HCPCS code E0277: Powered pressure-reducing air mattress

A powered pressure-reducing air mattress is a medical device designed to prevent and treat pressure ulcers (bedsores) by redistributing a patient's body weight. It utilizes air pressure to reduce pressure points, thereby minimizing the risk of skin breakdown in individuals who are bedridden or have limited mobility. These pressure reduction mattresses are commonly used in hospital settings. They may be covered under various insurance plans, including Medicare, depending on the patient's condition and the specific requirements of the insurance provider.

Yes, but special billing rules apply. If a patient is renting a hospital bed that includes a mattress (e.g., E0260), and E0277 is determined to be medically necessary, the standard mattress must be returned to the supplier. The supplier must then stop billing for the hospital bed with a mattress and begin billing for the appropriate hospital bed frame without a mattress (e.g., E0261) concurrently with the E0277. Billing for two mattresses at the same time is considered a duplicate service and will be denied.

If the pressure ulcer does not heal or continues to worsen, the treating practitioner should document that other aspects of the comprehensive treatment plan are being modified to promote healing. If the patient meets the criteria, they may be considered for an even higher level of support, such as a Group 3 Air-Fluidized Bed (E0194), which has its own stringent medical necessity criteria.