Article Detail - JA DME

When a hospital bed with a mattress is in a capped rental period, providing a mattress-type pressure reducing support surface (PRSS) to replace an existing mattress is allowed if there is a change in the beneficiary's medical condition that justifies coverage of the PRSS. In this scenario, the regular mattress must be returned to the supplier and the supplier must stop billing the HCPCS code for the combination bed with mattress. For example.

• E0260 (semi-electric hospital bed, with side rails, with mattress) in an active rental period
• E0277 (powered pressure reducing air mattress) becomes medically necessary within active hospital bed rental
  • E0277 will be denied unless the hospital bed with mattress is removed and billing resumes with a HCPCS for a bed without a mattress.
    • Example: E0261 (semi-electric hospital bed, with side rails, without mattress)

See the PRSS webpage for more information.