Compression garments

The medical prescription is replaced by the therapy protocol. The following form is used for this purpose: Appendix N - Compression and support garments (Annexe N - Vêtements de compression et de contention). The protocol must be completed for straight-knit compression garments as well as circular-knit compression garments.

To receive compression stockings, the insured person must present the treatment protocol at an orthopaedic shop or pharmacy. For straight-knit compression stockings and other compression garments costing €125 or more, the supplier must submit a quotation to the CNS prior to delivery. This request must be authorised by the CNS prior to delivery (certificate of coverage).

In addition to the registration number and name of the insured person, the prescription must also contain the contact details of the attending physician (name and doctor code). Furthermore, more detailed information on the clinical picture and the prescribed product must be provided:

• diagnosis,
• date of surgery (if applicable),
• start of lymphatic drainage (if applicable),
• details of the body part and model (if necessary, exact details of the product),
• knitting method,
• minimum pressure,
• precise information on the treatment/duration of treatment
  

In the case of a new prescription before the expiry of the renewal period, the reasons for the early renewal must be stated.

The prescription must be signed, stamped and dated by the doctor.

Over a period of 12 months, I am entitled to two pairs of circular knit compression stockings/tights and four pairs of straight knit compression stockings/tights. At the end of the 12 months, the prescription can be renewed.

For other compression garments, the decision will be made on the basis of a justified medical prescription.

No authorisation is required for circular knitted compression stockings. Patients can purchase them directly from a pharmacist or orthopaedic specialist and are then reimbursed by the CNS when they submit the necessary documents.

However, for straight-knit garments and other compression garments, a quotation must be submitted to the CNS together with the treatment protocol and a measurement sheet before the product is dispensed. If the application is approved, the seller will receive a certificate of coverage from the CNS and the patient will be able to receive the compression garments.

In all cases, the patient or seller must submit the complete documentation (treatment protocol, invoice, measurement sheet) to the CNS in order to be reimbursed.

The request for reimbursement for compression stockings/tights must include the following documents:

• the paid invoice from the pharmacy or orthopaedic shop/supplier;
• the complete treatment protocol (Appendix N);
• the quotation (only for straight-knit compression garments costing €125 or more);
  
• a measurement sheet (details inAppendix H).

The claim for coverage of other compression garments must include the following documents:

• the invoice from the pharmacy or orthopaedic specialist.
• the treatment protocol (Appendix N) duly completed;
  
• the prior quotation if the price is ⩾ £125.

In the event of refusal of coverage, the parties are free to lodge a written objection with the CNS Council of Administration within forty days of notification.

To be admissible, an objection must be signed by the patient himself, his legal representative or his proxy. The legal representative may be a lawyer or a representative of a professional or trade association to which the patient may belong. This shall be attested by a special written power of attorney.

It is recommended that the objection be sent by registered mail to the Council of Administration of the CNS.

The patient can purchase compression garments at a pharmacy or orthopaedic supply store. It is advisable to check in advance whether the prescribed compression garments are available locally.

In order to ensure the quality of care, the seller must provide the CNS with proof that the necessary additional training has been completed.