How To Use HCPCS Code E0181

HCPCS code E0181 describes a powered pressure reducing mattress overlay/pad, alternating, with pump, including heavy duty. This code is used to identify a specific type of medical equipment that is designed to provide pressure relief and support for patients who are at risk of developing pressure ulcers or bedsores. In this article, we will explore the details of HCPCS code E0181, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS E0181?

HCPCS code E0181 is used to identify a powered pressure reducing mattress overlay/pad, alternating, with pump, including heavy duty. This medical equipment is designed to provide alternating pressure therapy, which helps to redistribute pressure and reduce the risk of developing pressure ulcers or bedsores. The mattress overlay or pad is powered by a pump that controls the alternating pressure cycles, providing relief to different areas of the body.

2. Official Description

The official description of HCPCS code E0181 is “Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. Place the powered pressure reducing mattress overlay/pad on top of the patient’s existing mattress.
2. Connect the pump to the mattress overlay/pad.
3. Ensure that the pump is properly set up and functioning.
4. Instruct the patient on how to use the mattress overlay/pad and the pump.
5. Monitor the patient’s condition and adjust the pressure settings as needed.
6. Regularly inspect and maintain the equipment to ensure its proper functioning.

4. When to use HCPCS code E0181

HCPCS code E0181 should be used when providing a powered pressure reducing mattress overlay/pad, alternating, with pump, including heavy duty, to a patient who is at risk of developing pressure ulcers or bedsores. This code is typically used for patients who are bedridden or have limited mobility and require additional support to prevent the formation of pressure ulcers.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0181, healthcare providers should ensure that the following documentation requirements are met:

• A detailed description of the equipment provided, including the brand, model, and specifications.
• The patient’s medical records, including the diagnosis or condition that necessitates the use of the powered pressure reducing mattress overlay/pad.
• A prescription or order from a qualified healthcare professional.
• Proof of medical necessity, such as documentation of the patient’s risk factors for developing pressure ulcers or bedsores.

6. Historical Information and Code Maintenance

HCPCS code E0181 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code E0181 is eligible for coverage under Medicare. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology. Healthcare providers should check with individual insurance carriers to determine coverage and reimbursement rates for this code.

8. Examples

Here are five examples of when HCPCS code E0181 should be billed:

1. A patient with limited mobility and a high risk of developing pressure ulcers due to a spinal cord injury.
2. An elderly patient who is bedridden and requires additional support to prevent the formation of bedsores.
3. A patient with a chronic illness that causes prolonged periods of immobility and increases the risk of pressure ulcers.
4. A patient undergoing post-operative care who is unable to change positions frequently.
5. A patient with a history of pressure ulcers who requires a powered pressure reducing mattress overlay/pad for ongoing prevention.