Correct Coding - Face Down Positioning Devices - JA DME

Joint DME MAC Publication

This article was originally published in 2003 and is being republished as a reminder to suppliers on the correct coding and coverage of these devices.

Following vitrectomy and certain other eye surgery procedures, patients are instructed to position themselves with their face down through most of the day. There are certain devices that facilitate this positioning. Examples (not all-inclusive) are a face cushion that is attached to a frame that can rest on a table or be positioned on a bed, or a cushion pad that is attached to a chair-like device.

CMS has confirmed that these devices are statutorily noncovered because they do not fall within a Medicare benefit category. These types of devices are considered "precautionary devices" and also can be used for purposes other than the treatment of an illness or injury. The denial is a coverage denial, not a medical necessity denial.

For dates of service prior to January 1, 2004, the face cushion and frame should be coded A9270 (NONCOVERED ITEM OR SERVICE).  For dates of service on or after January 1, 2004, code E0190 (POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE) must be used.  For all dates of service, the chair-like device should be coded as A9270.

For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form located on the PDAC website.