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https://www.wocn.org/page/PressureReducingSupportSurfacesPriorAuthorization
Pressure Reducing Support Surfaces Prior Authorization. URGENT: An upcoming process change will make it mandatory to submit prior authorization for pressure reducing support surfaces as …
https://www.cgsmedicare.com/jb/mr/prsspa.html
Pressure Reducing Support Surfaces Prior Authorization. CMS has added the following Group 2 Pressure Reducing Support Surfaces Healthcare Common Procedure Codes (HCPCS) to the required prior Authorization List: E0193, E0277, E0371, E0372, and E0373.
https://med.noridianmedicare.com/web/jddme/cert-reviews/mr/pre-claim/required-programs/prior-authorization-for-prss
In 2019 it expanded to include Pressure Reducing Support Surfaces (PRSS) HCPCS codes E0193, E0277, E0371, E0372, and E0373 for new rental series claims with a …
https://www.cms.gov/Medicare/Medicare-Contracting/ContractorLearningResources/downloads/JA1014.pdf
- A group 2 support surface is covered if the patient has a stage II pressure sore located on the trunk or pelvis, has been on a comprehensive pressure sore treatment program (which has included the use of an appropriate group 1 support surface for at least one month), and has sores which have worsened or remained the same over the past month.
https://www.cgsmedicare.com/pdf/dme_checklists/grp2_support_surfaces_2018re.pdf
• All new rental series claims for the following Group 2 Support Surfaces with a date of delivery on or after July 22 , 2019 for the states of California, Indiana, New Jersey, and North ... Group 2 Pressure Reducing Support Surface (PRSS) (DME MAC Jurisdictions B & C) Author: CGS - CH
https://med.noridianmedicare.com/documents/2230703/7218263/PRSS+Group+2+LCD+and+PA
Pressure Reducing Support Surfaces - Group 2 (L33642) ... A group 2 support surface is covered if the beneficiary meets at least one of the following three Criteria (1, 2 or 3): ... or DME MAC articles. Claims that do not meet coding guidelines shall be denied as not : reasonable and necessary/incorrectly coded.
https://www.aapc.com/blog/1387-oig-applies-pressure-on-support-surface-claims/
Aug 17, 2009 · More than three-quarters of all pressure reducing support surface claims in the first half of 2007 did not meet Medicare coverage criteria, totaling an estimated $33 million in inappropriate payments, according to an August 2009 Office of Inspector General (OIG) report entitled “Inappropriate Medicare Payments for Pressure Reducing Support Surfaces.”
https://oig.hhs.gov/oei/reports/oei-02-07-00421.pdf
more than one support surface for the same beneficiary on the same service date. In several 1 OIG. Inappropriate Medicare Payments for Pressure Reducing Buppo/·t Bul'iaces, OEI-02-07-00420, August 2009. OEI-02-07-00421 Vublerabilities in Medicare Payments …
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/MedQtrlyComp_Newsletter_ICN908064.pdf
reviews of support surfaces claims have consistently yielded high improper payment rates. Based on these findings, CMS conducted a special study of Pressure Reducing Support Surface (PRSS) claims. The following discussion presents . PRSS coverage requirements, the common causes of improper payments for PRSS claims, an
https://med.noridianmedicare.com/web/jddme/cert-reviews/mr/pre-claim/required-programs/prior-authorization-for-prss
Prior Authorization for Pressure Reducing Support Surfaces Due to the CMS final rule 42 CFR §§405 and 414., in 2016, a Condition of Payment Prior Authorization (COPPA) process for certain DMEPOS that are frequently subject to unnecessary utilization was established.
https://www.cgsmedicare.com/pdf/dme_checklists/grp2_support_surfaces_2018re.pdf
Group 2 Pressure Reducing Support Surface (PRSS) DOCUMENTATION CHECKLIST Page 2 Originated January 31, 2018 Revised June 6, 2019 © 2019 Copyright, CGS ...
https://www.cms.gov/Medicare/Medicare-Contracting/ContractorLearningResources/downloads/JA1014.pdf
Medicare Policy Regarding Pressure Reducing Support Surfaces – JA1014 . ... • Before submitting a support surface claim to the DME MAC the supplier must have on file a dispensing order, the detailed written order, information from the treating physician ... • Pressure Reducing Support Surface – …
https://med.noridianmedicare.com/documents/2230703/6750839/Documentation+Checklist+-+Pressure+Reducing+Support+Surfaces+%28PRSS%29%20-+Group+2
Documentation Checklist Pressure Reducing Support Surfaces (PRSS) - Group 2 The content of this document was prepared as an educational tool and is not intended to grant rights or impose obligations. Use of this document is not intended to take the place of either written law or regulations.
https://www.aapc.com/blog/1387-oig-applies-pressure-on-support-surface-claims/
Aug 17, 2009 · More than three-quarters of all pressure reducing support surface claims in the first half of 2007 did not meet Medicare coverage criteria, totaling an estimated $33 million in inappropriate payments, according to an August 2009 Office of Inspector General (OIG) report entitled “Inappropriate Medicare Payments for Pressure Reducing Support Surfaces.”
https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-guidelines/p/pressure-reducing-support-surfaces.pdf
Pressure reducing support surfaces are a type of durable medical equipment (DME) used for the care of pressure sores, also known as pressure ulcers. Pressure ulcers are lesions caused by unrelieved pressure resulting in damage of underlying tissue. A major distinction between support surfaces is that some are powered by electricity and others are
http://www.insuranceclaimdenialappeal.com/2017/02/cpt-a9270-e1399-pressure-reducing.html
A support surface which does not meet the characteristics specified in the Coding Guidelines section of the Pressure Reducing Support Surfaces – Group 2 Policy Article will be denied as not reasonable and necessary. (See Coding Guidelines and Documentation sections concerning billing of E1399.)
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_143060
Pressure reducing support surfaces are used to prevent and treat pressure sores and decubitus ulcers. ... • Recent mycutaneous flap or skin graft for pressure ulcer on the trunk or pelvis and they have been on a pressure reducing support surface immediately prior to discharge from a hospital or LTC facility (surgery within past 60 days ...
https://www.cgsmedicare.com/jb/pubs/news/2017/01/cope1705.html
Jan 05, 2017 · January 5, 2017. Hospital Beds and Pressure Reducing Support Surfaces - Billing Instruction. Joint DME MAC Article. Recently there have been questions about the billing of hospital beds at the same time as a mattress-type pressure reducing support surface (PRSS).
https://www.northwoodinc.com/wp-content/uploads/2014/09/Pressure-Reducing-Support-Surfaces-Group-1.pdf
Pressure Reducing Support Surfaces – Group 1 Description A pressure reducing support surface is a foam overlay or mattress that provides support to prevent pressure ulcers. Policy Pressure reducing support surfaces are considered reasonable and necessary for Members requiring support to prevent pressure ulcers. Policy Guidelines
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