How To Use HCPCS Code E0372

HCPCS code E0372 describes a powered air overlay for a standard mattress, specifically designed to provide support and comfort for patients. This code is used to identify the supply of a powered air overlay that is used in conjunction with a mattress of standard length and width. In this article, we will explore the details of HCPCS code E0372, 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 E0372?

HCPCS code E0372 is used to identify a powered air overlay for a standard mattress. This overlay is designed to provide additional support and comfort for patients who may be bedridden or have limited mobility. It is typically used in healthcare settings such as hospitals, nursing homes, and home healthcare environments.

2. Official Description

The official description of HCPCS code E0372 is “Powered air overlay for mattress, standard mattress length and width.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The provider should ensure that the standard mattress is clean and free from any debris or damage.
2. Place the powered air overlay on top of the mattress, ensuring that it covers the entire surface area.
3. Connect the powered air overlay to a power source, following the manufacturer’s instructions.
4. Adjust the settings of the powered air overlay according to the patient’s comfort and support needs.
5. Monitor the patient’s response to the powered air overlay and make any necessary adjustments.
6. Regularly inspect and maintain the powered air overlay to ensure its proper functioning.

4. When to use HCPCS code E0372

HCPCS code E0372 should be used when providing a powered air overlay for a standard mattress to patients who require additional support and comfort. This code is applicable for patients who are bedridden, have limited mobility, or require prolonged bed rest. It is important to note that this code may have specific coverage instructions that apply, so healthcare providers should review the guidelines and requirements before using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E0372, healthcare providers should ensure that the following documentation requirements are met:

• Medical records should clearly indicate the need for a powered air overlay and the medical necessity for its use.
• A detailed description of the patient’s condition and the reasons for using a powered air overlay should be documented.
• The start and end dates of the powered air overlay usage should be clearly documented.
• Any supporting documentation, such as physician orders or prescriptions, should be included in the medical records.

6. Historical Information and Code Maintenance

HCPCS code E0372 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition.

7. Medicare and Insurance Coverage

HCPCS code E0372 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 that it is not applicable as HCPCS priced under one methodology. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions on billing and reimbursement for HCPCS code E0372.

8. Examples

Here are five examples of when HCPCS code E0372 should be billed:

1. A patient with limited mobility and pressure ulcers requires a powered air overlay for their standard mattress to alleviate pressure and promote healing.
2. A bedridden patient with chronic pain requires a powered air overlay to provide additional support and comfort during their recovery.
3. A patient with a spinal cord injury requires a powered air overlay to prevent the development of pressure ulcers and maintain skin integrity.
4. An elderly patient with mobility issues requires a powered air overlay to reduce the risk of falls and provide a more comfortable sleeping surface.
5. A patient with a chronic illness that causes muscle weakness requires a powered air overlay to improve their overall comfort and quality of life.