Guidelines for Recommending Flexitouch Therapy

Clinically Appropriate Diagnoses
  • Primary lymphedema
  • Lymphedema secondary to
    • Cancer treatment including
      • Surgical intervention
      • Lymph node dissection
      • Radiation
    • Surgery
    • Venous insufficiency
    • Trauma
    • Infection
    • Other etiologies
Other Clinical Guidelines

Patient’s medical record provides documentation that patient has tried at least four weeks of conservative home therapy, including use of compression bandaging or garment. Documentation must indicate that the patient continues to manifest significant lymphedema symptoms, which may include continued swelling, fibrosis, issues with impaired skin integrity and recurrent cellulitis.

  1. Patient has physical and cognitive ability to don/doff garments and operate the device or has a caregiver to assist.
  2. Patient has no contraindications that prohibit use of Flexitouch therapy as determined by a physician.
  3. Medicare patients must meet Medicare clinical requirements.
  4. If the patient continues to struggle with home management of lymphedema and meets the medical criteria, he or she may be a good candidate for Flexitouch therapy. A product specialist is available to discuss individual needs and to demonstrate the Flexitouch device. Please call 866-435-3948 to schedule an appointment.
FDA Indications and Contraindications

Indications for Use:

  • Primary lymphedema
  • Post mastectomy edema
  • Edema following trauma and sports injuries
  • Post immobilization edema
  • Venous insufficiencies
  • Lymphedema
  • Reduced wound healing time
  • Treatment and assistance in healing: stasis dermatitis; venous stasis ulcers; arterial and diabetic leg ulcers

Contraindications:

  • Pulmonary edema
  • Thrombophlebitis
  • Congestive heart failure
  • Deep vein thrombosis
  • Episodes of pulmonary embolism
  • Acute infections and inflammations
  • Acute cancer
  • Where increased lymphatic return is undesirable


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