Pillows and Cushions

Aetna does not cover most therapeutic pillows and cushions (including backrest/lumbar cushions) and deems the MedCline Positioning Device experimental, but will cover cushions that are integral to or medically necessary accessories for covered DME (e.g., wheelchair seat cushions to prevent or treat severe burns/decubiti) and certain specialized pressure‑reducing support surfaces when medically necessary to prevent or treat decubitus ulcers. Key requirement: coverage is limited to items that meet the contractual DME definition—being durable and primarily medical in nature—or are part of/necessary for covered DME or approved pressure‑reducing support surface indications.

"Certain specialized support surfaces may be covered when medically necessary to prevent or treat decubitus ulcers (see CPB 0430 - Pressure Reducing Support Surfaces)."

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