CG-DME-15 Hospital Beds and Accessories

This policy addresses coverage of hospital beds and related accessories (for example, fixed-height and variable-height beds). Coverage is medically necessary for a fixed-height bed when the member needs body positioning not possible with an ordinary bed to relieve pain, prevent contractures, maintain alignment, or avoid respiratory infections; requires head-of-bed elevation >30 degrees most of the time for CHF, chronic pulmonary disease, or aspiration risk after pillows/wedges have been tried and ruled out; or needs special attachments such as traction; a variable-height bed is covered only if these criteria are met and adjustable bed height is required. Not covered: hospital beds when criteria are unmet; total electric beds (height adjustment is a convenience feature); ordinary/non-hospital beds; power or manual lounge beds; and non-medical accessories considered comfort or convenience items.

"A fixed height hospital bed is consideredmedically necessaryifone or more ofthe following criteria are met:"