Prescription Information

Breast Pump

• A description or HCPC code of the product prescribed (i.e., "double electric breast pump" or E0603).
• A diagnosis code (DX). Typical diagnosis codes are Z39.1 (Encounter for care and examination of lactating mother) and Z34.83 ( Encounter for supervision of other normal pregnancy, third trimester) there maybe others.
• Your physician's signature.
• The date your physician signed the prescription.

Maternity Compression Stockings

• A description or HCPC code of the product prescribed (i.e., "compression stockings, 20-30 mmHg" or A6530).
• A quantity up to four pairs as decided between you and your physician (or midwife).
• A diagnosis code (DX). Typical diagnosis codes are O12.03 (Gestational Edema) and O22.03 (Varicose veins) there may be others.
• Your physician's signature.
• The date your physician signed the prescription.

Pregnancy Support Band

• A description or HCPC code of the product prescribed (i.e., "pregnancy support band" or L0621).
• A quantity up to two support bands as decided between you and your physician (or midwife).
• A diagnosis code (DX). Typical diagnosis codes are M54.5 (Low back pain ) and R10.2 (Pelvic and perineal pain ) there maybe others.
• Your physician's signature.
• The date your physician signed the prescription.