Pressure Reducing Support Surfaces

Aetna covers Group 1 mattress overlays or mattresses as medically necessary DME for members who are completely immobile, have limited mobility, any-stage pressure ulcers on the trunk/pelvis, impaired nutritional status, or fecal/urinary incontinence, and considers support surfaces that allow bottoming out not medically necessary. Group 1 or Group 2 support surfaces and air‑fluidized beds are considered experimental/investigational (not covered) when those criteria are not met, and air‑fluidized beds are contraindicated or unsuitable if electrical/structural capacity is inadequate, the caregiver is unable to provide required care, the patient has coexisting pulmonary disease, requires unprotected wet dressings, or other known contraindications exist.

"A group 1 mattress overlay or mattress is considered medically necessary DME when the member meets: Altered sensory perception"