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...
Hi,
I have a patient with scleroderma and raynaud's disease with a painful necrotic ulcer of the right 2nd fingertip, non healing > 6 months. She has seen hand surgery who suggests avoidance of debri...
Hi,
I currently have very limited information on an incoming patient. History of oral cancer 12/2022 with 8 weeks radiation, most recent treatment 4/2023. Referred by surgeon for preparation of ir...
Wondering the recommendation for EEG leads in HBO. How long the glue needs to dry in order to safely treat patient in Multi Place Chamber. Also is there any safety concerns with having a E cylinder ...
We are an outpatient hospital based wound center in southern California under Noridian. Is Epifix amniotic tissue product covered under CMS for only venous leg ulcers, or does coverage extend to ulcer...
Hello, there was a post in May of 2022 regarding the Dexcom G6. The conclusion was that there are no significant safety concerns with subjecting Dexcom G6 CGM transmitters to hyperbaric environments b...
She is a 69 yrs old and an ambulatory patient and nutrition is adequate. She is T2DM and Blood glucose is well controlled with metformin and A1c is 5.6.
Recently she had a whipple surgery in 5 mo...
We have a patient who qualifies for HBOT DFU G3, however he does have a peritoneal catheter for dialysis. Is there any reason as to why he could not dive? We do not see a reason not to, but since th...
Hello,
We have an HBO candidate who had 17 SRT treatments over a year and a half ago. Just making sure that since it was not Ionizing radiation, it is not covered under HBO guidelines?
thank you...
70 year old male with cryoglobulinemic vasculitis, multiple ulcers to the feet and fingers, in various stages of tissue necrosis. The ulcers are quite extensive and he is at risk for amputation. His p...
Hello,
I am more accustomed to dealing with open wounds as opposed to dermatological issues ( fungal infections of the skin, dermatitis). Is there a good resource that can be useful for learni...
Hello there team,
We have been seeing an increase in patients with these acute and chronic inflammatory ulcers (via Pathology report) mostly with medial lower leg ulcers that are very fibrotic. ...
