2025 HCPCS code E0328
(Active) Effective Date: N/A Revision Date: N/A Durable Medical Equipment (DME) - Hospital Beds and Associated Supplies E- Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Feed
Supply of a manually operated pediatric hospital bed with 360-degree side rails up to 24 inches high, including mattress.
Modifiers GA, GZ, and KX may be applicable depending on the specific circumstances and payer requirements.GA is for waiver of liability, GZ indicates expected denial, and KX signifies that requirements specified in the medical policy have been met.
The medical necessity of the bed must be clearly established and documented. This might include a physician's statement explaining why a manual pediatric hospital bed is required given the patient's diagnosis and clinical condition. The documentation needs to justify the specific type of bed (manual operation, height and side rail specifications).
The physician or other qualified healthcare provider is responsible for determining the medical necessity of the hospital bed and ordering the DME. The supplier is responsible for providing the bed and any necessary setup or instruction.
- E- Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
- E0100-E8002 (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) > E0250-E0373 (Hospital Beds and Associated Supplies)
In simple words: This code covers the cost of a special hospital bed for children.It's a manually adjustable bed with safety rails all around, reaching 24 inches high, and includes a mattress. The doctor must show why the child needs this type of bed.
This HCPCS code, E0328, represents the provision of a manually adjustable pediatric hospital bed.The bed includes 360-degree side rails extending to a height of 24 inches above the spring mattress. The headboard and footboard also reach this height. A mattress is included in the supply.This code is used when the height and head/leg elevation require manual adjustment. Documentation of medical necessity and direct patient encounter is crucial for reimbursement.
Example 1: A child with a neuromuscular disorder requiring assistance with mobility and positioning needs a hospital bed with safety rails to prevent falls. E0328 is used., A child recovering from a surgery requiring frequent repositioning needs a safe and adjustable bed.E0328 is used, and the need for manual adjustment is documented., A child with severe cerebral palsy requires a stable and safe sleeping surface with side rails to prevent injury. E0328 would be reported.
Documentation must include the diagnosis supporting the medical necessity of the bed, the physician's order for the DME, and details of the patient's condition requiring this specific type of bed.Any advance beneficiary notice (ABN) issued should also be documented.
** Always confirm payer policies and any local coverage determinations before submitting claims for reimbursement.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applied to this code as it represents the supply of the equipment.
- Fee Schedule : Consult payer-specific fee schedules for historical and current rates.These vary across insurance providers and geographic locations.
- Specialties:Pediatrics, Orthopedics, Neurology, Rehabilitation Medicine
- Place of Service:Home, Inpatient Hospital, Skilled Nursing Facility, Other Place of Service (depending on clinical setting)