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    v1.0.28
    OpenPayerBilling CodesDurable Medical EquipmentHCPCS hcpcs-e0199-dry-pressure-pad-mattress-standard-size
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    HCPCS E0199: Dry Pressure Pad for Standard Mattress

    HCPCS Level II code E0199 describes a dry pressure pad for a mattress sized to standard mattress length and width, classified as durable medical equipment used to provide pressure redistribution and moisture protection for patients at risk of pressure ulcers; service type: mattress accessory/durable medical equipment; typical site of service: home health or long-term care settings where a standard mattress is used.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Patient Lifts, Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure.

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    Clinical & Coding Specifications

    Clinical Context

    A patient with limited mobility or at high risk for pressure injuries is prescribed a dry pressure pad sized for a standard mattress to reduce localized pressure and shear while in bed. Typical patients include elderly individuals in skilled nursing facilities, postoperative patients with reduced mobility on a general medical-surgical floor, and homebound patients receiving home health nursing. The clinical workflow: after a risk assessment (e.g., Braden Scale) documents risk of pressure injury or presence of Stage 1 pressure injury, the ordering clinician documents medical necessity and places an order for a dry pressure pad (E0199). A durable medical equipment supplier or facility mattress services provides the pad; nursing documents placement, patient tolerance, and skin checks during routine care visits. Billing uses the HCPCS Level II code E0199 with appropriate modifier(s) when applicable; documentation supports diagnosis linkage (for example, pressure ulcer, immobility) and supplier delivery records.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97110Therapeutic exercises to develop strength and endurance, range of motion and flexibilityPerformed by physical therapy to improve mobility and reduce pressure risk before or alongside pad use.
    97530Therapeutic activities, direct (one-on-one) patient contactFunctional activities to reduce immobility that complement use of a pressure pad.
    97597Debridement, open wounds, selective debridement (first 20 sq cm)Wound care procedures that may be billed when pressure ulcers require debridement in conjunction with pressure-relief interventions.
    99501Home visit for establishing or modifying a plan of care (non-covered by some payors)Home health assessments that can document need for a pressure pad; used by some home health clinicians.
    99497Advance care planning including completion of POLST or similar, first 30 minutesOccasionally documented in complex care planning where pressure injury prevention is part of broader goals-of-care discussions.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    251B00000XCase Management AgencyAn organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
    251S00000XCommunity/Behavioral Health AgencyA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intell…
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    3336L0003XLong Term Care PharmacyA pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermed…
    207VC0200XCritical Care Medicine (Obstetrics & Gynecology) PhysicianAn obstetrician/gynecologist, who specializes in critical care medicine diagnoses, treats and supports female patients with multiple organ dysfunction…
    225700000XMassage TherapistAn individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hy…
    225A00000XMusic TherapistMusic therapists use music interventions to assess clients' strengths and needs, develop goals, implement services, and evaluate and document progress…

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    E10.65Type 1 diabetes mellitus with hyperglycemia
    E11.65Type 2 diabetes mellitus with hyperglycemia
    E86.0Dehydration
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    G81.90Hemiplegia, unspecified affecting unspecified side
    G82.20Paraplegia, unspecified
    G83.4Cauda equina syndrome
    I69.398Other sequelae of cerebral infarction
    L89.159Pressure ulcer of sacral region, unspecified stage
    L89.309Pressure ulcer of unspecified buttock, unspecified stage

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Patient Liftsuniverahealthcare2026-11-16
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Positive Airway Pressure Devices for Pulmonary Disorders Continued RentalCareSource Georgia2026-10-01
    Bone Growth StimulatorsProvidence Health Plan2026-10-01
    Durable Medical Equipment (DME) Medical Necessity and CoverageMass General Brigham Health Plan2026-10-01
    Speech Generating DevicesMass General Brigham Health Plan2026-10-01
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-E0100-CANE-DURABLE-MEDICAL-EQUIPMENT-AMBULATION

    HCPCS E0100: Cane, Adjustable or Fixed, With Tip

    HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

    HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

    HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

    HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

    HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

    HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

    HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

    HCPCS Level II E0112: Underarm Wooden Crutches, Pair

    HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

    HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

    HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

    HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

    HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

    HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

    HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

    HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

    HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

    HCPCS E0118: Crutch Substitute, Lower Leg Platform

    Showing 1–10 of 670

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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