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HQ 965918




February 12, 2003

CLA-2 RR:CR:TE 965918 ttd

CATEGORY: CLASSIFICATION

TARIFF NO.: 6115.93.3000

Mr. Tom Miesen
Gloria-Med America, Inc.
1813 E. John Sims Parkway, Suite 3
Niceville, FL 32578

RE: Modification of New York Ruling Letter E82593, dated June 11, 1999; Classification of Medical Graduated Compression Stockings

Dear Mr. Miesen:

This letter concerns New York Ruling Letter (NY) E82593, issued to you on June 11, 1999, regarding the tariff classification of compression hosiery under the Harmonized Tariff Schedule of the United States Annotated (HTSUSA). After review of that ruling, Customs has determined that the classification for one of the three styles considered has changed from subheading 6115.93.9020, HTSUSA, as other stockings to subheading 6115.93.3000, HTSUSA, as surgical stockings with graduated compression for orthopedic treatment. For the reasons that follow, this ruling modifies, in part, NY E82593.

Pursuant to section 625(c)(1) Tariff Act of 1930 (19 U.S.C. 1625(c)(1)) as amended by section 623 of Title VI (Customs Modernization) of the North American Free Trade Agreement Implementation Act (Pub. L. 103-82, 107 Stat. 2057, 2186), notice of the proposed modification of NY E82593 was published on January 8, 2003, in the Customs Bulletin, Volume 37, Number 2. As explained in the notice, the period within which to submit comments on this proposal was until February 7, 2003. No comments were received in response to this notice.

FACTS:

The article under consideration is one style of compression hosiery, identified in NY E82593 as Style Soft 141 (style 141). Style 141 is comprised of 63 percent polyamide and 38 percent elastane fabric, with a decitex of 486. Style 141 supplies graduated compression ranging from 20-30 mm Hg1 and is prescribed by a physician.

In NY E82593, Customs classified style 141 in subheading 6115.93.9020, HTSUSA, which provides for "Panty hose, tights, stockings, socks and other hosiery including stockings for varicose veins, and footwear without applied soles, knitted or crocheted: Of synthetic fibers: Other: Other, Other." We note that at the time NY E82593 was issued we considered the following:

It is Customs position that surgical compression hosiery, because of their construction and application of use, are more than simple compression stockings to treat varicose veins. The hosiery is made of heavy gauge, opaque, elasticized knit fabric, and is designed to supply compression in the range of 30-40 mm mercury to 50-60 mercury. They are prescribed by physicians for the treatment of venous diseases and other serious conditions such as reversible and irreversible lymphedema and severe post-thrombotic treatment.

ISSUE:

What is the proper classification of the subject graduated compression hosiery under the HTSUSA?

LAW AND ANALYSIS:

Classification of goods under the HTSUSA is governed by the General Rules of Interpretation (GRI). GRI 1 provides that classification shall be determined according to the terms of the headings and any relative section or chapter notes. Merchandise that cannot be classified in accordance with GRI 1 is to be classified in accordance with subsequent GRI taken in order. The Harmonized Commodity Description and Coding System Explanatory Notes (EN), constitute the official interpretation of the Harmonized System at the international level. While neither legally binding nor dispositive, the EN provide a commentary on the scope of each heading of the HTSUSA and are generally indicative of the proper interpretation of these headings.

Heading 6115, HTSUSA, provides for "Panty hose, tights, stockings, socks and other hosiery, including stockings for varicose veins, and footwear without applied soles, knitted or crocheted."

In HQ 963517 and HQ 963518, both dated January 2, 2002, Customs classified stockings with graduated compression ranging 20-30 mm Hg as surgical stockings for orthopedic treatment. To reach our decision, we considered a study evaluating the effects of duration of use of class I (20-30 mm Hg) graduated compression hosiery. See Robert Weiss, Neil Sadick, Mitchel Goldman, & Margaret Weiss, Post-Sclerotherapy Compression: Controlled Comparative Study of Duration of Compression and its Effects on Clinical Outcome DERMATOL SURG, 35: 105-108 (1999). This study essentially persuaded our office that compression greater than 20 mm Hg is presently considered necessary for reduction of venous insufficiency.2 We noted certain statements made in the study, including " . . . in terms of controlling objective and subjective parameters of venous insufficiency no difference was found between class I (20-30 mm Hg) and class II (30-40 mm Hg) compression stockings." Based on our review, we found that the study suggested that sclerotherapy results overall can be significantly improved by class I compression and should be part of the post-operative sclerotherapy protocol. In citing other studies, the study concluded that class I (20-30 mm Hg) compression may be recommended over class II since patient compliance is much higher and symptom improvement is identical. See Jungbeck C, Thulin I, Darenheim C, Norgen L. Graduated Compression Treatment in Patients with Chronic Venous Insufficiency; A Study Comparing Low and Medium Grade Compression Stockings. PHLEBOLOGIE, 12:142-5 (1997).

Moreover, during our review of HQ 963517 and HQ 963518, this office examined several letters from vascular surgeons and dermatologists familiar with the beneficial effects of compression on the venous system. The letters indicated consensus within the medical community that surgical stockings with graduated compression of 20-30 mm Hg are principally used for orthopedic purposes and are primarily prescribed by physicians to prevent or correct bodily deformities and the consequences associated with venous disease. The letters established that it is widely recognized that 20 mm Hg of compression is considered necessary for the treatment of venous disease. We noted in HQ 963517 and HQ 963518 that the physicians stated that they recommend using surgical supports with graduated compression of 20 to 30 mm Hg for several reasons: to prevent telangiectatic matting following sclerotherapy, to prevent thrombus formation and phlebitic reactions following sclerotherapy, to reduce post-operative edema, to prevent venous ulcerations, to prevent venous dermatitis and as treatment protocol for post-operative invasive vascular procedures.

In HQ 963517 and HQ 963518, Customs determined that physicians generally recommend graduated compression therapy as a treatment for venous insufficiency. We further recognized that graduated compression hosiery is generally available in three classes of compression; class I specifically covers a compression range of 20-30 mm Hg. We found that physicians generally prescribe compression stockings and that doctors indicated that patients generally find the hosiery uncomfortable and do not wear them unless directed by a doctor. Moreover, letters from medical authorities and conversations with medical professionals confirmed that certified and well-trained personnel must measure various parts of the foot and leg of a patient in order to obtain a proper fit for the stockings. We also found that pharmacies and medical supply companies prefer that a patient have a prescription that prescribes the amount of compression and noted that stockings obtained by prescription are often covered by insurance. We observed that graduated compression stockings are significantly more expensive than support hosiery of the types generally found in retail stores, noting that panty hose with 20-30 mm Hg compression typically sell for approximately $75.00 to $100.00 and similar thigh-high stockings typically sell for $60.00 to $95.00 per pair.

Accordingly, in HQ 963517 and HQ 963518, we concluded that surgical panty hose and stockings with graduated compression ranging from 20-30 mm Hg should be considered surgical hosiery with graduated compression for orthopedic treatment when prescribed by a physician and/or specially fitted to the patient.

As the subject merchandise has a graduated compression range of 20-30 mm Hg and is prescribed by a physician, Customs finds the instant graduated compression hosiery is within the scope of subheading 6115.93.3000, HTSUSA, providing for surgical stockings with graduated compression for orthopedic treatment.

HOLDING:

Based on the foregoing, style 141 is classified under subheading 6115.93.3000, HTSUSA, which provides for "Panty hose, tights, stockings, socks and other hosiery, including stockings for varicose veins, and footwear without applied soles, knitted or crocheted: Other: Of synthetic fibers: Surgical stockings with graduated compression for orthopedic treatment." The general column one rate of duty is "Free."

NY E82593 is hereby MODIFIED, in part. In accordance with 19 U.S.C. ยง1625(c), this ruling will become effective 60 days after its publication in the Customs Bulletin. Sincerely,

Myles B. Harmon, Director
Commercial Rulings Division

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