Wound Prevention and Treatment

Bed Sores, Pressure Ulcers, and Wounds

Pressure ulcers, wounds, deep wounds, pressure sores, bed sores, pressure wounds. There are many names for pressure ulcers, but they all form under the same circumstances and follow the same treatment plan, no matter how your doctor names the condition.

A "Never Event"

Every year, Medicare identifies a list of "Never Events," conditions that are identifiable, measurable, and preventable. Pressure ulcers are deemed a Never Event. As a result, Medicare will no longer pay for the extra cost of treating patients pressure ulcers incurred in hospitals, meaning that facilities with high incidences of pressure ulcers could see their quality scores go down.

Acting Fast

Pressure ulcers and wounds can develop in as little as one week. Taking the appropriate steps in advance to reduce the risk of pressure ulcers is the best way to prevent expensive wounds before they happen.

Low Air Loss Mattresses

Low Air Loss Mattresses are primarily categorized by Medicare as a pressure ulcer treatment product, but they can also serve the preventative goal of stopping pressure ulcers from worsening. These mattresses use advanced an advanced rotation technology consisting of rows of inflatable mattress tubes. After fully inflating in only a few minutes, the mattress alternates between each row of tubes, mimicking a patient shifting in bed or being rotated by a doctor or nurse.

In order to properly categorize wounds and pressure ulcers, doctors use pressure ulcer stages to specify the severity of a pressure ulcer. Low Air Loss Mattresses are an absolutely essential home medical supply product for patients with a Stage 3 wound or multiple Stage 2 wounds and provide the most comprehensive treatment for pressure ulcers and wounds.

It's important to note, however, that a patient's wounds must be located on the trunk, pelvis, buttocks, or torso in order for patients to be eligible for a low air loss mattress. Patients with pressure ulcers on the head or heels are not eligible for low air loss mattress.

Gel Mattress Overlays

Gel Mattress Overlays can be put on any bed and provide an essential barrier between patients and the surfaces they're bound to regularly. Incontinent patients with mobility limitations may be particularly susceptible to pressure ulcers due to moisture. Moisture can exaggerate and hasten skin breakdown, leading to more pressure ulcers that form faster. You do not have to order a hospital bed in order to get a gel mattress overlay, as these mattresses fit on beds of all types.

Wheelchair Cushions

Moisture reduction can be an important part of preventing pressure ulcers. Many patients who qualify for a wheelchair will also qualify for skin protection condition with special moisture-reducing technology that enables the patient's skin to stay dry and free from breakdown or infection. Read on below to see what conditions and codes qualify for a skin protection cushion. If your patient doesn't qualify for a skin protection cushion, don't worry, all patients who qualify for a wheelchair qualify for a general use cushion.

Wound Prevention Features

Humans spend over a third of our lives asleep. For patient's recovering from acute conditions or who suffer from other afflictions, this ratio could become even more exaggerated. It's absolutely essential that patients spending extended amounts of time in bed have a bed that's comfortable. Our gel overlays provide an extra added layer of comfort to any mattress, similar to the levels of comfort a mattress pad might provide.

Yet, unlike a mattress pad, our gel overlays provide a medically proven and are engineered with evidence-based practice in mind. A gel overlay will not only provide you with essential feelings of comfort, but you'll also have the absolute best in pressure-reducing ulcer prevention technology and moisture management.

How to Document Medical Necessity for Low Air Loss Mattresses

Documenting medical necessity for low air loss mattresses can be trickier than documenting for other pieces of medical equipment. In fact, Low Air Loss Mattresses also have one of the highest Medicare rejection rates for insufficient documentation. Make sure to follow the guidelines below as closely as you possibly can in order to make the procedure as smooth as possible.

Medical documentation must include:

Frequent Changes in Body Position

‍All medical records and charts for home hospital bed patients must meet this criteria. The patient must require frequent changes in body position in order to qualify or have an immediate need for changes in body position.

Need for Elevation

‍Make sure to document that the patient needs to have their head elevated more than 30 degrees. In addition, list the reason why the patient needs their head elevated. This factor is the difference maker in whether the patient qualifies and is essential to verifying that the patient needs a semi-electric bed that can elevate versus a regular bed.

Medical Condition Requiring Frequent Changes in Body Position

‍In order for a patient to qualify, they need to have a condition that requires their body to be positioned in ways not possible in an ordinary bed. Make sure to list this condition and why a regular bed won’t suffice.

Changes in Body Position to Alleviate Pain

‍If the patient suffers from pain related to certain body positions, make sure to document this. List how repositioning the patient will alleviate these pains and why these pains cannot be alleviated in an ordinary bed.

The Need for Traction Equipment

‍If the patient requires traction equipment, give the reason why traction equipment is necessary.

Important Point in Documenting Medical Necessity for Low Air Loss Mattresses

Make sure to indicate the following:

Location of the wound
Dimensions (length, width, and depth) of the wound

Wound Prevention/Treatment Plan Including:

Education of the patient and caregiver on the management of pressure ulcers
Regular assessment of the wound by a nurse or physician
A turning/positioning schedule
A wound treatment care plan, such as a saline rinse
A moisture/incontinence management plan
A nutritional assessment and intervention plan for the patient
Use of a group I support surface for at least 30 days. Gel mattress overlays are a Group I support surface which can be used as part of wound prevention plan of care.

In addition, the medical chart must document one of the following three scenarios:

First Scenario – The patient has two or more Stage II wounds on the trunk or pelvis and the patient has been using a group I support surface (such as a gel overlay) for at least 30 days with no improvement or worsening of the wound.
Second Scenario – The patient has large or multiple Stage III or Stage IV wounds on the trunk or pelvis.
Third Scenario – The patient had a myocutaneous flap or skin graft for a wound on the trunk or pelvis and the patient needs a low air loss mattress in order to be discharged from the facility

Qualifying Conditions for Skin Protection Cushions

B91 - Sequelae of Poliomyelitis
G10 - Huntington's Disease
G11.1 - G11.9 - Various Ataxia
G12.1 - G12.9 - Muscle Atrophy
G20 - G21.4 - Parkinson's Disease
G30.0 - G30.9 - Alzheimer’s
G35 - Multiple Sclerosis
G80 - G80.9 - Cerebral Palsy
G81.0 - G 81.94 - Hemiplegia
G82.20 - G83.14 - Paraplegia/Quadriplegia/Monoplegia
I69.041 - I69.959 - Hemiplegia/Monoplegia due to Intracerebral/Intracranial/Cerebrovascular Disease (such as a stroke or other brain injury))
L89.130 - l89.45 - Pressure Ulcer on the Torso
M62.89 - Other Specified Disorders of Muscle
S78.0 - 78.929 - Hip Replacement
S88.0 - S88.929 - Amputation

Complete Products List

Home Hospital Beds

Trapeze for Hospital Bed
Semi-Electric Hospital Bed with Full Rails
Semi-Electric Hospital Bed with Half Rails
Semi-Electric Hospital Bed without Rails

Support Surfaces and Wound Treatment

Gel Mattress Overlays
Low Air Loss Mattresses

Other Products

Hoyer Patient Lift with Full Body Sling
Hoyer Patient Lift with Mesh Sling Commode Opening
3-in-1 Commode
3-in1 Commode with Drop Arm

Mobility Equipment

Standard Walker
Junior Walker
Lightweight Manual Wheelchair
Heavy-Duty Manual Wheelchair
Reclining Wheelchair

Wheelchair Cushions and Support Surfaces

General Use Wheelchair Seat Cushion
Positioning Wheelchair Seat Cushion
Skin Protection Wheelchair Seat Cushion
Back Support Cushion

Wheelchair Features

Anti-Tipping Devices
Heel Loops
Brake Handle Extensions
Elevating Leg Rests
Arm Troughs
Oxygen Tank Carriers
Transfer Boards
Height Adjustable Arms
Seat Belts

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Wound and Pressure Ulcer Prevention and Treatment

Low Air Loss Mattresses, Gel Mattress Overlays, and Wheelchair Cushions