Summary & Overview
HCPCS E0373: Nonpowered Advanced Pressure Reducing Mattress
HCPCS Level II code E0373 designates a nonpowered advanced pressure reducing mattress, a type of durable medical equipment used to prevent and manage pressure injuries in patients with limited mobility. Nationally, appropriate classification of support surfaces affects coverage decisions, device procurement, and clinical placement across post-acute and home settings. The code matters for clinicians, medical equipment suppliers, and payers because it delineates a nonpowered option distinct from powered alternating or low-air-loss mattresses.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of device definition and clinical context, payer coverage considerations, and the kinds of benchmarks and policy updates typically relevant to support surface billing. The publication summarizes common billing practices, typical sites of service where E0373 applies, and areas where policy clarifications or documentation standards influence coverage. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code E0373 describes a nonpowered advanced pressure reducing mattress intended to provide pressure redistribution for patients at risk of pressure ulcers. This device is a specialized support surface designed to reduce interface pressure and shear for individuals with limited mobility.
-
Service type: Durable medical equipment (support surface)
-
Typical site of service: Long-term care facilities, nursing homes, inpatient hospital beds, and home settings where a stationary, nonpowered mattress is used to manage or prevent pressure injuries.
Clinical & Coding Specifications
Clinical Context
A typical patient receiving a E0373 nonpowered advanced pressure reducing mattress is an adult or elderly patient with limited mobility, significant risk for pressure ulcers, or existing stage I–III pressure injuries being managed in an inpatient hospital, long-term acute care hospital (LTACH), skilled nursing facility (SNF), or outpatient durable medical equipment (DME) setting. The clinical workflow begins with a clinician assessment (nurse or physician) documenting immobility, decreased sensation, or wound staging and completing a pressure injury risk assessment such as the Braden Scale. A physician or advanced practice provider orders the advanced pressure reducing mattress as durable medical equipment to support pressure redistribution. The DME provider delivers and sets up the mattress at the patient’s bed location (hospital room, SNF bed space, or home) and educates nursing staff or caregivers on positioning, skin checks, and support surface use. Follow-up wound care or skin surveillance occurs regularly; orders may be adjusted based on wound healing, changes in mobility, or transfer of care to another facility. Billing uses E0373 for the mattress itself; facility charges and nursing services are billed separately.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / default |