Pressure Reducing Support Surfaces - Group 2 - Policy Article

Group 2 pressure-reducing support surfaces are covered under the DME benefit only when the item meets Medicare statutory/regulatory requirements and the reasonable and necessary criteria in the related LCD. Coverage and coding depend on device characteristics tied to specific HCPCS codes (E0193, E0277, E0371, E0372, E0373) with PDAC CVR/PCL listing required for E0371 and E0373; Final Rule 1713 requires a prior face-to-face encounter and Written Order Prior to Delivery for specified codes, and claims lacking required documentation or modifiers (KX/GA/GZ) will be denied or rejected.

"Pressure-reducing support surfaces are covered under the Durable Medical Equipment benefit when the item is eligible under Medicare, meets the reasonable and necessary (R&N) criteria in the related..."

Sign up to see full coverage criteria, indications, and limitations.