Following vitrectomy and certain other eye surgery procedures, patients are instructed to position themselves with their face down through most of the day. There are certain devices that facilitate this positioning. Examples (not all-inclusive) are a face cushion that is attached to a frame that can rest on a table or be positioned on a bed or a cushion pad that is attached to a chair-like device. CMS has confirmed that these devices are statutorily non-covered because they do not fall within a Medicare benefit category. The reasons are that they are considered "precautionary devices" and also the equipment can be used for purposes other than the treatment of an illness or injury. The denial is a non-coverage denial, not a medical necessity denial.
The face cushion and frame should be coded as A9270 for dates of service prior to January 1, 2004 and as E0190 (positioning cushion/pillow/wedge, any shape or size) for dates of service on or after January 1, 2004. The chair-like device should be coded as A9270.
Published by Palmetto GBA as the SADMERC, December 4, 2003. Republished by Noridian as the PDAC, August 2008. Republished by Palmetto GBA as the PDAC, January 2019.