{"id":178419,"date":"2026-08-14T08:17:02","date_gmt":"2026-08-14T08:17:02","guid":{"rendered":"https:\/\/pabau.com\/?p=178419"},"modified":"2026-08-14T09:28:34","modified_gmt":"2026-08-14T09:28:34","slug":"hcpcs-code-e0371","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/","title":{"rendered":"HCPCS code E0371: Prior authorization and billing guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"HCPCS code E0371: Prior authorization and billing guide\",\"description\":\"HCPCS code E0371 covers a nonpowered advanced pressure reducing overlay. Learn the Medicare prior authorization process, Group 2 coverage criteria under LCD L33642, capped rental modifiers, covered ICD-10 codes, and the errors that trigger denials.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-e0371\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-10\",\"dateModified\":\"2026-08-14\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>HCPCS code E0371 covers a nonpowered advanced pressure reducing overlay for a standard mattress, billed to Medicare Part B as durable medical equipment.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Medicare has required prior authorization for E0371 nationwide since October 21, 2019, so the request goes in before the overlay is delivered.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Coverage runs through LCD L33642, which looks for stage 2, 3 or 4 pressure ulcers on the trunk or pelvis.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>E0371 is a capped rental item, so each claim carries RR plus KH, KI or KJ depending on the rental month.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau keeps the wound assessments, orders and photos behind an E0371 claim in one patient record.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">HCPCS code E0371 pays for a nonpowered advanced pressure reducing overlay that sits on a standard mattress. Medicare decides this one before the overlay reaches the patient, because prior authorization is mandatory ahead of delivery.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That sequence catches suppliers out. E0371 has sat on the required prior authorization list nationwide since October 2019. No affirmed decision means no tracking number, and no tracking number means an automatic denial.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The criteria are fixed and knowable, though. Once your intake captures the right handful of facts, an affirmed decision usually comes back inside a week.<\/p>\n\n\n\n<h2 id=\"h-what-hcpcs-code-e0371-covers-and-which-products-qualify\" class=\"wp-block-heading\">What HCPCS code E0371 covers and which products qualify<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">E0371 pays for one thing, an advanced nonpowered overlay that sits on top of an existing mattress. The official descriptor from the <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/healthcare-common-procedure-system\" target=\"_blank\" rel=\"nofollow noopener\">Centers for Medicare and Medicaid Services<\/a> reads \u00ab\u00a0nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width.\u00a0\u00bb<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It&rsquo;s a HCPCS Level II code, the set CMS uses for equipment and supplies that CPT does not describe. Payment falls under the Part B durable medical equipment benefit at Social Security Act section 1861(s)(6).<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">HCPCS code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">E0371<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Long descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">HCPCS Level II, durable medical equipment<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare benefit<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Part B durable medical equipment<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Support surface group<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Group 2<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Coverage policy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">LCD L33642, with policy article A52490<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Payment category<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Capped rental, 13 months<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Prior authorization<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required nationwide since October 21, 2019<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Policy article <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleId=52490\" target=\"_blank\" rel=\"nofollow noopener\">A52490<\/a> is strict about what the product itself has to be. An overlay only qualifies as E0371 when it meets all four of these:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Cell height and design that reduce pressure well beyond a Group 1 overlay and prevent bottoming out.<\/li>\n\n\n\n<li>A total height of 3 inches or greater.<\/li>\n\n\n\n<li>A surface built to reduce friction and shear.<\/li>\n\n\n\n<li>Documented evidence that the product works for the conditions in the Group 2 coverage criteria.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">One more hurdle trips up new suppliers. Only products that have passed a written coding verification review by the Pricing, Data Analysis and Coding contractor may be billed as E0371.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The product also has to appear on the PDAC Product Classification List under that code. If it doesn&rsquo;t, the line denies as incorrect coding, however strong the clinical record is.<\/p>\n\n\n\n<h2 id=\"h-prior-authorization-comes-first-and-the-claim-waits-on-it\" class=\"wp-block-heading\">Prior authorization comes first, and the claim waits on it<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Yes, E0371 needs prior authorization, and it needs it before delivery. CMS added the five pressure reducing support surface codes to the required list in July 2019, starting with four states. The program went nationwide for dates of delivery on or after October 21, 2019.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Here&rsquo;s how one E0371 rental moves from order to payment:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>The practitioner writes a Standard Written Order.<\/strong> It names the patient, the item, the order date, and the ordering practitioner, and it carries their signature.<\/li>\n\n\n\n<li><strong>You build the request package.<\/strong> That is the SWO, the medical records that prove medical necessity, and your DME MAC&rsquo;s prior authorization coversheet.<\/li>\n\n\n\n<li><strong>The DME MAC reviews it.<\/strong> Decisions land within five business days for both first submissions and resubmissions. Expedited reviews aim for two business days.<\/li>\n\n\n\n<li><strong>An affirmed decision arrives with a 14-byte unique tracking number.<\/strong> That UTN is your permission slip.<\/li>\n\n\n\n<li><strong>You deliver within one month.<\/strong> An affirmation expires 30 days after the decision date, and a late delivery means starting the request again.<\/li>\n\n\n\n<li><strong>The claim carries the UTN.<\/strong> On a CMS-1500 it goes in the first 14 positions of item 23. Electronic claims carry it in the 2300 loop, with REF01 as \u00ab\u00a0G1\u00a0\u00bb and REF02 as the number.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Miss step four and the claim never gets reviewed on its merits. Claims for these codes without a decision and a matching UTN are denied automatically.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A non-affirmed decision isn&rsquo;t the end of it. The DME MAC sends a detailed letter naming what was missing, and CMS permits unlimited resubmissions. Most suppliers who fix the record on the first pass get an affirmation on the second try.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One caution is worth holding onto. An affirmation is a <em>provisional<\/em> decision, not a payment guarantee. The claim can still be denied later for things the reviewer could not see, such as a missing proof of delivery.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Store the UTN against the rental series, not against a single claim. Every monthly rental claim in that series carries the same tracking number. Pull it from the patient record each month rather than retyping it from the affirmation letter.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h3 id=\"h-some-suppliers-can-now-skip-prior-authorization\" class=\"wp-block-heading\">Some suppliers can now skip prior authorization<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Suppliers with a strong track record can now skip the paperwork. CMS judged eligibility on the prior authorization requests suppliers submitted between June 1, 2025 and November 30, 2025. Notifications went out by April 2, 2026, and the first annual exemption cycle opened on June 1, 2026.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The threshold is at least 10 prior authorization requests and a provisional affirmation rate of 90 percent or better. Exempt suppliers stop submitting requests for a year, and any request they do send gets rejected. Exemption is judged separately in each DME MAC jurisdiction.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It isn&rsquo;t a free pass, though. From January each year, exempt suppliers get a post-payment document request covering a 10-claim sample. Fall below a 90 percent approval rate on that sample and the exemption is withdrawn.<\/p>\n\n\n\n<h2 id=\"h-the-group-2-criteria-your-record-has-to-prove\" class=\"wp-block-heading\">The Group 2 criteria your record has to prove<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A Group 2 surface such as E0371 is covered when the patient meets any one of three criteria in <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/lcd.aspx?LCDId=33642\" target=\"_blank\" rel=\"nofollow noopener\">LCD L33642<\/a>. Only one has to be true, but the record has to show it clearly.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Criterion 1:<\/strong> multiple stage 2 pressure ulcers on the trunk or pelvis that have failed to improve over the past month. The patient must have been on a full ulcer treatment program throughout.<\/li>\n\n\n\n<li><strong>Criterion 2:<\/strong> large or multiple stage 3 or stage 4 pressure ulcers on the trunk or pelvis.<\/li>\n\n\n\n<li><strong>Criterion 3:<\/strong> a myocutaneous flap or skin graft for a trunk or pelvis pressure ulcer within the past 60 days. The patient must also have been on a Group 2 or 3 surface before discharge. That discharge from a hospital or nursing facility must fall within the past 30 days.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Criterion 1 is where most requests fail, because the treatment program has six named parts. All of them have to appear in the notes for that month:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Use of an appropriate Group 1 support surface, such as a powered overlay billed under <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-e0181\/\">E0181<\/a>.<\/li>\n\n\n\n<li>Regular assessment by a nurse, practitioner or other licensed healthcare professional.<\/li>\n\n\n\n<li>Appropriate turning and positioning.<\/li>\n\n\n\n<li>Appropriate wound care.<\/li>\n\n\n\n<li>Appropriate management of moisture and incontinence, where supplies such as <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-e0352\/\">E0352<\/a> carry their own coverage rules.<\/li>\n\n\n\n<li>Nutritional assessment and intervention that fits the overall care plan.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Notice what is not on that list. LCD L33642 never mentions a Braden Scale score, and it does not set a numeric risk threshold. A Braden score is useful clinical evidence, but it won&rsquo;t substitute for the six elements above.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two limits then govern how long the surface stays covered. When criterion 3 is the basis, coverage generally runs 60 days from the date of surgery. Otherwise, continued use is covered until the ulcer heals. It also continues while the notes show the care plan changing, or the surface still being needed for wound management.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The LCD also expects the chosen surface to stop the patient bottoming out. There is a physical test for that. Slide an outstretched hand palm up under the overlay, beneath a bony prominence such as the coccyx or lateral trochanter.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you can readily feel the bone, the surface is bottoming out. Run the test three ways: supine with the head flat, supine with the head raised no more than 30 degrees, and side lying.<\/p>\n\n\n\n<h2 id=\"h-only-trunk-and-pelvis-icd-10-codes-support-an-e0371-claim\" class=\"wp-block-heading\">Only trunk and pelvis ICD-10 codes support an E0371 claim<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The covered diagnosis list in policy article A52490 holds 52 codes. Every one is an L89 pressure ulcer code for the back, hip or buttock. Nothing outside that set will support the claim on its own.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The pattern is easy to hold in your head. Take the trunk and pelvis subcategories, then keep only the stage 2, stage 3, stage 4 and unstageable codes.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Site<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Subcategories on the list<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Example code<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Back, including the sacral region<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.10-, L89.11-, L89.12-, L89.13-, L89.14-, L89.15-<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.153, pressure ulcer of sacral region, stage 3<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Hip<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.20-, L89.21-, L89.22-<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.214, pressure ulcer of right hip, stage 4<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Buttock<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.30-, L89.31-, L89.32-<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.322, pressure ulcer of left buttock, stage 2<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Contiguous site of back, buttock and hip<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.42, L89.43, L89.44, L89.45<\/td>\n<td style=\"padding:12px 16px;color:#374151\">L89.44, contiguous site, stage 4<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The exclusions matter just as much, and they are where audits find money. These do not appear on the list at all:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stage 1 and deep tissue pressure injury codes.<\/strong> The sixth character 1 and 6 codes are absent throughout.<\/li>\n\n\n\n<li><strong>Unspecified stage codes.<\/strong> L89.90 and every other sixth character 9 code will not support the claim.<\/li>\n\n\n\n<li><strong>Ulcers away from the trunk and pelvis.<\/strong> Elbow, ankle, heel, other site and unspecified site are all outside the policy.<\/li>\n\n\n\n<li><strong>Risk and mobility diagnoses on their own.<\/strong> Paraplegia, muscle wasting and personal history codes may add context, but they cannot carry the claim.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Heel ulcers cause the most confusion here. They are common and serious, but the policy is written around the trunk and pelvis, so the surface is not covered. The wound care itself still bills separately under codes such as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-97597\/\">97597<\/a>.<\/p>\n\n\n\n<h2 id=\"h-e0371-rents-by-the-month-so-the-modifiers-change-with-it\" class=\"wp-block-heading\">E0371 rents by the month, so the modifiers change with it<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">E0371 sits in the capped rental category, not the purchase category. That single fact decides most of the modifier work, and getting it wrong is a common reason for a rejected line.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare pays a monthly rental for up to 13 months of continuous use. Payment drops by 25 percent from the fourth month onward. After the thirteenth paid month, title transfers to the patient. That happens on the first day after the last rental month, and Medicare then covers reasonable maintenance and servicing.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When it goes on the line<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">RR<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Every rental month, alongside the KH, KI or KJ modifier<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">KH<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First rental month<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">KI<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Second and third rental months<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">KJ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fourth rental month onward<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">KX<\/td>\n<td style=\"padding:12px 16px;color:#374151\">All LCD criteria are met and the evidence is on file<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">GA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Criteria are not met and you hold a signed ABN<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">GZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Criteria are not met and there is no valid ABN<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">KX, GA and GZ are not optional. A52490 states that a claim line billed without one of the three is rejected as missing information, so it never reaches a coverage decision.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two older habits are worth retiring. NU marks new purchased equipment, so it does not belong on a capped rental line. And since January 1, 2023, Certificates of Medical Necessity are gone. A claim that arrives with a CMN attached is rejected and returned.<\/p>\n\n\n\n<h3 id=\"h-when-a-switch-restarts-the-rental-clock-and-when-it-does-not\" class=\"wp-block-heading\">When a switch restarts the rental clock, and when it does not<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Work through a real sequence. A patient with a stage 4 sacral ulcer starts on a powered overlay, E0372, in January. By April the wound has worsened, so you switch them to a nonpowered advanced overlay, E0371.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The rental clock does not restart. Both codes are Group 2 overlays, so Medicare treats them as not significantly different. Month four of the original series simply continues on the new code, even if a different supplier takes over.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Change one detail and the answer flips. Move the same patient to a powered Group 2 mattress under <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-e0277\/\">E0277<\/a> and a new capped rental period does begin. A mattress and an overlay count as different groupings.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CMS treats these five groupings as significantly different from one another:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Group 1 overlays<\/li>\n\n\n\n<li>Group 1 mattresses<\/li>\n\n\n\n<li>Group 2 overlays<\/li>\n\n\n\n<li>Group 2 mattresses and beds<\/li>\n\n\n\n<li>Group 3 beds<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-three-place-of-service-questions-that-decide-payment\" class=\"wp-block-heading\">Three place of service questions that decide payment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Place of service is the quiet denial. The clinical record can be flawless, but if the patient was not in a qualifying setting, the DME MAC does not pay. Three questions settle almost every case.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Which POS code goes on a home delivery?<\/strong> POS 12. That covers a private residence, and it is the setting the DME benefit is written around.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Can you bill for a patient living in a facility?<\/strong> Sometimes. A facility only counts as the patient&rsquo;s home when it does not meet Medicare&rsquo;s definition of a hospital or a skilled nursing facility. Assisted living and many nursing facilities qualify, so POS 13, 14 or 32 can be correct.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What about a Part A skilled nursing facility stay?<\/strong> Do not bill the DME MAC. During a covered Part A stay, the facility is paid for the equipment. A POS 31 line sends the wrong claim to the wrong payer.<\/p>\n\n\n\n<h2 id=\"h-run-this-checklist-before-you-submit-an-e0371-claim\" class=\"wp-block-heading\">Run this checklist before you submit an E0371 claim<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most denials on this code come from four or five recurring holes. Walk the list once before the request goes out, and again before the claim does.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Standard Written Order on file.<\/strong> Signed, dated, and received before you bill. No CMN, and no order written after delivery.<\/li>\n\n\n\n<li><strong>One of the three criteria evidenced.<\/strong> Ulcer stage, site and history in the practitioner&rsquo;s own notes, not summarized by the supplier.<\/li>\n\n\n\n<li><strong>The month of Group 1 treatment documented<\/strong> if you are relying on criterion 1. All six elements, with dates.<\/li>\n\n\n\n<li><strong>An ICD-10 code from the covered list.<\/strong> Trunk or pelvis, coded to stage, never the unspecified stage version.<\/li>\n\n\n\n<li><strong>Affirmed <a href=\"https:\/\/pabau.com\/templates\/medical-prior-authorization-form\/\">prior authorization<\/a> with a live UTN.<\/strong> Delivered within one month of the decision date.<\/li>\n\n\n\n<li><strong>The right modifier stack.<\/strong> RR plus KH, KI or KJ for the month, plus KX, GA or GZ.<\/li>\n\n\n\n<li><strong>A PDAC-verified product.<\/strong> Confirm the exact model appears on the Product Classification List under E0371.<\/li>\n\n\n\n<li><strong>Proof of delivery retained.<\/strong> It is a supplier standard, and reviewers ask for it.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-e0371\/track-claims-from-start-to-finish.webp\" alt=\"Pabau claims dashboard tracking a claim from submission to payment\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s claim tracking shows the status of every E0371 rental month in one view, so nothing gets chased across two systems.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The rate itself is the one thing you can&rsquo;t memorize. E0371 is priced per state on the <a href=\"https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/dmepos\/dmepos-fee-schedule\" target=\"_blank\" rel=\"nofollow noopener\">DMEPOS fee schedule<\/a>, which is republished every quarter. Pull the current file rather than the physician fee schedule lookup, which does not price DME at all.<\/p>\n\n\n\n<h2 id=\"h-how-e0371-compares-with-the-other-group-2-codes\" class=\"wp-block-heading\">How E0371 compares with the other Group 2 codes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Group 2 holds five codes, and picking between them is a product question rather than a clinical one. Match the code to what the delivery ticket says you supplied.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">What it describes<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Powered<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Form and minimum height<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">E0371<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Nonpowered advanced pressure reducing overlay for mattress<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Overlay, 3 inches or greater<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">E0372<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Powered air overlay for mattress<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Overlay, inflated cell height 3.5 inches or greater<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">E0373<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Nonpowered advanced pressure reducing mattress<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Full mattress, 5 inches or greater<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">E0277<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Powered pressure reducing air mattress<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Full mattress, inflated cell height 5 inches or greater<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">E0193<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Powered air flotation bed, low air loss therapy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hospital bed with an integrated powered surface<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">E0371 against E0373 is the pair that causes the most rework. E0371 lies on top of the patient&rsquo;s existing mattress. E0373 replaces the mattress and sits straight on the bed frame. Bill one when you supplied the other and the coding is wrong, whatever the intent.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One more thing is worth saying plainly, because it circulates in coding forums and vendor sheets. There is no HCPCS code E0374. Where a crosswalk or product catalog shows it, the item you supplied is almost certainly E0373 or E0277.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The bed frame underneath the surface follows the same DMEPOS rules. Our hospital bed guides for <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-e0293\/\">E0293<\/a> and <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-e0302\/\">E0302<\/a> cover that side of the order.<\/p>\n\n\n\n<h2 id=\"h-how-pabau-keeps-e0371-documentation-ready-before-delivery\" class=\"wp-block-heading\">How Pabau keeps E0371 documentation ready before delivery<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Prior authorization changes what good documentation means. The record no longer has to survive an audit months later. It has to be complete on the day the request goes out. Practices that keep wound notes in one system and billing in another tend to find the missing record at submission. By then the clock is already running.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau closes that distance by keeping the clinical record and the claim in one place. Wound assessments, staged photos, practitioner orders, <a href=\"https:\/\/pabau.com\/templates\/patient-discharge-form\/\">discharge records<\/a> and treatment history all sit on the same patient file. Assembling a request package then means pulling records rather than chasing them.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two features do most of the work here. Pabau&rsquo;s <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">digital forms<\/a> can be built around the six elements of the Group 1 treatment program. Nurses then capture ulcer stage, site, turning schedule and nutrition notes at the bedside.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&rsquo;s <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management tools<\/a> then keep each rental month tied to that record, so nothing is reconstructed after a rejection.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-e0371\/customizable-consent-and-intake-forms.webp\" alt=\"Pabau customizable intake and consent form builder\"\/><figcaption class=\"wp-element-caption\"><em>Custom intake forms in Pabau hold the Group 2 wound fields, so ulcer stage and site are recorded before the request goes out.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The outcome is a shorter path from assessment to affirmation. Teams in <a href=\"https:\/\/pabau.com\/industry\/gp-clinic-software\/\">primary care<\/a> and <a href=\"https:\/\/pabau.com\/industry\/physical-therapy-emr\/\">physical therapy<\/a> practices see fewer non-affirmed requests, and billers stop rebuilding records that already exist somewhere in the practice.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Get E0371 documentation right the first time                <\/h3>\n\n                <p class=\"description\">\n                    Pabau keeps wound assessments, orders and claim history on one patient record, so your prior authorization package is complete before the overlay is delivered.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">E0371 rewards preparation over persistence. Because prior authorization sits ahead of delivery, an appeal months later cannot rescue a record that was thin on the day of the request.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So build the work backward from the decision letter. Capture the ulcer stage and site the way the ICD-10 list expects, and document all six parts of the treatment program. Then confirm the product sits on the PDAC list before anything ships.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Do that consistently and the 90 percent affirmation rate that earns an exemption stops looking out of reach. The trade-off is straightforward, since more effort upfront buys far less rework later. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau keeps wound care documentation and DME claims on one record, ready before the request goes out.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing the wound treatment as well as the surface?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-g0281\/\">HCPCS code G0281<\/a> covers electrical stimulation for chronic pressure ulcers that have stopped improving.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Reaching for a skin substitute?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-q4101\/\">HCPCS code Q4101<\/a> sets out the Apligraf billing rules for chronic wound care.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Certifying a home health plan of care?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-g0179\/\">HCPCS code G0179<\/a> explains the physician recertification rules that sit alongside a DME order.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Debriding an ulcer down to bone?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-11044\/\">CPT code 11044<\/a> walks through the depth rules that decide which debridement code you bill.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Chasing wound assessments after the fact?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/medical-forms-at-your-healthcare-practice\/\">Completing forms before appointments<\/a> shows how form design captures required fields at the point of care.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786620376544\"><h3 class=\"schema-faq-question\">Does E0371 require a face-to-face encounter before delivery?<\/h3> <p class=\"schema-faq-answer\">No. E0371 is not on the CMS list of codes that require a face-to-face encounter and a written order prior to delivery. A Standard Written Order is still mandatory before you bill, and the medical record still has to support the Group 2 criteria.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786620376545\"><h3 class=\"schema-faq-question\">Who submits the E0371 prior authorization request?<\/h3> <p class=\"schema-faq-answer\">The supplier submits it in almost every case, and CMS calls that party the requester. A beneficiary may send their own request, though CMS encourages them to work through the supplier. The practitioner supplies the records either way.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786620376546\"><h3 class=\"schema-faq-question\">Do Medicare Advantage plans follow the same E0371 rules?<\/h3> <p class=\"schema-faq-answer\">Not always. Advantage plans must cover at least what Original Medicare covers, but they set their own authorization forms, timelines and supplier networks. Check the plan&rsquo;s own DME policy before you deliver.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786620376547\"><h3 class=\"schema-faq-question\">When can an E0371 overlay be replaced?<\/h3> <p class=\"schema-faq-answer\">Once the patient owns it after 13 rental months, Medicare&rsquo;s five-year reasonable useful lifetime applies. Before that point, a replacement is payable only if the item is lost, stolen or damaged beyond repair.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786620376548\"><h3 class=\"schema-faq-question\">Can you bill the patient after a non-affirmed decision?<\/h3> <p class=\"schema-faq-answer\">Only if you hold an Advance Beneficiary Notice signed before delivery. Add the GA modifier so the denial shifts liability to the patient. Without that notice, the charge stays with you.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>HCPCS code E0371 pays for a nonpowered advanced pressure reducing overlay that sits on a standard mattress. Medicare decides this one before the overlay reaches the patient, because prior authorization is mandatory ahead of delivery. That sequence catches suppliers out. E0371 has sat on the required prior authorization list nationwide since October 2019. No affirmed [&hellip;]<\/p>\n","protected":false},"author":85,"featured_media":178418,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"81","_yoast_wpseo_content_score":"60","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1548],"tags":[],"class_list":["post-178419","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-hcpcs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>HCPCS code E0371: Prior authorization and billing guide<\/title>\n<meta name=\"description\" content=\"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HCPCS code E0371: Prior authorization and billing guide\" \/>\n<meta property=\"og:description\" content=\"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-14T08:17:02+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-14T09:28:34+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-e0371.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Monika Lazarevska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Monika Lazarevska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"15 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/\"},\"author\":{\"name\":\"Monika Lazarevska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/5763062f66fccbf75a390f99ee0b985a\"},\"headline\":\"HCPCS code E0371: Prior authorization and billing guide\",\"datePublished\":\"2026-08-14T08:17:02+00:00\",\"dateModified\":\"2026-08-14T09:28:34+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/\"},\"wordCount\":3033,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/hcpcs-code-e0371.webp\",\"articleSection\":[\"Billing Codes\",\"HCPCS\"],\"inLanguage\":\"fr-FR\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/\",\"name\":\"HCPCS code E0371: Prior authorization and billing guide\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/hcpcs-code-e0371.webp\",\"datePublished\":\"2026-08-14T08:17:02+00:00\",\"dateModified\":\"2026-08-14T09:28:34+00:00\",\"description\":\"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.\",\"mainEntity\":[{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376544\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376545\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376546\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376547\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376548\"}],\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#primaryimage\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/hcpcs-code-e0371.webp\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/hcpcs-code-e0371.webp\",\"width\":1200,\"height\":630},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/\",\"name\":\"Pabau\",\"description\":\"Clinic Software for your Business | Go Paperless Today\",\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/pabau.com\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\",\"name\":\"Pabau\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2022\\\/05\\\/Logo-4-e1654525062364.png\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2022\\\/05\\\/Logo-4-e1654525062364.png\",\"width\":736,\"height\":195,\"caption\":\"Pabau\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/Pabau\\\/\",\"https:\\\/\\\/x.com\\\/pabaucrm\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/pabau-ltd\\\/\",\"https:\\\/\\\/www.instagram.com\\\/pabausoftware\\\/\"],\"description\":\"Pabau is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/5763062f66fccbf75a390f99ee0b985a\",\"name\":\"Monika Lazarevska\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg\",\"caption\":\"Monika Lazarevska\"},\"description\":\"Monika Lazarevska writes content for owners and healthcare professionals who want clear, no-fluff content that actually helps them run their practice better. With a background in storytelling and SEO, she knows how to make even the driest topics worth reading. Off the clock, you'll find her in a caf\u00e9 somewhere in Europe, probably with a good book and an even better coffee.\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/blog\\\/author\\\/monika-lazarevska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376544\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376544\",\"name\":\"Does E0371 require a face-to-face encounter before delivery?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. E0371 is not on the CMS list of codes that require a face-to-face encounter and a written order prior to delivery. A Standard Written Order is still mandatory before you bill, and the medical record still has to support the Group 2 criteria.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376545\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376545\",\"name\":\"Who submits the E0371 prior authorization request?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The supplier submits it in almost every case, and CMS calls that party the requester. A beneficiary may send their own request, though CMS encourages them to work through the supplier. The practitioner supplies the records either way.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376546\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376546\",\"name\":\"Do Medicare Advantage plans follow the same E0371 rules?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Not always. Advantage plans must cover at least what Original Medicare covers, but they set their own authorization forms, timelines and supplier networks. Check the plan's own DME policy before you deliver.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376547\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376547\",\"name\":\"When can an E0371 overlay be replaced?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Once the patient owns it after 13 rental months, Medicare's five-year reasonable useful lifetime applies. Before that point, a replacement is payable only if the item is lost, stolen or damaged beyond repair.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376548\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-e0371\\\/#faq-question-1786620376548\",\"name\":\"Can you bill the patient after a non-affirmed decision?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Only if you hold an Advance Beneficiary Notice signed before delivery. Add the GA modifier so the denial shifts liability to the patient. Without that notice, the charge stays with you.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"HCPCS code E0371: Prior authorization and billing guide","description":"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/","og_locale":"fr_FR","og_type":"article","og_title":"HCPCS code E0371: Prior authorization and billing guide","og_description":"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.","og_url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/","og_site_name":"Pabau","article_publisher":"https:\/\/www.facebook.com\/Pabau\/","article_published_time":"2026-08-14T08:17:02+00:00","article_modified_time":"2026-08-14T09:28:34+00:00","og_image":[{"width":1200,"height":630,"url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-e0371.webp","type":"image\/webp"}],"author":"Monika Lazarevska","twitter_card":"summary_large_image","twitter_creator":"@pabaucrm","twitter_site":"@pabaucrm","twitter_misc":{"\u00c9crit par":"Monika Lazarevska","Dur\u00e9e de lecture estim\u00e9e":"15 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#article","isPartOf":{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/"},"author":{"name":"Monika Lazarevska","@id":"https:\/\/pabau.com\/fr\/#\/schema\/person\/5763062f66fccbf75a390f99ee0b985a"},"headline":"HCPCS code E0371: Prior authorization and billing guide","datePublished":"2026-08-14T08:17:02+00:00","dateModified":"2026-08-14T09:28:34+00:00","mainEntityOfPage":{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/"},"wordCount":3033,"publisher":{"@id":"https:\/\/pabau.com\/fr\/#organization"},"image":{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#primaryimage"},"thumbnailUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-e0371.webp","articleSection":["Billing Codes","HCPCS"],"inLanguage":"fr-FR"},{"@type":["WebPage","FAQPage"],"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/","url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/","name":"HCPCS code E0371: Prior authorization and billing guide","isPartOf":{"@id":"https:\/\/pabau.com\/fr\/#website"},"primaryImageOfPage":{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#primaryimage"},"image":{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#primaryimage"},"thumbnailUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-e0371.webp","datePublished":"2026-08-14T08:17:02+00:00","dateModified":"2026-08-14T09:28:34+00:00","description":"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.","mainEntity":[{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376544"},{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376545"},{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376546"},{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376547"},{"@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376548"}],"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#primaryimage","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-e0371.webp","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-e0371.webp","width":1200,"height":630},{"@type":"WebSite","@id":"https:\/\/pabau.com\/fr\/#website","url":"https:\/\/pabau.com\/fr\/","name":"Pabau","description":"Clinic Software for your Business | Go Paperless Today","publisher":{"@id":"https:\/\/pabau.com\/fr\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/pabau.com\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/pabau.com\/fr\/#organization","name":"Pabau","url":"https:\/\/pabau.com\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/pabau.com\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/pabau.com\/wp-content\/uploads\/2022\/05\/Logo-4-e1654525062364.png","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2022\/05\/Logo-4-e1654525062364.png","width":736,"height":195,"caption":"Pabau"},"image":{"@id":"https:\/\/pabau.com\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/Pabau\/","https:\/\/x.com\/pabaucrm","https:\/\/www.linkedin.com\/company\/pabau-ltd\/","https:\/\/www.instagram.com\/pabausoftware\/"],"description":"Pabau is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.","foundingDate":"2011-10-20","numberOfEmployees":{"@type":"QuantitativeValue","minValue":"201","maxValue":"500"}},{"@type":"Person","@id":"https:\/\/pabau.com\/fr\/#\/schema\/person\/5763062f66fccbf75a390f99ee0b985a","name":"Monika Lazarevska","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cropped-Monika-Lazarevska-skala-2-1-e1783430903842-1-96x96.jpg","caption":"Monika Lazarevska"},"description":"Monika Lazarevska writes content for owners and healthcare professionals who want clear, no-fluff content that actually helps them run their practice better. With a background in storytelling and SEO, she knows how to make even the driest topics worth reading. Off the clock, you'll find her in a caf\u00e9 somewhere in Europe, probably with a good book and an even better coffee.","url":"https:\/\/pabau.com\/fr\/blog\/author\/monika-lazarevska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376544","position":1,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376544","name":"Does E0371 require a face-to-face encounter before delivery?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. E0371 is not on the CMS list of codes that require a face-to-face encounter and a written order prior to delivery. A Standard Written Order is still mandatory before you bill, and the medical record still has to support the Group 2 criteria.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376545","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376545","name":"Who submits the E0371 prior authorization request?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The supplier submits it in almost every case, and CMS calls that party the requester. A beneficiary may send their own request, though CMS encourages them to work through the supplier. The practitioner supplies the records either way.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376546","position":3,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376546","name":"Do Medicare Advantage plans follow the same E0371 rules?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Not always. Advantage plans must cover at least what Original Medicare covers, but they set their own authorization forms, timelines and supplier networks. Check the plan's own DME policy before you deliver.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376547","position":4,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376547","name":"When can an E0371 overlay be replaced?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Once the patient owns it after 13 rental months, Medicare's five-year reasonable useful lifetime applies. Before that point, a replacement is payable only if the item is lost, stolen or damaged beyond repair.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376548","position":5,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-e0371\/#faq-question-1786620376548","name":"Can you bill the patient after a non-affirmed decision?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Only if you hold an Advance Beneficiary Notice signed before delivery. Add the GA modifier so the denial shifts liability to the patient. Without that notice, the charge stays with you.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"hcpcs code e0371","seo_title":"HCPCS code E0371: Prior authorization and billing guide","meta_description":"HCPCS code E0371 needs Medicare prior authorization before delivery. See Group 2 criteria, capped rental modifiers, and denial fixes.","content_score":"60","is_cornerstone":"","related_keyphrases":[{"keyword":"nonpowered advanced pressure reducing overlay","score":67},{"keyword":"e0371 documentation requirements","score":61},{"keyword":"group 2 support surface medicare","score":56},{"keyword":"dme hcpcs codes billing","score":61},{"keyword":"e0371 coverage criteria","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/178419","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/users\/85"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/comments?post=178419"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/178419\/revisions"}],"predecessor-version":[{"id":180332,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/178419\/revisions\/180332"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media\/178418"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media?parent=178419"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/categories?post=178419"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/tags?post=178419"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}