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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say that a gradient compression wrap is only covered when it is used as a primary or secondary 
dressing over wounds that meet the statutory requirements for a qualifying wound (surgically created or 
modified, or debrided). 
 
Claims for gradient compression wraps used without a qualifying wound or when used for other non-qualifying 
conditions will be denied as statutorily non-covered, no benefit. Refer to the related Policy Article Non-
Medical Necessity Coverage and Payment Rules for information about the statutory benefit requirements. 
 
Utilization of a gradient compression wrap (A6545) is limited to one per 6 months per leg. Quantities 
exceeding this amount will be denied as not reasonable and necessary. Refer to the related Surgical Dressings 
Policy Article Non-Medical Necessity Coverage and Payment Rules section for information concerning non-
coverage once the ulcer has healed. 
 
You can find this information in the Local Coverage Determination (LCD) for Surgical Dressings (L33831). 
 
The rules say that in order for a beneficiarys item(s) to be eligible for reimbursement, all benefit requirements 
discussed below and the reasonable and necessary (R&N) requirements set out in the related Local Coverage 
Determination must be met. 
 
Surgical dressings are covered when a qualifying wound is present. A qualifying wound is defined as either of 
the following: 
 
    A wound caused by, or treated by, a surgical procedure; or, 
    After debridement of the wound, regardless of the debridement technique. 
 
The surgical procedure or debridement must be performed by a treating practitioner or other healthcare 
professional to the extent permissible under State law. Debridement of a wound may be any type of 
debridement (examples given are not all-inclusive): 
 
    Surgical (e.g., sharp instrument or laser) 
    Mechanical (e.g., irrigation or wet-to-dry dressings) 
    Chemical (e.g., topical application of enzymes) or 
    Autolytic (e.g., application of occlusive dressings to an open wound). Dressings used for mechanical debridement, to cover chemical debriding agents, or to cover wounds to allow 
for autolytic debridement are covered although the debridement agents themselves are noncovered. 
 
Examples (not all-inclusive) of clinical situations in which dressings are noncovered under the Surgical 
Dressings benefit are: 
 
    Drainage from a cutaneous fistula which has not been caused by or treated by a surgical procedure; or, 
    A Stage 1 pressure ulcer; or, 
    A first degree burn; or, 
    Wounds caused by trauma which do not require surgical closure or debridement - e.g., skin tear or abrasion; 
or, 
    A venipuncture or arterial puncture site (e.g., blood sample) other than the site of an indwelling catheter or 
needle. 
 
Claims for surgical dressings used for clinical conditions other than the qualifying wounds as described above 
will be denied as statutorily non-covered, no benefit. 
 
You can find this information in the Local Coverage Article for Surgical Dressings - Policy Article (A54563). 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.