified health provider

Medical Compression Garments must be prescribed by a suitably qualified health provider as follows:

• Registered Nurse (RN)
• Physiotherapist (Physio)
• Podiatrist (Pod)
• General Practitioner (GP)
• Specialist (S)
• Occupational Therapist (OT)

Prior approval

Prior approval and supporting information is required in the following circumstances:

• If the client requires more than 3 garments or 3 pairs (as applicable) per 6 months; and/or
• If the contracted / off the shelf items are not suitable, clinical justification is required.

Deciding on the most appropriate item

All assessments must be conducted by a suitably qualified health provider to determine the clinical need for the medical compression garment.

The assessing health provider should recommend and prescribe the most suitable medical compression garment on-contract to meet the DVA client’s clinical need, in consultation with the DVA client or their representative.

When, due to individual clinical circumstances and/or body dimensions, a customised medical compression garment is necessary clinical justification and prior approval is required.   

For items not requiring prior approval

• A suitably qualified health provider will complete the assessment and determine the most suitable item/s for the client and then send the completed Order Form – Mobility and Functional Support – D0992 to the contracted supplier of their choice.

For items requiring prior approval

• Send the completed
  
  Order Form – Mobility and Functional Support – D0992 and any additional supporting documentation listed below to RAPGeneralEnquiries@dva.gov.au for consideration through the prior approval process.
• Once you have received approval from DVA, you can proceed to order the item for the client.

Supporting documentation for prior approval request

For items requiring prior approval, the assessing health provider should provide DVA with

• The condition to be treated / diagnosis
• Clinical justification for the requested item
• Explanation of why off the shelf contracted items are not suitable (when applicable)

Quote from supplier

Additional information

Health Provider Hotline

1800 550 457

Health Providers can contact DVA for any enquiries by calling the Provider Hotline: (Please press Option 1 when prompted for RAP, or Option 3 for prior health approvals).