What is a Low Air Loss Mattress?

A powered pressure-reducing mattress system specifically designed for treating advanced pressure wounds. This therapeutic surface uses controlled air flow to manage tissue pressure, moisture, and temperature at wound sites, while the dynamic air circulation helps manage the wound environment. Features:

• Air pump/blower providing continuous air circulation
• Minimum 5-inch air cell height
• Sequential inflation/deflation or constant low pressure
• Designed to reduce friction and shear
• Compatible with standard hospital bed frames

Important Process Notes

Prior Authorization Required

• Medicare now requires prior authorization for Low Air Loss mattresses
• This differs from most other DME items
• See our “Prior Authorization Process Guide” for detailed requirements
• Plan for additional processing time during discharge planning

Documentation Best Practices

• Wound care notes from dressing changes are excellent documentation sources
• These notes typically include required elements:
  • Wound measurements
  • Staging
  • Location
  • Progress or deterioration
  • Current treatment
• Keep copies of recent wound care notes for authorization process

Coverage Criteria

Patient must meet at least ONE of these conditions:

1. Multiple Stage 2 pressure ulcers on trunk or pelvis that have failed to improve over past month despite:
   • Use of Group 1 support surface
   • Regular wound assessment
   • Appropriate turning/positioning
   • Moisture management
   • Nutritional assessment and intervention
2. Large or multiple Stage 3 or 4 pressure ulcers on trunk or pelvis
3. Recent myocutaneous flap or skin graft (within past 60 days) for pressure ulcer on trunk or pelvis, AND:
   • Was on Group 2 or 3 support surface immediately before discharge
   • Discharge within past 30 days

Key Point for Discharge Planning

Important: Low Air Loss mattresses are covered only for active wound treatment, not for prevention. Alternative surfaces should be considered for preventative care.

Documentation Requirements

1. Detailed wound assessment documenting:
   • Wound stage
   • Size and location
   • Previous treatments
   • Response to treatments
   • Include wound care notes when possible
2. Care plan showing:
   • Regular assessment schedule
   • Turning/positioning protocol
   • Wound care plan
   • Moisture management
   • Nutritional interventions
3. For Stage 2 wounds:
   • Documentation of failed Group 1 surface
   • 30-day wound progression notes

Alternative Options for Prevention

If patient doesn’t meet criteria for Low Air Loss but needs pressure reduction, see our “Group 1 Support Surfaces Guide” for preventative options.

Common Pitfalls to Avoid

1. Ordering for prevention only
2. Insufficient wound documentation
3. No documented failure of Group 1 surface for Stage 2 wounds
4. Missing comprehensive care plan
5. Incomplete documentation of wound measurements/staging
6. Not allowing enough time for prior authorization process