Anthem Blue Cross Connecticut MED.00105 Bioimpedance Spectroscopy Devices for the Detection and Management of Lymphedema Form

Effective Date

06/28/2023

Last Reviewed

05/11/2023

Original Document

  Reference



This document addresses the use of bioimpedance spectroscopy, a device which uses impedance ratios to measure extracellular fluid volume differences between limbs to aid in the clinical assessment of lymphedema.

Note: Please see the following related document for additional information:

  • CG-DME-06 Compression Devices for Lymphedema

Position Statement

Investigational and Not Medically Necessary:

The use of bioimpedance spectroscopy testing in the assessment, diagnosis, or management of individuals with known or suspected lymphedema is considered investigational and not medically necessary.