Item Brochure

Invacare
®
Therapeutic Support Surfaces
21
Group I Therapeutic Support Surfaces
Gel Overlay
A
lternating
P
ressure
Non-Powered
Model Name
Invacare
®
Gel Foam
Mattress Overlay
CareGuard
Alternating Pressure
Pad System
Invacare
®
Egress EZ
Mattress
Solace
Prevention
Dual Layer Foam
Mattresses
Solace
Therapy
Tri-Layer Foam
Mattresses
Solace
Resolution
Mattresses
Model Number
IVCGFMO2 CG9701 MATTEZCA,
MATTEZLTCA
SPS1080
SPS2080
SPS3080
STS1080
STS2080
STS3080
SRS1080
HCPCS Code
E0185 (IN) E0181 (CR) E0184 (IN) E0184 (IN) E0184 (IN) E0184 (IN)
Patient Risk Level
Low Low Medium-High Low Med-High High-Risk & Therapy
R
eimbursement Range*
$271.88 - $338.33 $18.47 - $31.72 $105.34-$194.70 $105.34-$194.70 $105.34-$194.70 $105.34-$194.70
Type of Therapy
General Pressure Reduction
Alternating Pressure
Features
Built-in Side Supports
3" Hard side
supports with hand holds
SPS2080
SPS3080
Comfort Settings/
Therapy Time Settings (min)
Adjustable
Cover
70 Denier nylon top
9 oz. tri-laminate
vinyl bottom
waterproof,
vapor permeable
Latex free vinyl
70 Denier nylon top 11 oz. tri-laminate
vinyl bottom waterproof,vapor permeable
Quick CPR Release
Fortress Cut Convolute Foam
Mattress Construction
Gel Pads Foam Foam Foam Foam
Mattress Dimensions
34" x 77" x 3.5" 34" x 118" x 2.5" 36" x 80" x 6" 36" x 80" x 6" 36" x 80" x 6" 36" x 80" x 6"
Weight Capacity
250 lb. 250 lb. 350 lb. 350 lb. 350 lb. 350 lb.
CFR Fire Safety Testing
16 CFR 1632, 16 CFR 1633
Not required
Limited Warranty
Mattress
6 months 30 days
5 year
7 year
5 year 5 year 5 year
Power Unit
1 year
Cover
1 year 1 year 1 year 1 year
MEDICARE CRITERIA*
Support surfaces may be static (non-
powered, reactive) or dynamic
(moveable, active). A static surface is
recommended if a patient can assume
varying positions without bearing
weight on a pressure ulcer. Dynamic
surfaces are required if the patient
cannot change positions without
bearing weight on the pressure ulcer
OR if the patient fully compresses the
static support surface.
1. Completely immobile (patient cannot
move around without assistance).
OR
2. Limited mobility (patient cannot
make changes in body positions
significant enough to alleviate
pressure) PLUS one of Number 4-7.
OR
3. Any stage pressure ulcer on the
trunk or pelvis PLUS one of Num-
bers 4-7
OR
4. Impaired nutritional status.
5. Fecal or urinary incontinence.
6. Altered sensory perception.
7. Compromised circulatory status.
Group I Treatment
Group I surfaces may be covered if the patient meets the following criteria:
* Medicare Criteria: This information is not intended to be, nor should it be considered, billing or
legal advice.Providers are responsible for determining the appropriate billing codes when submit-
ting claims to the Medicare program, and should consult an attorney or other advisor to discuss
specific situations in further detail.