Item Brochure

MEDICARE CRITERIA*
Support surfaces may be static (non-powered, reactive) or dynamic
(moveable active surface). A static surface is recommended if a patient
can assume varying positions without bearing weight on a pressure ulcer,
generally a Group I surface. Dynamic surfaces (usually Group II) 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.**
Group II Treatment
Group II surfaces may be covered if the patient meets the following criteria:
1. Multiple stage II pressure ulcers located on the trunk or pelvis.
AND
2. Patient has been on a comprehensive ulcer treatment program***
for at least the past month which has included the use of a Group I
support surface, and ulcers have worsened or remained the same
over the past month.
OR
A
lternating Pressure
Alternating Pressure
Low Air Loss
Invacare
®
Therapeutic Support Surfaces Product Comparison
Group II Therapeutic Support Surfaces
All references to HCPCS codes: Providers are responsible for determining the appropriate billing codes when submitting claims to the Medicare program and should consult an attorney or other advisor
to discuss specific situations in further details. (IN) Inexpensive and routinely purchased (one time payment). (CR) Capped Rental (payment/mo.).
22
Model Name
microAIR
®
50
- 5" Overlay
microAIR
®
51
Mattress
microAIR
®
60
10" AP Mattress
microAIR
®
55
AP/LAL
microAIR
®
65
AP/LAL
microAIR
®
85
True Low Air Loss AP
Model Number
MA50
MA51 MA60 MA55 MA65 MA85
HCPCS Code
E0372 (CR)
E0277 (CR) E0277 (CR) E0277 (CR) E0277 (CR) E0277 (CR)
Patient Risk Level
Therapy
Therapy Therapy Therapy Therapy Therapy
Reimbursement Range*
$458.00-$539.00 $645.46-$703.47 $645.46-$703.47 $645.46-$703.47 $645.46-$703.47 $645.46-$703.47
Type of Therapy
Alternating Pressure
■ ■ ■ ■ ■
Low Air Loss
On-demand On-demand True
Lateral Rotation
Features
Alarm Silence
■
■ ■ ■ ■ ■
Blower
1275 LPM
Built-in Side Supports
Comfort Settings
■
■ ■ ■ ■ ■
State of the Art Compressor
10 LPM 10 LPM 50 LPM 10 LPM 50 LPM
Cover
70 Denier
quilted nylon
600 Denier nylon
bottom
70 Denier
quilted nylon
600 Denier nylon
bottom
Dual quilted slip
layer cover
1000 Denier nylon
bottom
70 Denier
quilted nylon
1000 Denier nylon
bottom
Dual quilted slip
layer cover
1000 Denier nylon
bottom
Dual quilted slip
layer cover
1000 Denier nylon
bottom
Quick CPR Release
■
■ ■ ■ ■ ■
Fowler Indicator
■
■ ■ ■ ■ ■
Mattress Construction
16 - Bladders
16 -Bladders 20 -Bladders 16 -Bladders 20 -Bladders 20 -Bladders
Mattress Dimensions
36" x 80" x 6"
36" x 80" x 8" 36" x 80" x 10" 36" x 80" x 8" 36" x 80" x 10" 36" x 80" x 10"
Power Failure/Low Pressure Alarm
■
■ ■ ■ ■ ■
Quick Connect Coupler
■
■ ■ ■ ■
■
magnetic
Safety Mat 2" Foam
■ ■ ■ ■ ■
Therapy Time Settings (min)
5, 10, 15, 20
5, 10,15, 20 5, 10,15, 20 5, 10, 15, 20 5, 10,15, 20
Weight Capacity
350 lb.
350 lb. 350 lb. 350 lb. 350 lb. 350 lb.
Wireless Fowler
■ ■ ■
Z Cell
CFR Fire Safety Testing
16 CFR 1632, 16 CFR 1633
Not required
■ ■ ■ ■ ■
Limited Warranty
Mattress
1 year
1 year 1 year 1 year 1 year 1 year
Power Unit
2 year
2 year 2 year 2 year 2 year 2 year
Cover
1 year
1 year 1 year 1 year 1 year 1 year