Group 2 Pressure Reducing Support Surfaces - DME.SW.103.A

Group 2 pressure‑reducing support surfaces (HCPCS E0193, E0277, E0371–E0373) are covered only for ulcers on the trunk or pelvis when there are multiple stage 2 ulcers with a documented comprehensive ulcer treatment program, or when a Group 1 surface has failed or is contraindicated, or when there is one or more stage 3–4 ulcer, or a myocutaneous flap/skin graft for the site within the past 60 days (single stage 2 ulcers or ulcers outside the trunk/pelvis are not covered). Coverage requires documentation of ulcer location and stage, the comprehensive treatment program elements (regular clinician assessment; turning/positioning; wound care; moisture/incontinence management; nutritional assessment/treatment), evidence of prior Group 1 trial or contraindication when applicable, and date/type of any flap or graft.

"Group 2 Support Surfaces may be indicated when there is documentation of the one of the following:"