RETIRED - Group 3 Support Surfaces - Coverage Criteria Reminder

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.

Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Original Effective Date: 05/20/2010
Revision Effective Date: 11/01/2013

Recently it has come to the attention of the DME MACs that there is confusion regarding the coverage of air-fluidized bed technology (Group 3 support surfaces) for patients who have undergone surgical flap or graft procedures. Medicare does not cover air-fluidized beds in the home setting for patients with surgical grafts or flaps. Coverage for patients with these conditions is outlined in the LCD for Group 2 support surfaces. Coverage of a Group 3 support surface is limited to bed-ridden or chair-bound patients with stage III or stage IV pressure ulcers that without the use of an air-fluidized bed would be institutionalized. The LCD contains additional coverage criteria including physician oversight requirements, conservative management and other provisions related to Medicare reimbursement for these products. Suppliers and physicians are encouraged to consult the LCD for full coverage, coding and documentation requirements.

Publication History

Date of Change Description
05/20/10 Originally Published
11/01/13 Revised
03/25/21 Retired. Refer to the LCD and LCD-related Policy Article for guidance.

 

Last Updated Dec 10 , 2023