Overview
Group 1 support surfaces are appropriate for patients at risk for pressure injuries or those with early-stage wounds. These surfaces are often the first line of defense in pressure injury prevention and early intervention.
Coverage Criteria
A patient must meet at least ONE of these conditions:
- Completely immobile (cannot make changes in body position without assistance), OR
- Limited mobility with ONE of the following:
- Impaired nutritional status
- Fecal or urinary incontinence
- Altered sensory perception
- Compromised circulatory status, OR
- Any stage pressure ulcer on the trunk or pelvis with ONE of the above conditions
Available Options
Pressure Pad Overlays
Gel/Gel-like Overlays
- 2 inches or greater height
- Good for low to moderate risk
- Helps with pressure redistribution
Air Overlays
- 3 inches or greater height
- Air cells provide pressure redistribution
- May be static or alternating pressure
Water/Fluid Overlays
- 3 inches or greater filled height
- Good pressure redistribution
- Consider weight when filled
Pressure Reduction Mattresses
Foam Mattresses
- 5 inches or greater height
- Multiple layers for comfort and support
- Must have waterproof cover
Air, Water, or Gel Mattresses
- 5 inches or greater height
- Replaces standard mattress
- More stable than overlays
Selection Guidelines
Best for Prevention
- Foam or gel overlays for low-risk patients
- Multi-layered foam mattresses for moderate-risk patients
- Air-filled overlays for patients needing frequent repositioning
Best for Early Intervention
- Alternating pressure overlays for Stage 1 pressure injuries
- Air or gel mattresses for patients with multiple risk factors
- Powered overlays for patients with early Stage 2 wounds
Documentation Requirements
Risk assessment documenting:
- Mobility status
- Incontinence status
- Nutritional status
- Sensory impairment
- Circulatory status
If pressure injury is present:
- Location and stage
- Current treatment plan
Important Notes
- All surfaces must have waterproof covers to be covered by insurance
- Medicare covers most Group 1 surfaces without prior authorization
- Document size and weight if ordering bariatric options
- Consider upgrading to Group 2 surface if wounds worsen despite proper intervention
When to Consider Group 2 Surfaces
Consider upgrading to Group 2 surfaces (see Low Air Loss Mattress Guide) when:
- Multiple Stage 2 wounds fail to improve over 30 days
- Stage 3 or 4 wounds develop
- Patient has recent myocutaneous flap or skin graft
