How To Use HCPCS Code E0371

HCPCS code E0371 describes a nonpowered advanced pressure reducing overlay for a standard mattress. This code is used to identify a specific type of support surface that is designed to reduce pressure and prevent the development of pressure ulcers in patients who are at risk. In this article, we will explore the details of HCPCS code E0371, 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 E0371?

HCPCS code E0371 is used to identify a nonpowered advanced pressure reducing overlay for a standard mattress. This overlay is designed to provide additional support and pressure redistribution for patients who are at risk of developing pressure ulcers. It is typically used in healthcare settings such as hospitals, nursing homes, and home healthcare.

2. Official Description

The official description of HCPCS code E0371 is “Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. Place the nonpowered advanced pressure reducing overlay on top of the standard mattress.
2. Ensure that the overlay covers the entire length and width of the mattress.
3. Secure the overlay in place using the provided straps or fasteners.
4. Instruct the patient on proper positioning and body alignment to maximize the effectiveness of the overlay.
5. Monitor the patient regularly for any signs of discomfort or skin breakdown.
6. Adjust or replace the overlay as needed to maintain optimal pressure redistribution.

4. When to use HCPCS code E0371

HCPCS code E0371 should be used when providing a nonpowered advanced pressure reducing overlay for a standard mattress to a patient who is at risk of developing pressure ulcers. This code is typically used for patients who have limited mobility, are bedridden, or spend a significant amount of time in a seated or reclined position. It is important to ensure that the patient meets the criteria for using this code, as specified by the payer or insurance provider.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0371, healthcare providers need to document the medical necessity of the nonpowered advanced pressure reducing overlay and provide supporting documentation, such as the patient’s medical history, risk assessment for pressure ulcers, and any other relevant clinical information. It is also important to include the start and end dates of the service or supply, as well as the quantity provided.

6. Historical Information and Code Maintenance

HCPCS code E0371 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 E0371 is covered by Medicare and other insurance providers. 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. Providers should verify coverage and reimbursement rates with the specific payer or insurance provider.

8. Examples

Here are five examples of when HCPCS code E0371 should be billed:

1. A patient with limited mobility and a high risk of developing pressure ulcers receives a nonpowered advanced pressure reducing overlay for their standard mattress.
2. A bedridden patient in a nursing home requires a nonpowered advanced pressure reducing overlay to prevent pressure ulcers.
3. A home healthcare provider supplies a nonpowered advanced pressure reducing overlay to a patient who spends a significant amount of time in a seated position.
4. A hospital provides a nonpowered advanced pressure reducing overlay to a patient who is recovering from surgery and is at risk of developing pressure ulcers.
5. A patient with a history of pressure ulcers receives a nonpowered advanced pressure reducing overlay to prevent recurrence.