Additionally, patient has a wound on right 2nd toe, and MRI results are positive for acute osteomyelitis. Patient was treated with antibiotics and had toe amputated. Is there any contraindications fo...
67 YO female patient with primary colorectal CA treated with surgery, chemotherapy and radiation. Developed coccygeal abscess and subsequent large, non-healing soft tissue defect/ wound due to late ef...
Patient 89 y/o bedbound, currently receiving care for right buttock wound of 3+months. Patient's PCP recently started on wound vac therapy last week and reports decrease in size already. Due to wound ...
12/13/24 by
DMC,
75 yo M with large fungating penile mass has been present for years but patient has previously declined treatment or evaluation went to the clinic today for worsening constipation and pain. His clinic...
Hi, can you direct me to a resource regarding maintaining the consistency of HBOT (particularly for ORN patients) versus titrating treatments down to 2 times per week from 5 days per week? Thank you!
Have been treating pt in HBO for CRO. Recently hospitalized for cellulitis and was taken to OR by Podiatrist with Bone Bx of 1st, 3rd, and 5th Metatarsal Right Foot. Prolene Sutures 3-0 and 1-0 applie...
Thank you for your guidance regarding dermal product approved list and indications. We do have the approved CMS list for VLU and DFU. Do you know if there is an option to apply dermal products not on ...
Patient was previously admitted with the same sacral wound. We have ordered for the application of iodosorb for the slough at this time but would like to see receive your recommendations.
What are the points and counter-points of comparing patient outcomes for using skin grafts versus HBO to treat non-healing wounds about the knee.
Good evening,
Where would I be able to locate literature evidence on whether or not utilizing sterile technique/sterile gloves for sharp debridement and wound dressings decreases incidence of wound ...
I am new at this. Can Aquacel Ag+, ribbon, sheets, etc go into a monoplace hyperbaric chamber.? The risk assessment tool gave it a #3, "high risk" and the ribbon was almost a #4. Not sure why. Plus th...
Hi! We have a maxillofacial surgeon's office that regularly sees patients with medication-related osteonecrosis of the jaw. They rarely start off with IV antibiotic treatment. The usual coarse is ma...
Patient with type 2 DM required a BKA with a history of Wagner 4 DFU prior. Developed eschar at the amputation site and was sent to vascular surgery, with further revascularization attempts made. He i...
11/15/24 by
Bill Khoury,
What protocols are out there for comfort care/palliative patients for the inpatient acute care setting?
Are there care-plans that are designed for comfort care/palliative care patients in the acute c...
Is there evidence that HBOT can help mental health? Specifically, depression and anxiety?
I'm looking for ideas and information on how to handle wound cleansers/dressings in the hospital outpatient department.
Do you have single use wound cleanser? Or do you keep one bottle and wipe it ...
A patient was referred back to HBOT in June 2024 by her maxillofacial surgeon and has completed 78 treatments since that time. Recent maxillofacial surgeon note states now stage 2. Surgeon continues t...
Hello! I have an 88-year-old male who is hoping to receive HBO TX. He had a Toria intraocular lens implanted in February 2024 to correct cataracts. Can you please help me to know if this lens is compa...
Is there a case study on the hbo effects on treating PTSD
11/5/24 by
Jay Braun,
Hello! A referral, from ID actually, was received for a patient with soft tissue radiation necrosis (radiation cystitis). Hx: prostate cancer, s/p radical prostatectomy. Current symptoms include pelv...
Unna boots versus urgo wraps
Any recommendations for patients that required myringotomy tubes as a result of Middle Ear barotrauma or eustachian tube dysfunction when finished with HBOT? We are trying to keep our ENTs up to date ...
Nearly every search I perform asking this question results in "Yes", Medicare will cover HBOT for Central Retinal Arterial Occlusion. Wound Reference specifically says "NO". How does this differ from ...
Hi. Looking for thoughts on this incoming referral for STRN from neurologist. Hx: Presented with memory issues and confusion, lesion on MRI, surgery Dec 2022, pathology (+) glioblastoma, EBRT plus te...
Hello,
For patients with a trach, how do you deliver your air break in a mono chamber? Thanks.
Hi I have a payer denial, BCBS of SC stating the HBO is investigational on the following patient's condition. It was preapproved with the codes below. I'm thinking this may be a coding issue. Would...
Hi! Our clinic received a referral for a patient with recurrent gross hematuria. History of T-cell large granular lymphocytic leukemia, s/p chemo and bone marrow transplant (2023). Developed hemorrha...
We have a diabetic with multiple comorbidities that has a surgical chronic wound from a spinal surgery. Has anyone done HBO for this type of wound in this location?
Hi, Are there any known issues with concurrent use of Zytiga and HBOT. We have a patient with radiation cystits and hematuria, history of adenocarcinoma of the prostate in 2012, >7000 cGy radiation, s...
We are a hospital based outpatient wound & hyperbaric center. We were told by our hospital coder that we can bill our patient visits based on either time or element complexity. In addition, one of the...
Hi, I have a 72 year old male referred by urology for radiation cystitis with hematuria. He has a history of a subdural hematoma, 4mm midline shift which required a craniotomy 3-4 years ago. No neurol...
Hello,
Are there other tips or tricks for bandages that slip. More specifically, on patients that have normal shaped leg contours. I am aware of using extra padding for " wine bottle shaped l...
I would like your thoughts of diving a patient with diagnosis of complex regional pain syndrome type 2. Past history of crush injury to right foot 18 years ago with recurring and worsening right foot ...
Patient referred to HBOT for STRN at site of right breast cancer s/p radiation to R breast in 2014. 45 Gy to whole R breast, 61 Gy to tumor bed, R breast. Presenting with pain, mild induration, and u...
Is it possible that Dakins, with a pH of 9-10, can really be noncytotoxic?
We have a patient who is diving for Late effects of radiation. The patient is only able to come on Monday Tuesday and Friday. Would this be a beneficial treatment plan for the patient, or should pat...
Are there any special precautions taken for an HBO candidate with an ICD, which is rated for pressurization. Assuming the patient meets all other criteria. I haven't seen any specific guidelines from ...
Hello I was wondering if Radiation Pneumonitis is an indication for hyperbaric medicine, STRN? The patient continues to have right pleural effusions that require drainage. What is the heal rate like?...
My question is regarding qualification for skin substitutes. Per the CMS LCD: "For purposes of this LCD a Failed Response is defined as an ulcer or skin deficit that has failed to respond to documente...
I was diving a patient for mandible RON. Most recent PET scan shows pelvic bone metastasis. ORAL surgeon called the patient stating that HBO is spreading cancer and she has to stop it. What would be a...
Hi! Dialysis Pt with history of PAD,left BKA, bedbound and right leg contracture. Right lateral foot has arterial ulcer with exposed tendon. Pt non adherent to offloading. Referred to vascular, pt is ...
Hello, I was wondering if velcro trach collars were allowed in Monoplace chambers.
Program director says if wound is sutured closed after debridement of Osteo, it then no longer qualifies for HBO because there is no open wound. I have always thought that sutured is not healed, and m...
Everyone says you can't have a thigh wound with Wagner Grade3, but the code is listed by CMS in Group 2. Thoughts?
I have a 75 y/o M who had an extensive multiloculated soft tissue abscess in the lower lumbar and sacral subcutaneous tissue. This measured 15 x 6 cm transversely and 14 cm superior to inferior. He ...
I cannot remember where I saw the information for total contact cast and HBO. The cast has to be done after the Patient's HBO treatment. Not before? So, if the patient had a doctor visit for cast plac...
I have been working with a 60 y.o. male over the last 9 days who came into the acute care setting w/cellulitis to the LLE which escalated significantly over his stay. Blood cultures came back positive...
I have read osteoradionecrosis -Mandible should be at 2.5ATA, however DFUs and Chronic Osteo can range from 2.0 to 2.5 ATA. What makes the difference in choosing 2.0 vs 2.5 ATA? Is 2.5ATA preferred ...
Located in Indiana. Over the past year we have received a couple denials for HBOT with Anthem Medicaid.
In the denial letter Anthem references the MCG 27th Edition Ambulatory Care Guideline for HB...
Hello,
Looking for clarification on proper use of the I70 codes that are listed under "Group 2 - Wound Ulcer Codes" and include various locations of the leg and foot.
I have a patient with DM, n...
