Description:
An air fluidized bed is a device employing the circulation of filtered air through ceramic spherules (small, round ceramic objects) that is marketed to treat or prevent bedsores or to treat extensive burns.

An air fluidized bed uses warm air under pressure to set small ceramic beads in motion, which simulate a fluid movement. When the patient is placed in the bed, his/her body weight is evenly distributed over a large surface area, which creates a sensation of floating.

Policy:
Use of the air fluidized bed is considered MEDICALLY NECESSARY when ALL of the following indications are met for patients who:

• Are bedridden and are unable to fully or partially ambulate.
• Have a stage 3 (full-thickness tissue loss) or stage 4 (deep tissue destruction) pressure sore.
• Have exhausted conservative treatment without improvement.
• In the absence of an air fluidized bed, the patient would require institutionalization.
• Have a trained adult caregiver available to assist the patient with activities of daily living, fluid balance, dry skin care, repositioning, recognition and management of altered mental status, dietary needs, prescribed treatments and management and support of the air fluidized bed system and its problems, such as leakage.
• Have a physician who directs the home treatment regimen and re-evaluates and recertifies the need for the air fluidized bed on a monthly basis.
• Have utilized and ruled out all other alternative equipment. Such alternatives include, but are not limited to, gel flotation pads, egg crate mattresses and pressure pads and pumps.

Home use of the air fluidized bed is NOT MEDICALLY NECESSARY under ANY of the following circumstances:

• The patient requires treatment with wet soaks or has moist wound dressings that are not protected with an impervious covering such as plastic wrap.
• The caregiver is unable to provide the type of care required by the patient on an air fluidized bed.
• Structural support is inadequate to support the weight of the air fluidized system (it weighs 1,600 pounds or more).
• The home electrical system is insufficient for the anticipated increase in energy consumption.

References:

1. Hayes, Inc., The Health Technology Assessment Company. Negative Pressure Wound Therapy for Wound Healing. Published: July 28, 2003.
2. National Institute for Clinical Excellence (NICE). The prevention and treatment of pressure ulcers. Clinical Guideline No. 29. London, UK: NICE; 2005.
3. Nixon J, Nelson E A, Cranny G, et al.; PRESSURE Trial Group. Pressure relieving support surfaces: A randomised evaluation. Health Technol Assess. 2006;10(22):1-180.
4. Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: A systematic review. JAMA. 2006;296(8):974-984.

Coding Section

Procedure and diagnosis codes on Medical Policy documents are included only as a general reference tool for each policy. They may not be all-inclusive.

Index
Air Fluidized Beds
Beds, Air Fluidized
Clinitron Beds

This medical policy was developed through consideration of peer-reviewed medical literature generally recognized by the relevant medical community, U.S. FDA approval status, nationally accepted standards of medical practice and accepted standards of medical practice in this community, Blue Cross Blue Shield Association technology assessment program (TEC) and other non-affiliated technology evaluation centers, reference to federal regulations, other plan medical policies and accredited national guidelines.

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