E0180
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Appropriate management of moisture/incontinence
- Nutritional assessment and intervention consistent with the overall plan of care
- Optimization of nutrition status to promote wound healing;and
- Debridement by any means, including wet-to-dry gauze dressings, to remove devitalized tissue from the wound bed;and
- Use of a group 1 mattress overlay or mattress is consideredmedically necessaryif the individual meets:
- Criterion 1,or
1 Active Policy
ANTHEM-CG-DME-16 — CG-DME-16 Pressure-Reducing Support Surfaces
Related Codes
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