Side Rails and Safety Enclosures
BCBS ND considers safety enclosures for beds medically necessary DME only when the member's condition places them at risk for falls or climbing out of bed is a concern and they are an integral part of, or an accessory to, a medically necessary hospital bed. A safety enclosure frame/canopy for use with a hospital bed is a safety enclosure used to prevent a member from leaving the bed.
BCBS ND considers bedside rails for beds medically necessary DME only when the member's condition requires them and they are an integral part of, or an accessory to, a medically necessary hospital bed. Examples of conditions where bedside rails may be considered medically necessary include members with seizures, vertigo, disorientation, and neurological disorders.
Note: Side rails and safety enclosures for beds are considered safety features; under most benefit plans, safety items are excluded from coverage. Under benefit plans with this exclusion, bedside rails and safety enclosures are excluded from coverage unless they are an integral part of a medically necessary bed.
Powered Air Flotation Beds (Low Air Loss Therapy)
Powered air flotation beds may be considered medically necessary for individuals in the third or fourth stages of decubitus ulceration and who meet all of the requirements for a manual hospital bed.
Institutional beds under the brand name of Flexicair will be denied as non-covered because they are inappropriate for home use. The appropriateness of all other brands of powered air flotation beds for use in the home must be established on an individual consideration basis.
Power Air Flotations Beds (Low Air Loss Therapy) not meeting the criteria as indicated in this policy are considered not medically necessary.
Procedure Codes
