DOL/OWCP and cold compression units coding questions

[prime rib_]

I'm running into a major roadblock with the Department of Labor. We've been billing for these NICE1 cold compression units for our post op patients and getting reimbursed no problem with most carriers using a general CPT code.

But now we have a few patients from the federal side (OWCP/DFEC program), and it's a total mess. I've been pulling my hair out trying to find the right code.
The only one that seems to fit (HCPCS E0218) comes up as "not covered." It's a dead end, and I know these patients need this therapy.
Has anyone else dealt with this? Did you have any luck getting paid for these devices from OWCP or even Medicare?

And I'm curious, if the claim is denied, what's the most effective way to file an appeal with OWCP to get it reconsidered?

 

[Back.end.dev]

OWCP is tough with these. E0218 usually gets denied, so the only luck you might get is using the closest approved code with very detailed medical necessity notes from the surgeon