Hospital Beds

Revised: April 17,

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Overview of Hospital Beds Usage

Hospital beds play a crucial role in the effective positioning and comfort of patients during their recovery process.

Eligible Providers for Hospital Beds

• Medical supply companies
• Pharmacies that offer home medical equipment
• Home healthcare agencies
• Indian Health Services
• Federally qualified health centers (FQHCs)
• Rural health clinics

Third-Party Liability (TPL) and Medicare Considerations

Providers need to comply with all necessary criteria and accreditation to facilitate coverage through third-party insurance or Medicare for patients for whom the Minnesota Health Care Programs (MHCP) does not serve as the primary payer.

It is essential to be aware that MHCP imposes quantity limitations and criteria applicable to all members unless only Medicare's coinsurance or deductible is in question.

Eligible Patients

Coverage for hospital beds is primarily available to MHCP members who can demonstrate a legitimate medical necessity for their use.

Included Services and Covered Bed Types

Fixed-Height Manual Hospital Beds

Codes: E, E, E, E
These beds are eligible for patients diagnosed with:

• A medical condition necessitating positioning that cannot be accommodated by a regular bed, even with the use of pillows or wedges.
• Conditions that require safeguarding against serious injury where standard bedding solutions are insufficient.
• Medical needs for specialized attachments, like traction apparatus, that cannot be adapted for routine beds.
• A requirement for the bed's head to be raised beyond 30 degrees that pillows or wedges cannot fulfill.

Variable-Height Manual Hospital Beds

Codes: E, E, E, E
These are covered for individuals meeting criteria for a fixed-height manual hospital bed, requiring specific height adjustments for:

• Facilitating safe and easy transfers to and from the bed.
• Enabling caregivers to provide necessary care without strain or injury.

Semi-Electric Hospital Beds

Codes: E, E, E, E
Coverage applies to members who require:

• Regular position adjustments to manage discomfort or medical issues.
• Instantaneous position changes to alleviate health concerns.

Total Electric Hospital Beds

Codes: E, E, E, E
Eligibility pertains to members who meet the criteria for hospital beds with both of the following conditions:

• Require at least daily height adjustments to assist caregivers effectively.
• Caregivers cannot manually change the height but can provide necessary care while being limited by practicalities.

Bariatric and Extra-Wide Hospital Beds

Codes: E-E
Covered for eligible members whose weight fits within the specified limitations of the requested hospital bed.

Coverage may also be approved for patients with conditions such as daily seizures, uncontrollable movement disorders, or those at significant risk for injuries with standard beds. Requests must correspond with established criteria.

Hospital Beds for Children

Codes: E-E
These beds are necessary for patients with specific medical conditions that dictate the need for pediatric-sized beds equipped to meet their requirements. The bed is expected to last no less than five years.

Enclosed Hospital Beds

Codes: E (enclosure), E (crib), E (complete unit)

Enclosed beds are regarded as a medical necessity only under extreme conditions, due to the confining nature inherent to them. MHCP will classify a bed as essential if the patient has significant mobility concerns that pose a high injury risk.

The following conditions must be satisfied for coverage:

• Evidence of cognitive impairment leading to unsafe mobility.
• A diagnosis such as brain injury, severe cerebral palsy, or other behavioral disorders.
• Documentation showing efforts to manage the problem using less intrusive measures have been unsuccessful.

In cases where members exhibit evidence of climbing out of bed or wandering around their home, further documentation is required.

Accessories and Options for Enclosed Beds

Options and accessories for enclosed beds can be covered if warranted by medical necessity. Each accessory must be evaluated by a qualified healthcare professional.

• High-side door systems for those who can exceed standard safety height.
• Gel-infused mattresses for conditions sensitive to temperature.
• Padding to prevent injury for those with specific diagnoses.
• Mechanisms for semi-electric or electric adjustments for patients unable to operate manual beds.

Restoration of Mattresses and Safety Rails

Codes: E-E (mattress), E. E (rails)
These can be covered when used in conjunction with an owned hospital bed.

Services Generally Not Covered

There are some services that are usually excluded from coverage but might be approved in specific cases. Please refer to the criteria for noncovered services detailed in the MHCP Provider Manual for further clarification.

• Standard beds sold as furniture, including non-medical form adjustable beds.
• Orthopedic-type mattresses.
• Waterbeds and lounge beds.
• Bed accessories and linens.
• Heat and massage devices.
• Enclosed beds under continuous one-on-one supervision.

Authorization Process

All authorization requests need to be submitted along with required documentation to the designated review authority.

Billing Guidance

• The provision of services must be coordinated properly by the providers. Refer to the billing policy overview for essential guidelines.
• Ensure accurate coding for beds, rails, and mattresses to avoid billing delays.
• Consider the implications of Medicare coverage and its intersection with MHCP benefits.

KAIRUIJIEDE goods are distributed globally with a focus on quality. We aim to offer customers more high-value-added products, striving for a brighter future together.

For further queries or to discuss your specific needs, please contact us regarding your requirements for Hospital bed wholesale. Our sales team is well-prepared to assist in identifying the most suitable options for you.