A group 2 support surface is covered if the patient meets:
a. Criterion 1 and 2 and 3, or
Criterion 4, or
Criterion 5 and 6.
- Multiple stage II pressure ulcers located on the trunk or pelvis (ICD-9 707.02-707.05).
- Patient has been on a comprehensive ulcer treatment program for at least the past month which has included the use of an appropriate group 1 support surface.
- The ulcers have worsened or remained the same over the past month.
- Large or multiple stage III or IV pressure ulcer(s) on the trunk or pelvis (ICD-9 707.02-707.05).
- Recent myocutaneous flap or skin graft for a pressure ulcer on the trunk or pelvis (surgery within the past 60 days) (ICD-9 707.02 -707.05).
- The patient has been on a group 2 or 3 support surface immediately prior to a recent discharge from a hospital or nursing facility (discharge within the past 30 days). is limited to 60 days from the date of surgery.
Continued use of a group 2 support surface is covered until the ulcer is healed or, if healing does not continue, there is documentation in the medical record to show that: (1) other aspects of the care plan are being modified to promote healing, or (2) the use of the group 2 support surface is medically necessary for wound management.