medical bed Talent

... the talents of tomorrow Talent is a pediatric bed with adjustable height in four motorized sections, with adjustable backrest and thigh support with side controls on the rails, and reclining leg rest.  All ...

You will get efficient and thoughtful service from defeng.

hospital bed Creo

Creo is the pediatric bed with a three-section bed frame for the safe and comfortable inpatient stay of small patients. It is an adjustable height bed with a high ...

medical bed Smile

... inpatient bed, which is appreciated for its exclusive design, customizable with fun inserts that create a playful and colourful environment. A small bed for great patients It adapts to patients ...

hospital bed EMBRACE NEXT

Embrace is our new two-section paediatric bed with manual raising of the mattress platform. The Embrace Next paediatric bed, with its simple and modern design, follows ...

hospital bed EMBRACE PLUS NEXT

Embrace plus next is our new two-section paediatric bed with electric raising of the mattress platform. Paediatric bed, with its simple and modern design, follows ...

hospital bed EMBRACE ADVANCE NEXT

The Embrace Advance Next bed extends electrically to adapt to children of all sizes. If the child is feeling unwell, the highest position can be selected quickly and easily and it ...

medical bed 505.52

Height: 166 cm
Width: 75 cm
Length: 165 cm

This product has two sliding barricades. The barricades can slide down completely and there is a security drop which prevents them from falling. In accordance with the AFSSAPS guideline (dated 07/30/), all tubes are spaced approximately ...

medical bed 505.57

Height: 166 cm
Width: 75 cm
Length: 165 cm

The patient cot features 4 sliding boundaries and measures 150x60 cm without upright position and 120x60 cm with upright position. The security drop is there to prevent the sliding rail from falling and help the entire opening facility ...

hospital bed MGE-C15

Height: 650 mm
Width: 900 mm
Length: 1,880 mm

... from 74 cm to 119 cm, ensuring flexibility for caregivers and patient safety. Utility Shelf: A convenient shelf under the bed provides practical storage space for medical supplies. Covered Casters: 5-inch covered casters ...

hospital bed MGE-C26

Height: 600 mm
Width: 935 mm
Length: 1,885 mm

... Available Certificate: CE / ISO MGE-C26 is a versatile and reliable medical bed designed specifically for children, ensuring comfort. Certified with CE and ISO, this bed adheres to the highest standards, ...

hospital bed B-62

Height: 650 mm
Width: 830 mm
Length: 1,660 mm

1. Epoxy coated bed platform, aluminium alloy lateral guard rails; 2. Back rest function, which can be operated by crank; 3. Aluminium alloy lateral guard rails with adjustable height 4. Freight saving knock-down construction.

medical bed ICC411

... versions of the ICC 411 stylish and innovative oval-shaped pediatric crib are available: special compact size suitable for infants up to around 2 years of age, or standard pediatric size for children ...

hospital bed ICC 407

The ICC 407 offers both 2-side or 4-side lowering and is available with single-section steel mesh platform with, or without, trendelenburg functions. This crib can also be delivered PKD (partial knocked down) for on-site assembly for ...

hospital bed B 122

Height: 940 mm
Width: 520 mm
Length: 810 mm

2 .The overall use of steel cold rolled steel tube material thickness of 1.5mm main pipe specifications of 25×25mm. 3. the baby basin is made of high quality ABS material, non-toxic to human body, adjustable range 0-25°.Equipped ...

hospital bed B 120

Height: 750 mm
Width: 520 mm
Length: 900 mm

2. The main body is assembled by plastic steel and PE material. 3. the guardrail is made of ASB injection molding, the baby basin is made of high-quality ABS material, non-toxic to human body, adjustable range 0-25°.Equipped ...

hospital bed

Height: 950 mm
Width: 450 mm
Length: 800 mm

2. the whole use of NATIONAL standard SUS304 stainless steel material, the main pipe specification is φ 25mm, wall thickness is not less than 1.5mm, plate thickness is not less than 1.2mm.Each layer shall be designed with transverse stiffeners ...

medical bed tom 2

Height: 58 cm - 83 cm
Width: 83 cm
Length: 151 cm

The fully electrically adjustable toddler bed Attractive shapes, modern materials and a colorful design determine the appearance of the tom 2 bed and create a pleasant and trustworthy feel-good environment ...

hospital bed YA-PD5-4

Height: 505 mm - 750 mm
Width: 995 mm
Length: 1,900 mm

As a new generation of MEDIK's 5-function electric pediatric bed, YA-PD5-4 combines safety, attractive appearance, functionality and convenient operation. This model is widely accepted by hospitals and ...

medical bed BUDDY

Height: 155 cm
Width: 81 cm
Length: 167 cm

... mattress platform of the bed can be adjusted in height in several steps. The individual sides of the mattress platform can be positioned individually to achieve special positions. Universal accessory holders Compatibility ...

hospital bed Iaso Series

Height: 450 mm - 750 mm
Width: 1,020 mm
Length: 1,950 mm

... antibacterial materials are used in the bed to reduce the risk of bacterial infection. Back bed board is retractable, which prevents bedsores and making sitting on the bed comfortable. Bed ...

medical bed BAM202CE

Height: 500 mm - 800 mm
Weight capacity: 150 kg

... meet your different needs. Pediatric Bed Electric Children Bed Cartoon Bed Feature: 1. Electric control The overall height of the medical bed, ...

hospital bed ENB-301-02J

Height: 35 cm
Width: 105 cm
Length: 212 cm

These nursing bed is a bed specially designed for hospitals, nursing homes, assisted living facilities, outpatient clinics, and in home health care. These beds have special features ...

hospital bed A-20-1

Height: 575 mm - 870 mm
Width: 930 mm - 930 mm
Length: 1,930 mm - 1,930 mm

... overall lifting function adjusts the overall height of the bed to adapt to the v/orking height of different medical staff, and it also makes it convenient for patients to get in and out of bed Function ...

emergency bed PX-PC-01(T)

Height: 460 mm
Width: 690 mm
Length: 1,960 mm

Portable, lightweight but strong construction brings a practical and compact solution for non-ambulance patients. In addition, the folding system allows a wide range of applications. Durable, designed for rapid deployment by a single ...

hospital bed PHB-01

Height: 600 mm
Width: 700 mm
Length: 1,600 mm

High Quality mild steel Bed Sheet top made from 2 section CRCA Perfortaed Sheet. Backrest maneuvered by screw with folding handle from foot end. Mounted on 75 mm castors. Full length drop side rail on both sides Also ...

hospital bed PHB-02

Height: 600 mm
Width: 460 mm
Length: 750 mm

High quality Stainless Steel Bed sheet top made from SS Perforated Sheet. Mounted on 75 mm castors. Full length drop side rail on both sides. Also available in Epoxy Powder Coated.

hospital bed Ch578a

Height: 540 mm
Width: 980 mm
Length: 2,020 cm

This pediatric bed is designed for children. It’s fully-powered to provide patients with the utmost care, comfort and support and it also optimizes caregiver convenience and accessibility

hospital bed Ch678a

Height: 500 mm - 750 mm
Width: 980 mm
Length: 1,985 mm

The 3 function manual hospital bed is generally used by severely ill patients in clinical use. In addition to the backrest and knee rest, it also has hi-low function. Through rotating the manual crank, the bed ...

For more information, please visit pediatric hospital bed for home.

intensive care bed Ch838a-ch

Height: 500 mm - 750 mm
Width: 980 mm
Length: 1,875 mm

This pediatric bed is designed for patient children who need intensive care. The bed features transparent side rails and head/foot board to ensure the safety of the patient. ...

hospital bed STOCKTON

Height: 40 in - 50 in
Width: 83, 72 in
Length: 36 in

Our Stockton Youth Bed, available in manual or electric models (and in several beautifully designed colors), provides a cost-effective alternative to a full-size adult bed for Pediatric ...

medical bed MONROE

Height: 71 in - 81 in
Width: 83, 72 in
Length: 36 in

Our Monroe Youth Bed is designed for use by active pediatric patients who may be at risk of climbing out of bed. Featuring clear vinyl safety panels, this youth hospital bed ...

medical bed TM-K

Height: 570 mm
Width: 790 mm
Length: 1,600 mm

... Footrest max. angle : - 35° Trendelenburg: - 12° Hide of side rails: - 280 mm Height of head-foot boards: - 345 mm Under-bed clearance: - 160 mm Castors diameter: - 125 mm Safe working load: - 120 kg • Weight ...

hospital bed TM-K

Height: 1,000 mm
Width: 780 mm
Length: 1,550 mm

• Head and foot boards.(fixed) • Backrest adjustment. (manuel) • Traverse sheet mattress platform. • Metal side rails. • IV pole. • Electrostatic powder coated frame. (RAL and ) Mattress platform: - 700 x mm Height ...

hospital bed TM-K

Height: 1,000 mm
Width: 780 mm
Length: 1,550 mm

• Head and foot boards.(fixed) • Traverse sheet mattress platform. • Metal side rails. • IV pole. • Electrostatic powder coated frame. (RAL and ) Mattress platform: - 700 x mm Height of side rails: - 420 mm Height ...

hospital bed TAURUS JUNIOR

Height: 19 cm - 81 cm
Width: 93 cm
Length: 208 cm

It is s a pediatric bed created for young users. Its bright eye catching colors and 3 side rails for maximum safety make it ideal rehabilitation bed for children and ...

Hospital Beds and Accessories

Number: 

Table Of Contents

Policy
Applicable CPT / HCPCS / ICD-10 Codes
Background
References

Policy

Scope of Policy

This Clinical Policy Bulletin addresses hospital beds and accessories.

1. Medical Necessity

   Aetna considers hospital beds and accessories medically necessary durable medical equipment (DME) according to the criteria set forth below.

   1. Hospital Beds

      1. Aetna considers hospital beds medically necessary DME for members who meet any of the following criteria:
         
         
         1. The member's condition requires positioning of the body (e.g., to alleviate pain, promote good body alignment, prevent contractures, or avoid respiratory infections) in ways not feasible in an ordinary bed; or
         2. The member's condition requires special attachments (e.g., traction equipment) that can only be attached to a hospital bed cannot be fixed and used on an ordinary bed; or
         3. The member requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration.  Pillows or wedges must have been considered. 
            
            

            Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed.

         A fixed height hospital bed is one with manual head and leg elevation adjustments but no height adjustment.

      2. A semi-electric hospital bed is considered medically necessary if the member meets one of the criteria for a fixed height bed and requires frequent changes in body position and/or has an immediate need for a change in body position. A semi-electric bed is one with manual height adjustment and with electric head and leg elevation adjustments.
      3. A heavy duty extra wide hospital bed is considered medically necessary if the member meets one of the criteria for a fixed height hospital bed and the member's weight is more than 350 pounds, but does not exceed 600 pounds. Heavy duty hospital beds are hospital beds that are capable of supporting a member who weighs more than 350 pounds, but no more than 600 pounds.
      4. An extra heavy-duty hospital bed is considered medically necessary if the member meets one of the criteria for a hospital bed and the member's weight exceeds 600 pounds. Extra heavy-duty hospital beds are hospital beds that are capable of supporting a member who weighs more than 600 pounds.
      5. A total electric hospital bed is considered medically necessary if the member meets one of the criteria for a fixed height bed and either:
         
         
         1. Requires frequent changes in body position and/or has an immediate need for a change in body position; or
         2. Meets criteria for a variable height feature outlined below.

         A total electric bed is one with electric height adjustment and with electric head and leg elevation adjustments.

      6. For clinical policy on air-fluidized beds, see CPB - Pressure Reducing Support Surfaces.

   2. Mattresses

      Aetna considers mattresses medically necessary DME only where the hospital bed is medically necessary. Note: A separate charge for replacement mattresses should not be allowed where the hospital bed with mattress is rented.

      If a member's condition requires a replacement innerspring mattress or foam rubber mattress, it will be considered medically necessary for a member-owned hospital bed.

      For clinical policy on specialized pressure-reducing support surfaces, see CPB - Pressure Reducing Support Surfaces.

   3. Variable Height Feature

      Aetna considers hospital beds with a manual or electric variable height feature medically necessary DME for members who meet the criteria for hospital beds set forth above and who have any of the following conditions:

      1. Severe arthritis and other injuries to lower extremities (e.g., fractured hip, where the variable height feature is necessary to assist the member to ambulate by enabling the member to place his or her feet on the floor while sitting on the edge of the bed); or
      2. Severe cardiac conditions, where the member is able to leave the bed, but who must avoid the strain of “jumping” up and down; or
      3. Spinal cord injuries (including quadriplegic and paraplegic members), multiple limb amputees, and stroke members, where the member is able to transfer from a bed to a wheelchair, with or without help; or
      4. Other severely debilitating diseases and conditions, if the member requires a bed height different than a fixed height hospital bed to permit transfers to chair, wheelchair, or standing position.

      A variable height hospital bed is one with manual height adjustment and with manual head and leg elevation adjustments.

   4. Built-in Weight Scale

      A hospital bed with a built-in scale is considered medically necessary only for non-ambulatory individuals who require periodic weight measurements.

   5. Electric Powered Hospital Bed Adjustments

      Aetna considers electric powered adjustments to lower and raise head and feet medically necessary DME for members who meet the criteria for hospital beds set forth above and meet both of the following criteria:

      1. Member can operate the controls and cause the adjustments, and
      2. Member has a condition that requires frequent changes in body position and/or where there may be an immediate need for a change in body position (i.e., no delay can be tolerated).

      Note: Upon medical review, exceptions can be made to criterion 2 in members with spinal cord injury and brain damage.

      Examples of brand names of electric hospital beds include the Deluxe Franklin Bed.

   6. Side Rails and Safety Enclosures

      1. Aetna considers safety enclosures for beds medically necessary DME only when the member's condition places them at risk for falls or climbing out of bed is a concern and they are an integral part of, or an accessory to, a medically necessary hospital bed.  A safety enclosure frame/canopy for use with a hospital bed is a safety enclosure used to prevent a member from leaving the bed.
      2. Aetna considers bedside rails for beds medically necessary DME only when the member's condition requires them and they are an integral part of, or an accessory to, a medically necessary hospital bed.  Examples of conditions where bedside rails may be considered medically necessary include members with seizures, vertigo, disorientation, and neurological disorders.

   7. Pediatric Hospital Crib

      Aetna considers a pediatric hospital crib medically necessary when the child meets criteria for any of the afore-mentioned hospital beds.

   8. Bed Accessories

      The following bed accessories are considered medically necessary DME according to the criteria set forth below:

      • Bed cradles -- bed blanket cradles are considered medically necessary for members with acute gouty arthritis, burns, decubiti, or diabetic ulcer, when necessary to prevent contact with bed coverings.
      • Bed pans (autoclavable hospital type) -- reusable, autoclavable bed pans are considered medically necessary if member is bed-confined.
      • Trapeze equipment -- trapeze bars are considered medically necessary if the member is bed-confined and needs a trapeze bar to sit up because of respiratory conditions, to change body position for other medical reasons, or to get in and out of bed.  An “attachable” trapeze bar is not covered when used on a ordinary (non-hospital) bed.
      • Heavy duty trapeze equipment is considered medically necessary if the member meets the criteria for regular trapeze equipment and the member's weight is more than 250 pounds.
      • Urinals -- urinals are considered medically necessary for bed-confined members.

   9. Hospital Bed Repairs

      The following are repair units of service allowances that are considered medically necessary for common repairs to hospital beds (NHIC, ).

      Hospital Bed Part Being Repaired/Replaced  Allowed Units of Service (UOS) Hospital bed pendant 2 Hospital bed headboard/footboard 2

      One unit of service is equal to 15 mins.  Units of service include basic troubleshooting and problem diagnosis.

2. Experimental, Investigational, or Unproven

   1. Beds that provide kinetic therapy or continuous lateral rotation therapy (e.g., Kinetic Therapy Triadyne Bed, Hill-Rom TotalCare SpO2RT) are considered experimental, investigational, or unproven for prevention or treatment of pressure sores, because of a lack of evidence in the peer-reviewed medical literature of their effectiveness for that indication (AWMA, ; Cullum et al, ; Cullum et al, ).  Beds that provide kinetic therapy or continuous lateral rotation therapy are considered experimental, investigational, or unproven for long-term use outside of the acute-care hospital setting for preventing and treating pulmonary complications because the published peer-reviewed evidence of the effectiveness of these beds is limited to use in critically ill patients in the acute-care hospital setting.
   2. Beds that provide vibration therapy or percussion therapy for preventing and treating pulmonary complications related to immobility are considered experimental, investigational, or unproven because of a lack of adequate evidence in the peer-reviewed published medical literature of their effectiveness for this indication.
   3. Turning Bed: Aetna considers turning bed for the prevention of pneumonia and bedsores experimental. investigational, or unproven because its effectiveness has not been established.
   4. Enclosure Beds and Frame/Canopy Beds: The Vail Enclosure Bed (Vail Products, Inc., Toledo, OH), a padded bed that is completely enclosed with netting, is considered experimental, investigational, or unproven because the U.S. Food and Drug Administration has determined that this device poses significant safety risks.

3. Policy Limitations and Exclusions

   1. Side rails and safety enclosures for beds are considered safety features; under most benefit plans, safety items are excluded from coverage. Under benefit plans with this exclusion, bedside rails and safety enclosures are excluded from coverage unless they are an integral part of a medically necessary bed.
   2. Powered Chair Conversion Feature: Electric chair positioning features are not covered since they are considered convenience features. The TotalCare Bariatric Bed is an example of a bed with an electric chair positioning feature.
   3. Ordinary (Non-Hospital) Beds: Ordinary beds do not meet Aetna's definition of covered DME, in that ordinary beds are not primarily medical in nature, are not primarily used in the treatment of disease or injury, and are normally of use in the absence of illness or injury.  Please check benefit plan descriptions.  An ordinary bed is one that is typically sold as furniture.  It consists of a frame, box spring, and mattress.  It is a fixed height, and has no head or leg elevation adjustments.  An ordinary bed will accommodate most transfers to a chair, wheelchair, or standing position.  If needed, it can almost always be adapted to accommodate these transfers. The need for a particular bed height would rarely by itself justify the need for a hospital bed.

   4. Aetna does not cover power or manual lounge beds because they are a comfort or convenience item. 

      In addition, power or manual lounge beds do not meet Aetna's definition of covered DME, in that they are not primarily medical in nature, are not primarily used in the treatment of disease or injury, and are normally of use in the absence of illness or injury.  Please check benefit plan descriptions.  These beds, like other ordinary beds, are typically sold as furniture.  The following are examples of brands of lounge beds that do not fall within the definition of DME:

      • Adjust-A-Sleep Adjustable Bed
      • Adjustable firmness/support mattresses (e.g., Select Comfort/Sleep Number Bed)
      • Craftmatic Adjustable Bed
      • Electropedic Adjustable Bed
      • Sealy Posturpedic Bed
      • Simmons Beautyrest Adjustable Bed
      • Visco-elastic or memory foam mattresses (e.g., Tempur-Pedic)
      • Waterbed.
   5. Institutional-Type Hospital Beds: Institutional-type hospital beds are inappropriate for home use.  These include oscillating beds, springbase beds, circulating beds, cage beds, and stryker frame beds.
   6. Enclosure Beds and Frame/Canopy Beds: Most plans exclude coverage of safety beds (SleepSafe Beds), enclosure beds (e.g., Cubby Bed, Posey Bed Enclosure Safety System; Vail Enclosure Bed) or a frame/canopy for use with a hospital bed and limb restraints as they are considered non-covered safety items.  Aetna's plans cover medically necessary services and supplies for the "diagnosis, care or treatment" of disease or injury.  Although restraints, helmets, safety straps, etc., may prevent injury, they are not considered care or treatment of disease or injury.  In addition, such safety items are specifically excluded from coverage.  Most medical plans specifically exclude charges for care furnished to provide a safe surrounding, including the charges for providing a surrounding free from exposure that can worsen the disease or injury.  Please check benefit plan descriptions.
   7. The following accessories do not meet Aetna's definition of covered DME because they are not primarily medical in nature, they are not mainly used in the treatment of disease or injury, and they are normally of use to persons who do not have a disease or injury:
      
      
      • Bed baths (a.k.a. Schmidt bath)
      • Bed boards (i.e., board inserted between bed spring and mattress to give extra support)
      • Bed elevation blocks (i.e., blocks to elevate the head or foot of bed)
      • Bed lifters (i.e., bed elevators) (e.g., Burke bed elevator)
      • Bed railing pads (i.e., protection over bed railing)
      • Bed spectacles (used for reading while lying flat in bed)
      • Bed trays/reading tables
      • Call switches (i.e., device to summon help)
      • Foot boards (i.e., board at the end of the bed)
      • Gatch boards (i.e., type of bed board)
      • Lap boards (i.e., board used on lap as a table or desk)
      • Overbed tables (e.g., Able table)
      • Standard beds and mattresses made of allergy-free materials.

   8. Limb restraints (leg restraints, limb holders, and wrist restraints) do not meet the requirement of durability for coverage as DME: In addition, limb restraints are excluded from coverage in plans that exclude safety items.  Most medical plans specifically exclude charges for care furnished to provide a safe surrounding, including the charges for providing a surrounding free from exposure that can worsen the disease or injury.  Please check benefit plan descriptions.

4. Related Policies

   • CPB - Pressure Reducing Support Surfaces

Code Code Description

Information in the [brackets] below has been added for clarification purposes.   Codes requiring a 7th character are represented by "+":

HCPCS codes covered if selection criteria are met:

E Hospital bed, fixed height, with any type side rails, with mattress E Hospital bed, fixed height, with any type side rails, without mattress E Hospital bed, variable height, hi-lo, with any type side rails, with mattress E Hospital bed, variable height, hi-lo, with any type side rails, without mattress E Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, with mattress E Hospital bed, total electric (head, foot, and height adjustments), with any type side rails, without mattress E Mattress, inner spring [covered for member owned hospital bed, if condition requires replacement] E Mattress, foam rubber [covered for member owned hospital bed, if condition requires replacement] E Bed pan, standard, metal or plastic E Bed pan, fracture, metal or plastic E Bed cradle, any type E Hospital bed, fixed height, without side rails, with mattress E Hospital bed, fixed height, without side rails, without mattress E Hospital bed, variable height, hi-lo, without side rails, with mattress E Hospital bed, variable height, hi-lo, without side rails, without mattress E Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress E Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress E Hospital bed, total electric (head, foot, and height adjustments), without side rails, with mattress E Hospital bed, total electric (head, foot, and height adjustments), without side rails, without mattress E Pediatric crib, hospital grade, fully enclosed, with or without top enclosure E Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress E Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress E Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress E Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress E Safety enclosure frame/canopy for use with hospital bed, any type (safety item) E Urinal; male, jug-type, any material E Urinal; female, jug-type, any material E Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard, and side rails up to 24 in. above the spring, includes mattress E Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard, and side rails up to 24 in. above the spring, includes mattress E Trapeze bars (a.k.a. Patient Helper), attached to bed, with grab bar E Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar E Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar E Trapeze bar, free standing, complete with grab bar K Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes

HCPCS codes not covered for indications listed in the CPB:

E Hospital bed, institutional type includes: oscillating, circulating and stryker frame, with mattress E Bed board E Over-bed table E Bedside rails, half-length (safety item) E Bedside rails, full-length (safety item) E Bed accessory: board, table, or support device, any type E Safety equipment (e.g., belt, harness or vest) E Restraints, any type (body, chest, wrist or ankle)

Other HCPCS codes related to the CPB:

E Dry pressure mattress E Air pressure mattress E Air-fluidized bed E Gel pressure mattress E Air pressure pad for mattress, standard mattress length and width E Powered pressure-reducing air mattress E Air pressure elevator for heel E Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width E Powered air overlay for mattress, standard mattress length and width E Nonpowered advanced pressure reducing mattress

ICD-10 codes covered if selection criteria are met:

Z91.81 History of falling [At risk for falls or climbing out of bed]

Background

This policy is adapted from Medicare Durable Medical Equipment Carrier (DMERC) policy.

Note on Vail Enclosure Bed: On March 22, , the U.S. Food and Drug Administration (FDA) and the U.S. Department of Justice initiated seizures of all finished Vail 500, , and Enclosed Bed Systems on the ground that use of these systems poses a public health risk because patients can become entrapped and suffocate, resulting in severe neurological damage or death.  The FDA believed the Vail products seized do not meet the Quality System regulations of the Federal Food, Drug and Cosmetic Act and pose significant health risk for consumers.  Furthermore, Vail Products failed or refused to furnish material or information to the FDA as required by Medical Device Reporting regulation and the Reports of Corrections and Removals regulation.  According to an FDA public health notification, Vail Products, on June 16, , stated that it is permanently ceasing the manufacture, sale and distribution of all Vail enclosed bed systemS  Vail Products will no longer be available to provide accessories, replacement parts, or retrofit kits.  Additionally, on June 23 and 24, , revised instruction manuals and warning labels were mailed to customers with Vail 500, Vail or Vail enclosed bed systems.  The revised manuals include new warnings, precautions, and instructions for use.  The safety precautions state that, if this bed must continue to be used, they should not be used for persons who are less than 45 inches tall or who weigh less than 46 lbs.  According to the revised safety precautions, these beds should not be used in persons who exhibit burrowing behavior; who are violent, aggressive, combative, or suicidal; who have multiple lines, or who have excessive pica eating disorder.

Turning Bed

Gentilello et al () noted that the risk of nosocomial pneumonia and atelectasis is high among critically ill immobilized patients.  These investigators hypothesized that continuous turning on the kinetic treatment table would reduce their incidence.  A total of 65 critically ill patients, immobilized because of head injury or traction, were prospectively randomized for treatment in a conventional bed (n = 38) or the kinetic treatment table (n = 27).  Patients were well-matched for baseline demographic and pulmonary risk factors.  Patients in the conventional bed group had a higher incidence of cigarette smoking.  The combined incidence of significant atelectasis or pneumonia was higher (66 %) in the conventional versus kinetic treatment table (33 %) groups (p < 0.01).  Atelectasis, pneumonia, adult respiratory distress syndrome, requirements for ventilator treatment, for PEEP, and for an FIO2 greater than 0.50 were not significantly different, but tended to be higher in the control group.  Survival and the incidence of decubitus ulcers were similar.

Delaney et al () examined if kinetic bed therapy reduces the incidence of nosocomial pneumonia and improves outcomes in critically ill mechanically ventilated patients.  These investigators searched Medline, EMBASE, CINAHL, CENTRAL, and AMED for studies, as well as reviewed abstracts of conference proceedings, bibliographies of included studies and review articles and contacted the manufacturers of medical beds.  Studies included were randomized or pseudo-randomized clinical trials of kinetic bed therapy compared to standard manual turning in critically ill mechanically ventilated adult patients.  Two reviewers independently applied the study selection criteria and extracted data regarding study validity, type of bed used, intensity of kinetic therapy, and population under investigation.  Outcomes assessed included the incidence of nosocomial pneumonia, mortality, duration of ventilation, and intensive care unit and hospital length of stay.  A total of 15 prospective clinical trials were identified, which included a total of 1,169 participants.  No trial met all the validity criteria.  There was a significant reduction in the incidence of nosocomial pneumonia (pooled odds ratio (OR) 0.38, 95 % confidence interval (CI): 0.28 to 0.53), but no reduction in mortality (pooled OR 0.96, 95 %CI: 0.66 to 1.14), duration of mechanical ventilation (pooled standardized mean difference (SMD) -0.14 days, 95 % CI: -0.29 to 0.02), duration of intensive care unit stay (pooled SMD -0.064 days, 95 % CI: -0.21 to 0.086) or duration of hospital stay (pooled SMD 0.05 days, 95 % CI: -0.18 to 0.27).  The authors concluded that while kinetic bed therapy has been purported to reduce the incidence of nosocomial pneumonia in mechanically ventilated patients, the overall body of evidence is insufficient to support this conclusion.  There appears to be a reduction in the incidence of nosocomial pneumonia, but no effect on mortality, duration of mechanical ventilation, or intensive care or hospital length of stay.  Given the lack of consistent benefit and the poor methodological quality of the trials included in this analysis, definitive recommendations regarding the use of this therapy cannot be made at this time.

Goldhill et al () reviewed the effect of rotational therapy (use of therapeutic surfaces that turn on their longitudinal axes) on prevention and/or treatment of respiratory complications in critically ill patients.  Published articles evaluating prophylaxis and/or treatment were reviewed.  Prospective randomized controlled trials were assessed for quality and included in meta-analyses.  A literature search yielded 15 non-randomized, uncontrolled, or retrospective studies.  Twenty prospective randomized controlled trials on rotational therapy were published between and .  Various types of beds were studied, but few details on the rotational parameters were reported.  The usual control was manual turning of patients by nurses every 2 hours.  One animal investigation and 12 clinical trials addressed the effectiveness of rotational therapy in preventing respiratory complications.  Significant benefits were reported in the animal study and 4 of the trials.  Significant benefits to patients were reported in 2 of another 4 studies focused on treatment of established complications.  Researchers have examined the effects of rotational therapy on mucus transport, intra-pulmonary shunt, hemodynamic effects, urine output, and intra-cranial pressure.  Little convincing evidence is available, however, on the most effective rotation parameters (e.g., degree, pause time, and amount of time per day).  Meta-analysis suggested that rotational therapy decreases the incidence of pneumonia but has no effect on duration of mechanical ventilation, number of days in intensive care, or hospital mortality.  The authors concluded that rotational therapy may be useful for preventing and treating respiratory complications in selected critically ill patients receiving mechanical ventilation.

In a systematic reviews of wound care management, Cullum et al () evaluated the clinical effectiveness and cost-effectiveness of:

1. pressure-relieving beds, mattresses and cushions for pressure sore prevention and treatment;
2. compression therapy for the prevention and treatment of leg ulcers;
3. low-level laser therapy, therapeutic ultrasound, electrotherapy and electromagnetic therapy for the treatment of chronic wounds.

A total of 19 electronic databases, including MEDLINE, CINAHL, EMBASE and the Cochrane Controlled Trials Register (CENTRAL), were searched.  Relevant journals, conference proceedings and bibliographies of retrieved papers were hand-searched.  An expert panel was also consulted.  Randomized controlled trials (RCTs) that evaluated these interventions were eligible for inclusion in this review if they used objective measures of outcome such as wound incidence or healing rates.  A total of 45 RCTs were identified, of which 40 compared different mattresses, mattress overlays and beds.  Only 2 trials evaluated cushions, 1 evaluated the use of sheepskins, and 2 looked at turning beds/kinetic therapy.  A total of 24 trials reporting 26 comparisons were included (2 of prevention and 24 of treatment strategies).  Four RCTs of laser (for venous leg ulcers), 10 of therapeutic ultrasound (for pressure sores and venous leg ulcers), 12 of electrotherapy (for ischemic and diabetic ulcers, and chronic wounds generally) and 5 of electromagnetic therapy (for venous leg ulcers and pressure sores) were included.  Studies were generally small, and of poor methodological quality.  The authors concluded that

1. foam alternatives to the standard hospital foam mattress can reduce the incidence of pressure sores in people at risk, as can pressure-relieving overlays on the operating table.  One study suggested that air-fluidized therapy may increase pressure sore healing rates,
2. compression is more effective in healing venous leg ulcers than is no compression, and multi-layered high compression is more effective than single-layer compression.  High-compression hosiery was more effective than moderate compression in preventing ulcer recurrence, and
3. there is generally insufficient reliable evidence to draw conclusions about the contribution of laser therapy, therapeutic ultrasound, electrotherapy and electromagnetic therapy to chronic wound healing.  

(No conclusion was drawn regarding the turning bed)

In an evidence-based analysis on “Management of chronic pressure ulcers” by the Health Quality Ontario (), as well as a National Pressure Ulcer Advisory Panel’s guideline on “Pressure ulcer treatment recommendations” (), turning/rotational bed is not mentioned as a management tool.

Furthermore, the Institute for Clinical Systems Improvement’s health care protocol on “Pressure ulcer prevention and treatment protocol” (ICSI, ) does NOT mention the use of turning/rotational bed.

Also, an UpToDate review on “Prevention of pressure ulcers” (Berlowitz, ) states that “Continuous lateral rotation was originally developed to enhance respiratory function in hospitalized patients, but has been advocated for the prevention and management of pressure ulcers.  Continuous lateral rotation is achieved with a mechanized bed that continuously rotates around its longitudinal axis.  Observational studies indicate modest improvements in healing rates when continuous lateral rotation is added to an advanced therapy surface.  Conceptually, the advantage gained by this automated approach to pressure reduction could be offset by the presence of continuous shearing forces.  Technical parameters such as bed rotation frequency and bed tilt angle need to be better defined.  Continuous rotation therapy is not likely to replace the need to reposition the patient every two hours, but clearly further study is warranted”.

Appendix

The items in Column II are included in the allowance for the corresponding item in Column I when provided at the same time:

Table: The items in Column II are included in the allowance for the corresponding item in Column I Column Roman OneI Column Roman TwoII Hospital bed, fixed height, with any type of side rails, with mattress Mattress, innerspring
Mattress, foam rubber
Bed side rails, half length
Bed side rails, full length  Hospital bed, fixed height, with any type of side rails, without mattress Bed side rails, half length
Bed side rails, full length  Hospital bed, variable height, Hi-Lo, with any type of side rails, with mattress  Mattress, innerspring
Mattress, foam rubber
Bed side rails, half length
Bed side rails, full length  Hospital bed, variable height, Hi-Lo, with any type of side rails, without mattress  Bed side rails, half length
Bed side rails, full length  Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress Mattress, innerspring
Mattress, foam rubber
Bed side rails, half length
Bed side rails, full length  Hospital bed, semi-electric (head and foot adjustment), with any type of side rails, without mattress Bed side rails, half length
Bed side rails, full length  Hospital bed, total electric (head, foot and height adjustments), with any type of side rails, with mattress  Mattress, innerspring
Mattress, foam rubber
Bed side rails, half length
Bed side rails, full length  Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress  Bed side rails, half length
Bed side rails, full length  Hospital bed, fixed height, without side rails, with mattress Mattress, innerspring
Mattress, foam rubber  Hospital bed, variable height, Hi-Lo, without side rails, with mattress Mattress, innerspring
Mattress, foam rubber  Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress Mattress, innerspring
Mattress, foam rubber  Hospital bed, total electric (head, foot and height adjustments) without side rails, with mattress Mattress, innerspring
Mattress, foam rubber  Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type of side rails, without mattress Bed side rails, half length
Bed side rails, full length  Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type of side rails, without mattress Bed side rails, half length
Bed side rails, full length  Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress Mattress, innerspring
Mattress, foam rubber
Bed side rails, half length
Bed side rails, full length  Hospital bed, pediatric, electric or semi-electric, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress Mattress, innerspring
Mattress, foam rubber
Bed side rails, half length
Bed side rails, full length 

When mattress or bedside rails are provided at the same time as a hospital bed, use the single code that combines these items.

References

The above policy is based on the following references:

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1. Australian Wound Management Association (AWMA), Pressure Ulcer Interest Sub-Committee. Clinical Practice Guidelines for the Prediction and Prevention of Pressure Ulcers. West Leederville, Australia: AWMA; .
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22. Kelley RE, Bell LK, Mason RL. Cost Analysis of kinetic therapy in the prevention of complications of stroke. South Med J. ;18(6):615-617.
23. Kirschenbaum L, Azzi E, Sfeir T, et al. Effect of continuous lateral rotational therapy on the prevalence of ventilator-associated pneumonia in patients requiring long-term ventilatory care. Crit Care Med. ;30(9):-.
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26. McInnes E, Bell-Syer SEM, Dumville JC, et al. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev. ;(4):CD.
27. Meyers C, Low L, Kaufman L, et al. Trendelenburg positioning and continuous lateral rotation improve oxygenation in hepatopulmonary syndrome after liver transplantation. Liver Transpl Surg. ;4(6):510-512.
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33. NHIC, Corp. Hospital beds and accessories. Medicare Local Coverage Determination (LCD) No. L. Durable Medical Equipment Medicare Administrative Contractor (DME MAC) Jurisdiction A. Hingham, MA: NHIC; revised January 1, .
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35. Pape HC. Is early kinetic positioning beneficial for pulmonary function in multiple trauma patients? Injury. ;29(3);219-225.
36. Patel UH, Jones JT, Babbs CF, et al. The evaluation of five specialized support surfaces by use of a pressure-sensitive mat. Decubitus. ;6(3):28-31, 34, 36-37.
37. Powell-Cope G, Baptiste AS, Nelson A. Modification of bed systems and use of accessories to reduce the risk of hospital-bed entrapment. Rehabil Nurs. ;30(1):9-17.
38. Powers J, Daniels D. Turning points: Implementing kinetic therapy in the ICU. Nurs Manage. ;35(5):suppl 1-8.
39. Priestley MA, Helfaer MA. Approaches in the management of acute respiratory failure in children. Curr Opin Pediatr. ;16(3):293-298.
40. Raoof S, Chowdhrey N, Raoof S, et al. Effect of combined kinetic therapy and percussion therapy on the resolution of atelectasis in critically ill patients. Chest. ;115(6):-.
41. Sahn SA. Continuous lateral rotational therapy and nosocomial pneumonia. Chest. ;99(5):-.
42. Schimmel L, Civetta JM, Kirby RR. A new mechanical method to influence pulmonary perfusion in critically ill patients. Crit Care Med. ;5(6):277-279.
43. Shapiro MJ, Keegan MJ. Continuous oscillation therapy for the treatment of pulmonary contusion. Am Surg. ;58(9):546-550.
44. Staudinger T, Kofler J, Mullner M, et al. Comparison of prone positioning and continuous rotation of patients with adult respiratory distress syndrome: Results of a pilot study. Crit Care Med. ;29(1):51-56.
45. Stiletto R, Ose C, Folsch C. Positioning therapy in the treatment of severe oxygenation disorders in critically ill patients: Part I - Current status in the practical use of positioning therapy in German ICUs. Results of a randomized, cross-sectional trial. Int J Intensive Care. ;1-5.
46. Tillett JM, Marmarou A, Agnew JP, et al. Effect of continuous rotational therapy on intracranial pressure in the severely brain-injured patient. Clin Intensive Care. ;21(7):-.
47. Traver GA, Tyler ML, Hudson LD, et al. Continuous oscillation: Outcome in critically ill patients. J Crit Care. ;10(3):97-103.
48. U.S. Department of Health and Human Services, Health Care Financing Administration (HCFA). Medicare Coverage Issues Manual §§ 60-9, 60-18. Baltimore, MD: HCFA; .
49. U.S. Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH). FDA Preliminary Public Health Notification: Vail Products Enclosed Bed Systems. Rockville, MD: FDA; updated June 24, .
50. U.S. Food and Drug Administration (FDA). FDA asks U.S. Marshals to seize adulterated and misbranded hospital bed systems. FDA Talk Paper. T05-10. Rockville, MD: FDA; March 22, .
51. Wang JY, Chuang PY, Lin CJ, et al. Continuous lateral rotational therapy in the medical intensive care unit. J Formos Med Assoc. ;102(11):788-792.
52. Whiteman K, Nachtmann L, Kramer D, et al. Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant patients. Am J Crit Care. ;4(2):133-139.