CRITERIA: Group 2 Support Surface. Criteria: Multiple Stage II ulcers on the trunk or pelvis and have been on a Group I support surface for 30 days with no ulcer improvement. Or, a single Stage III or IV ulcer on the trunk or pelvis. Or, Flap or graft surgery on the trunk or pelvis within the last 60 days; patient must have used a Group 2 or 3 product (ex: negative pressure wound pump) prior to discharge within the past 30 days.
Suggested Ecode: E0277 (POWERED PRESSURE-REDUCING AIR MATTRESS) $428.71/mo.
|MDT24A20||A20 Mattress Replacement System with pump||E0277|