We are proud to provide air-fluidized beds, mattress overlays, and other pressure-reducing support surfaces that can accommodate patients with pressure sores and similar injuries. The following information highlights the differences between each of the four pressure ulcer stages and which durable medical equipment (DME) is covered under each injury’s Medicare coverage criteria.
Pressure Injuries
Stage I
Non-blanchable erythema of intact skin
Intact skin with a localized area of non-blanchable erythema, which may appear differently in dark pigmented skin. Presence of blanchable erythema or changes in sensation, temperature, or firmness may precede visual changes. Color changes do not include purple or maroon discoloration, these may indicate deep tissue pressure injury.
Stage II
Partial-tickness skin loss with exposed dermis
The wound med is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister. Adipose (fat) is not visible. These injuries commonly result from adverse microclimate and shear forces in the skin over the pelvis and shear in the heel. This stage should not be used to describe moisture-associated skin damage (MASD), including incontinence-associated dermatitis (IAD), intertriginous dermatitis (ITD), medical adhesive-related skin injury (MARSI) or traumatic wounds (skin tears, burns, abrasions).
Stage III
Full-thickness skin loss
Full-thickness loss of skin in which adipose (fat) is visible in the ulcer and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location; areas of significant adiposity can develop in deep wounds. Undermining and tunneling may occur. Fascia, muscle, tendon, ligament, cartilage and/or bone are not exposed. If slough or eschar obscures the extent of tissue loss, this is an Unstageable Pressure Injury.
State IV
Full-thickness skin and tissue loss
Full-tickeness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining and/or tunneling often occur. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss, this is an Unstable Pressure Injury.
http://www.npiap.org/resources/educational-and-clinical-resources/pressure-injury-staging-illustrations
Medicare’s Support Surface Requirements
Group 1 – Prevention
(limited availability with Ethos)
Classification
- Pressure Reduction
- Purchased Equipment
Qualifications
- Complete/limited mobility
and one of the following
- High Risk Factors
- Stage 1 Wound
- Stage 2 Wound
E0184 – DryPressureMattress
E0185 – GelOverlay
E0180 – AlternatingPressurePad
Group 2 – Therapy
Classification
- Pressure Redistribution
- Rental Equipment
Qualifications
- Multiple stage 2 wounds – Following a 30 day “conservative” treatment plan
- Single Stage 2 or 4 on trunk
- Status Post Myocutaneous Flap Surgery
E0371 – NonPowered Overlay
E0372 – Powered Overlay
E0373 – NonPowered
E0277 – Powered Mattress
Group 3 – Therapy
Classification
- Pressure Redistribution
- Rental Equipment
Qualifications
- Stage 3 (full thickness tissue loss) or Stage 4 (deep tissue destruction) pressure injury
- Severe immobility (chairbound or bedridden)
- A trained adult caregiver available to assist patient with ADL
- Group 2 products tried without success (documented)
- Physician order and monthly recertification
- Institutionalization required w/o AFT (documented)
E0194 – Air Fluidized Therapy Bed
OutcomesMatter®
Our Comprehensive Approach to Wound Care
Starting day one Ethos Clinical Services, Patient Advocacy and Technical Services work closely with each patient and care team to achieve healing. Learn more about Ethos services.
Find the Right Support Surface with Ethos Therapy Solutions
At Ethos Therapy Solution, our mission is to help patients with limited mobility find the support surface that meets their wound healing needs. We provide patients, care teams, and healthcare providers across the United States find the right air fluidized beds, immersion beds, and mattress replacements & overlays. Call Ethos Therapy Solutions today to find out what we can do for you.