Group 1 Support Surface Form

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CG-DME-16 Pressure Reducing Support Surfaces – Groups 1, 2 & 3

    https://medicalpolicies.amerigroup.com/medicalpolicies/guidelines/gl_pw_a053642.htm
    Group 1 Support Surfaces (as defined in the Definition Section). Medically Necessary: Use of a group 1 mattress overlay or mattress is considered medically necessary if the individual meets:. Criterion 1, or Criterion 2 or 3 and at least one of criteria 4-7 . Completely immobile – that is, individual cannot make changes in body position without assistance

Medicare Policy Regarding Pressure Reducing Support ...

    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.

Support Surface Resources - CGS Medicare

    https://www.cgsmedicare.com/jc/mr/SSR.html
    Support Surface Resources. Documentation Checklist: Group 1 Pressure Reducing Support Surface; Documentation Checklist: Group 2 Pressure Reducing Support Surface; Documentation Checklist: Group 3 Pressure Reducing Support Surface; Inappropriate Medicare Payments for Pressure Reducing Support Surfaces ; Lessons Learned: Group 2 Support Surfaces

Group 2 Pressure Reducing Support Surface (PRSS) (DME MAC ...

    https://www.cgsmedicare.com/pdf/dme_checklists/grp2_support_surfaces_2018re.pdf
    • Continued use of a group 2 support surface is covered until the ulcer is healed or, if healing does not continue, there is documentation in the medical record to show that: (1) other aspects of the care plan are being modified to promote healing, or (2) the use of the group 2 support surface is medically necessary for wound management.

Pressure Reducing Support Surfaces - Group 1

    https://www.northwoodinc.com/wp-content/uploads/2014/09/Pressure-Reducing-Support-Surfaces-Group-1.pdf
    Pressure Reducing Support Surfaces – Group 1 Medical Policy 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 …

Pressure Reducing Support Surfaces - Group 2

    https://www.northwoodinc.com/wp-content/uploads/2014/09/Pressure-Reducing-Support-Surfaces-Group-2.pdf
    Pressure Reducing Support Surfaces – Group 2 codes listed in the table below), and has been on a group 2 or 3 support surface immediately prior to discharge from a hospital or nursing facility within the past 30 days If the member is on a group 2 surface, there should be a care plan established by

Statement of Ordering Physician Group 1 Support Surfaces

    https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/11563_13/spsrgroup1revised2007.pdf
    1) Completely immobile—i.e. patient cannot make changes in body position without assistance. 2) Limited mobility—i.e. patient cannot independently make changes in body position significant enough to alleviate pressure. 3) Any pressure ulcer on the trunk or pelvis. 4) Impaired nutritional status. 5) …

Support Surface Reimbursement for Homecare : Span America

    http://www.spanamerica.com/about_reimbursement_surfaces_home_care.php
    Support Surface Reimbursement for Homecare. ... This is a simplified guide to the Medicare patient criteria to qualify for Group 1 or Group 2 Support Surfaces, and the Span-America products that are approved for each Group. ... Recommended CMN and DIF Form for Group 2 support surfaces.

Documentation Checklist - Pressure Reducing Support ...

    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.



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