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2025 HCPCS code E0197

Air pressure pad for mattress, standard mattress length and width.

Coverage for E0197 requires medical necessity. The patient's diagnosis must justify the use of the air pressure pad. Documentation must support the need for pressure reduction due to immobility, limited mobility, or other documented medical conditions.

In simple words: This is a special air-filled pad that goes on top of a regular mattress. It helps prevent bedsores by reducing pressure on the skin.

An air pressure pad designed to overlay a standard hospital or home mattress for pressure ulcer treatment and prevention. It features interconnected air cells with a minimum height of 3 inches, providing pressure reduction. A durable, waterproof cover encloses the pad.

Example 1: A patient with limited mobility and a stage 1 pressure ulcer uses the air pressure pad to relieve pressure and promote healing., A bedridden patient at risk of developing pressure ulcers uses the pad as a preventative measure., A patient recovering from surgery and temporarily immobile uses the pad to minimize pressure during recovery.

Medical records should document the medical necessity for the air pressure pad, including the patient's diagnosis (e.g., pressure ulcer, limited mobility), the specific condition necessitating the device, and any relevant clinical findings.

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