Pressure Reducing Support Surfaces - Group 3- Policy Article

Group 3 pressure-reducing support surfaces (including air-fluidized beds, HCPCS E0194) are covered under the DME benefit when they meet reasonable-and-necessary requirements of the related LCD and other statutory rules. Claims for specified codes subject to Final Rule 1713 require a face-to-face encounter and a Written Order Prior to Delivery obtained before delivery, suppliers must retain evidence of LCD criteria and a monthly treating-practitioner statement documenting ulcer size, care-plan changes when not healing, and continued medical necessity, and proper use of modifiers (KX, GA, GZ) is required.

"Pressure-reducing support surfaces (Group 3) including air-fluidized beds (HCPCS E0194) are covered under the Durable Medical Equipment benefit when reasonable and necessary and when the related LC..."

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