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Tiffany Hamm, BSN, RN, CWS, ACHRN, UHMSADS

Nurse - RN
Industry, Wound care and HBOT, Not Applicable
Tiffany Hamm's Background
An Advanced Certified Hyperbaric Registered Nurse and Certified Wound Specialist with expertise in billing, coding and reimbursement specific to hyperbaric medicine and wound care services. UHMS Accreditation Surveyor and Safety Director. Principal partner of Midwest Hyperbaric LLC, a hyperbaric and wound consultative service. Tiffany received her primary and advanced hyperbaric training through National Baromedical Services in Columbia South Carolina. In 2021, Tiffany received the UHMS Associate Distinguished Service Award. "This award is presented to individual Associate member of the Society whose professional activities and standing are deemed to be exceptional and deserving of the highest recognition we can bestow upon them . . . who have demonstrated devotion and significant time and effort to the administrative, clinical, mechanical, physiological, safety, technical practice, and/or advancement of the hyperbaric community while achieving the highest level of expertise in their respective field. . . demonstrating the professionalism and ethical standards embodied in this recognition and in the UHMS mission.”

About Wound Reference
WoundReference is the only decision support platform designed exclusively for wound care and hyperbaric oxygen clinicians. Our point-of-care tools enable clinicians to work more efficiently.

Undersea and Hyperbaric Medical Society, Baromedical Nurse Association, American Board of Wound Management
  • HBO Treatment Indications With Protocols
    Hyperbaric Oxygen Therapy Treatment Protocol Guidelines and Indications
  • Wound Exam Notes Generator
    initial assessment SITE:________________________________________________________________________________________ Status: ☐ Being Treated ☐ Closed ☐ Amputated  Surgical Date: _______________ Date Onset: ___________  Pre- Debridement Measurement Length:_________ Width: __________ Depth: _________  Undermining  1. __________ cm, from _________ to _________ o’clock 2. __________ cm, from _________ to _________
  • ICD-10 Coding in HBOT
    Hyperbaric Oxygen Therapy Single and Dual ICD-10 diagnosis codes
  • HBO Physician Orders Overview
    Physician order sets for Hyperbaric Oxygen Therapy
  • Osteoradionecrosis - Mandibular
    Hyperbaric oxygen therapy (HBOT) protocol for osteoradionecrosis (mandibular), with evidence, sample documentation statements, checklists
  • Medical Director Job Description
    Hyperbaric Medical Director Job Summary
  • HBO Threshold Levels
    Hyperbaric Oxygen Therapy treatment threshold levels (lower limit, upper limit/utilization review)
  • Certified Hyperbaric Registered Nurse (CHRN)
    Hyperbaric Oxygen Therapy job description for Certified Hyperbaric Registered Nurse (CHRN)
  • Certified Hyperbaric Technologist
    Hyperbaric Oxygen Therapy Job Description for Certified Hyperbaric Technologist (CHT)
  • Staff Physician
    Hyperbaric Oxygen Therapy job description for Staff Physician
  • Go-No-Go Lists / Prohibited Items
    Hyperbaric Oxygen Approved, Restricted and Prohibited Items Examples, Risk Assessment Algorithm, and Prohibited Items Authorization Form
  • * Emergency Procedures
    Hyperbaric Oxygen Therapy Emergency Procedures
  • Standard Operating Procedures
    Hyperbaric Oxygen Therapy Chamber Operations
  • Ancillary Equipment
    Hyperbaric Oxygen equipment such as air break, ground testing and Transcutaneous Oximetry
  • Qualified Healthcare Professional
    Hyperbaric Oxygen Therapy job description for Advanced Practice Registered Nurse, Clinical Nurse Specialist, Physician Assistant
  • Physician Training Guidelines
    Guidelines for physician training in hyperbaric medicine
  • Hyperbaric Medicine - Job Descriptions & Training Guidelines
    Hyperbaric Oxygen Therapy Job descriptions and training guidelines
  • Non-Physician Training Guidelines
    Hyperbaric Oxygen Therapy job Non-physician Training Guidelines
  • Staff Qualifications
    Hyperbaric Oxygen Therapy Staff Qualifications
  • Physician Credentialing Guidelines
    Physicians engaged in the practice of hyperbaric medicine range across the entire spectrum of clinical specialties. This practical topic describes the Undersea and Hyperbaric Medical Society (UHMS)' position on eligibility, training, credentialing and continuing medical education for physicians who engage in the practice of hyperbaric medicine
  • Physician Credentialing Privilege List
    This form lists physician credentialing privileges in hyperbaric medicine and can be used as an evaluation form
  • Nursing Interventions
    Hyperbaric Oxygen Therapy nursing interventions, as recommended by the Baromedical Nurses Association
  • Patient Care
    Hyperbaric Oxygen Therapy patient care procedures
  • Safety Program Guidelines
    Hyperbaric Oxygen Therapy Safety Program Guidelines
  • Diabetic Foot Ulcer - Hyperbaric Oxygen Therapy
    Hyperbaric oxygen therapy (HBOT) protocol for patients with diabetes with lower extremity ulcers
  • HBO Purchase Recommendations
    Hyperbaric Oxygen Therapy Start-up Purchase Checklist
  • HBO Suite - Equipment
    Hyperbaric Oxygen therapy facility equipment list EQUIPMENTQTY  Sechrist – 3600 monoplace chamber 2 Cardiac monitor  2 Cardiac Monitor cable – Internal and External
  • HBO and Wound Care Suite - Equipment
    Hyperbaric Oxygen Therapy and Wound Care Department Equipment List
  • HBO - Ancillary Equipment and Supplies
    Hyperbaric Oxygen Therapy Suite Ancillary Equipment and Supplies list
  • Central Retinal Artery Occlusion
    Hyperbaric oxygen therapy (HBOT) protocol for Central Retinal Artery Occlusion
  • Clostridial Myonecrosis (Gas Gangrene)
    Hyperbaric oxygen therapy for treatment of clostridial myonecrosis. Evidence-based protocol, sample physician order template and documentation templates to support HBO indication. Operational considerations and nursing interventions
  • Decompression Illness and Arterial Gas Embolism
    Hyperbaric oxygen therapy for treatment of decompression illness and arterial gas embolism, evidence-based protocol, sample physician orders, documentation statements, evidence-based GRADE recommendations. Category A Continuing Education Credit
  • Acute Carbon Monoxide Poisoning
    Hyperbaric oxygen therapy (HBOT) protocol for acute carbon monoxide with GRADE recommendation, review of recent evidence, checklist, sample documentation statements. Approved for 1 Category A Continuing Education Credit by the NBDHMT
  • Pyogenic and Invasive Fungal Intracranial Abscesses
    Hyperbaric oxygen therapy for treatment of pyogenic and invasive fungal intracranial abscesses, evidence-based protocol, sample physician order template
  • HBO Medical Staff Credentialing Guidelines
    Hyperbaric Oxygen Therapy Staff Credentialing Guidelines. Links to topics on Medical Director guidelines, job description, and others
  • HBO Initial Patient Evaluation
    Overview of an initial patient evaluation for Hyperbaric Oxygen Therapy
  • An Introduction to Hyperbaric Oxygen Therapy
    Hyperbaric Oxygen Therapy Introduction and Indications for Treatment
  • Inclement weather? Check the Chamber Exhaust Termination Points
    In tornadoes and other harsh weather conditions, the chamber exhaust termination point can become buried in snowdrifts or draped with material resulting from heavy winds
  • Hyperbaric Safety Drills - Are You Prepared?
    Having written procedures in place is one thing, actually practicing them in the form of clinicians' monthly drills is a whole other endeavor. How to make them happen?
  • Active Shooter In A Healthcare Facility
    360 degrees of Safety - how can Safety Directors and hyperbaric facilities be prepared for eventual “active shooter events” (ASE) or “acts of terrorism”?
  • Obtaining Prior Authorization from Non-Medicare Carriers for Hyperbaric Oxygen Therapy
    INTRODUCTIONDenied claims due to unauthorized patient procedures or services can be a major loss in revenue. Although most medical offices and provider based departments are moving closer to 100 percent verification for patient services, there is still no guarantee that every account will be paid. Claims that are denied due to no prior authorization happen primarily in a hospital setting. (1)PROCESSThe coding of HBOT is represen
  • HBO Pre-Determination/ Prior Authorization
    Hyperbaric Oxygen Therapy Predetermination and Prior Authorization Form; easy to use to assist staff with obtaining the correct information.
  • Hyperbaric Chamber History and Consent
    Hyperbaric Oxygen Patient History and Consent
  • Hyperbaric Oxygen Therapy - The 30 Day Requirement For Diabetic Foot Ulcer
    INTRODUCTION HBO2 for DFUs has been shown to improve healing rates and decrease the number of major amputations in the diabetic population. Recent research and evidence have driven the new paradigm of aggressive treatment and the attempt to save a limb, if at all possible, to prevent the morbidity and mortality associated with a major amputation. HBO2 is an accepted and approved treatment for DFUs by the Center for Medicare Studies (CMS) and by third-party insuran
  • Prohibited Items, Risk Assessment And Authorization
    Are you a hyperbaric oxygen therapy Technologist, Nurse, Safety or Medical Director? In any of these roles, you will need to address prohibited items in HBOT
  • Know Your Place Of Service
    Inaccurate information on claims frequently leads to incorrect reimbursement and hassles when trying to fix errors. How can a clinical practice ensure claims are submitted correctly to minimize errors in reimbursement?
  • Quality of Care Requires Ongoing Competency Evaluations
    As clinical processes continue to grow in complexity, it is increasingly vital to patient safety that health care organizations ensure the competence of their care providers. By definition Competency is the application of knowledge and skill in performance. Competency is best assessed via return demonstration and observation.  Additional methods include, but are not limited to, simulation, mock reviews and case studies. Competency is NOT assessed via an education module
  • Housekeeping and the NFPA 99
    According to the NFPA 99 chapter 14 - 14.3.6.4 “A housekeeping program shall be implemented, whether or not the facility is in regular use”. A.14.3.6.4 provides some clarity to 14.3.6.4 – “ It is absolutely essential that all areas of, and components associated with, the hyperbaric chamber be kept meticulously free of grease, lint, dirt and dust. The NFPA 99 2012 edition gives us further guidance regarding the required training for the housekeeping personnel.  NFPA 99
  • CMS Targeted Probe and Educate for HBOT Codes 99183 & G0277
    CMS has authorized WPS Government Health Administrators (GHA) to conduct the Targeted Probe and Educate (TPE) review process
  • HBO Documentation Checklist
    Documentation checklist to support medical necessity in HBOT and be audit ready
  • Medicare Coverage Determinations for Hyperbaric Oxygen Therapy
    Hyperbaric Oxygen Therapy National and Local coverage determinations per Medicare Administrative Contractor (MAC)
  • Medicare requirements for HBO - compliance, review, pre-authorization
    Importance of documentation to justify medical necessity and proper billing in HBOT. Pre-authorization for HBOT
  • Transcutaneous Oximetry
    Application of transcutaneous oximetry in hyperbaric medicine with practical algorithm.
  • Radiation-induced Cutaneous Damage - Introduction and Assessment
    SUMMARY Radiation-induced cutaneous damage is a common sequela of radiation exposure, affecting up to 95 percent of patients who receive radiotherapy.(1–3) Skin damage can be either acute or chronic, based on the timing of presentation. Acute damage occurs within 90 days of exposure, and is dose dependent, ranging from transient erythema, to dry a
  • Radiation-Induced Cutaneous Damage - Treatment, Prevention, Patient Education
    Radiation-induced cutaneous damage is a common sequela of radiation exposure. This topic describes management of acute and late effects of radiation
  • Documentation: Consultation Intake questionnaire
    Hyperbaric Oxygen Therapy Consultation Intake Questionnaire
  • Medicare Billing Protocol and Workflow
    Hyperbaric oxygen therapy Medicare billing workflow for wound and hyperbaric therapy clinics.
  • Medicare Billing Protocol - Appeal of Claim
    Hyperbaric Oxygen Therapy Overview of the Medicare Claim's Appeal Process
  • Chronic Refractory Osteomyelitis
    Hyperbaric oxygen therapy (HBOT) protocol for chronic refractory osteomyelitis, with evidence, sample documentation statements, checklists
  • Medicare Targeted Probe and Educate Protocol
    The Centers for Medicare and Medicaid (CMS) Targeted Probe and Educate (TPE) Process is designed to help providers and suppliers reduce claims denials and appeals through one-on-one help. This topic provides guidance on how to successfully navigate the TPE process. It includes information on additional documentation request and latest results of recent TPE findings.
  • Cellular and/or Tissue Based Products
    Evidence-based topic on cellular and/or tissue products (also known as human skin equivalents, or skin substitutes) - clinical, coverage and reimbursement updates.
  • Compressed Gas Handling And Safety
    The safe handling and storage of compressed gas cylinders, in accordance with the National Fire Protection Association (NFPA), the Occupational Safety and Health Administration (OSHA), the Compressed Gas Association (CGA), and other Federal, State and local regulations provide guidance in maintaining a safe environment. Storage of Cylinders   All cylinder valve caps must be tightly secured unless the cylinder is connected for use. Valves must be clos
  • Acute Exceptional Blood Loss Anemia
    Hyperbaric oxygen therapy (HBOT) protocol for Acute Exceptional Blood Loss Anemia, documentation template and GRADE assessment of current evidence
  • Acute Peripheral Arterial Insufficiency
    Hyperbaric oxygen therapy (HBOT) protocol for Acute Peripheral Arterial Insufficiency
  • Acute Traumatic Ischemia, Crush Injury and Compartment Syndrome
    Hyperbaric oxygen therapy (HBOT) protocol for acute traumatic peripheral ischemia, crush injury and compartment syndrome with GRADE recommendations, review of recent evidence, checklist, sample documentation statements
  • Compromised Skin Grafts and Flaps
    Hyperbaric oxygen therapy for treatment of compromised flaps and skin grafts (including mutilated limb injuries), with evidence, sample documentation statements, checklists.
  • Idiopathic Sudden Sensorineural Hearing Loss
    Hyperbaric oxygen therapy (HBOT) protocol for Idiopathic Sudden Sensorineural Hearing Loss, with evidence-based graded recommendations, sample documentation statements, physician order template, checklists.
  • Necrotizing Soft Tissue Infections And Fournier's Gangrene
    Hyperbaric oxygen therapy for treatment of necrotizing soft tissue infections and Fournier's gangrene, protocol with evidence, sample physician order template and documentation guidance/template
  • Soft Tissue Radiation Necrosis
    Hyperbaric oxygen therapy (HBOT) protocol for soft tissue radiation injury, with evidence, sample documentation statements, checklists
  • Chamber Operations
    An overview of hyperbaric chamber operations.
  • Routine Inspection - Daily Chamber
    Hyperbaric Oxygen chamber daily inspection rationale and template.
  • Routine Inspection- Chamber Cylindrical Window Blemish
    Hyperbaric chamber acrylic inspection template. Normal 0 false false false
  • Routine Inspection - Semi-Annual Chamber Rate Verification
    Hyperbaric oxygen chamber semi-annual inspection rate verification form
  • Routine Inspection - Pre & Post Procedures and Safety Checklist
    Hyperbaric oxygen therapy pre and post treatment checklist templates.
  • Routine Inspection - Monthly Chamber Rate Verification
    Hyperbaric chamber monthly - chamber rate verification template. The Pressure Rate Set Control sets the rate of compression or decompression inside the Chamber.  All pressure change rates are linear. The numbers “1” through “5” indicate the approximate pressure change rate in pounds per square inch (psi) per minute (i.e., “3” equals 3.0 psi per minute change).
  • Medications In The Hyperbaric Environment
    When administered in concentrations greater than those found under ambient room air conditions, oxygen can put forth clinical effects having a therapeutic profile not unlike other pharmaceutical agents. As a drug, oxygen is most notable in the setting of hyperbaric oxygen therapy where the partial pressure (dosage) of oxygen prescribed is significantly higher than that which is typically encountered in routine clinical practice.
  • Housekeeping and the NFPA
    Housekeeping Training in the hyperbaric facility, what is required?
  • Safety stops, checklists… when to document
    Clinicians providing hyperbaric oxygen therapy go to great lengths to ensure patient safety with every treatment. We utilize processes and systems that have been developed within the field, in some cases through “near misses” and from standards set forth by The Joint Commission (TJC) and the Undersea and Hyperbaric Medical Society (UHMS).
  • Safety Time Out/Pause (STOP) Checklist
    A template for a Safety Time Out/Pause (STOP) checklist.
  • Routine Inspection - Monthly Chamber
    Monthly hyperbaric chamber rationale and template.
  • Prohibited Item Reminder
    Hyperbaric oxygen therapy Prohibited items reminder template.
  • Visual Acuity and HBOT
    Notification of Instructions Due To: A Change in Visual AcuityAs discussed during your hyperbaric patient education, vision changes are possible after receiving several (>20) hyperbaric treatments.  This is usually a temporary change that will resolve within 3 to 4 months after your last hyperbaric treatment.You are receiving this notification because during your last eye exam in the Hyper
  • Documentation: HBO Risks and Benefits
    Risk and Benefit Assessment for Hyperbaric Oxygen Therapy
  • Documentation: HBO Consultation History and Physical
    Consultation Template for Hyperbaric Oxygen Therapy
  • Risks and Benefits Documentation
    Hyperbaric Oxygen Risk and Benefit Documentation Template
  • Hyperbaric Oxygen Therapy and Visual Acuity
    HBOT documentation templates for weekly visual acuity exam throughout the course of HBOT
  • Utilization Review
    An overview of the utilization review process for hyperbaric oxygen therapy.
  • Modification of Treatment Protocol
    Sample Modification of Treatment Protocol Form, when patient's treatment protocol is modified
  • Medical Director Guidelines
    Hyperbaric Oxygen Therapy Medical Director Guidelines and Responsibilities
  • Documentation: HBO Progress Note
    Consultation template to assist providers with progress notes documentation requirements for HBOT
  • Ear Exam - Barotrauma
    Barotrauma may occur in patients receiving HBOT is middle-ear barotrauma (MEB). This topic describes assessment and treatment for MEB
  • Advanced Certified Hyperbaric Registered Nurse (ACHRN)
    Hyperbaric Oxygen Therapy job description for Advanced Certified Hyperbaric Registered Nurse (ACHRN)
  • Hyperbaric Nurse Manager
    Hyperbaric Oxygen Therapy Job Description for Hyperbaric Nurse Manager
  • Hyperbaric Safety Director
    Hyperbaric Oxygen Therapy job description for Hyperbaric Safety Director
  • Hyperbaric Chamber Operator
    Hyperbaric Oxygen Therapy job description for Hyperbaric Chamber Operator
  • Go-No-Go : Frequently Asked Questions
    Frequently asked questions about which items are prohibited, restricted or allowed inside a hyberbaric chamber during hyperbaric oxygen therapy
  • Prohibited Items Vs Restricted?
    Certain wound dressings, medical devices and other objects can raise important safety concerns when used inside hyperbaric chambers during hyperbaric treatments. This blog post provides clarification on the difference between items that are prohibited versus restricted during hyperbaric treatments.
  • Hyperbaric Program Staffing Guidelines
    Staffing guidelines for hyperbaric medicine departments. Roles and responsibilities, staffing ratios, staffing considerations
  • MIPS in Wound Care and Hyperbaric Medicine
    Collection period for MIPS Year 3 started in January 1st, 2019. In 2019, CMS expanded the types of clinicians who are subject to participation in MIPS, and implemented other updates. This blog post summarizes some of these changes and provides an overview on how WoundReference can help eligible clinicians and groups perform well in MIPS.
  • Staffing Guidance for Wound Care Centers
    Guidance on lean staffing for wound care centers. Identification of variables that impact staffing, staffing tool and tips
  • Hyperbaric Program Staffing Guidelines - Why do We Need Them?
    The development of staffing criteria of the hyperbaric service requires the consideration of several factors to ensure that each treatment is given safely. Frequently this process begins with the question of staff to patient ratio. That is, how many staff members do we need to operate three monoplace chambers? This blog post lists questions that programs should ask and resources they can tap for a solid staffing strategy.
  • Patient Education - Hyperbaric Oxygen Therapy for Diabetic Foot Ulcer
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for diabetic foot ulcers can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Webinar: How to find the right products for your patients
    How to leverage WoundReference free and premium tools to quickly find the right products for our patients. Unbiased, evidence-based information at your fingertips for Free!
  • Webinar: How can I find answers to my clinical questions? Make decisions with confidence
    Free webinar on how to leverage WoundReference free and premium tools to quickly find answers to clinical questions at the point-of-care and make decisions with confidence
  • Patient Education - Hyperbaric Oxygen Therapy for Chronic Refractory Osteomyelitis
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for chronic refractory osteomyelitis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Soft Tissue Radiation Injury
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for soft tissue radiation injury can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • CMS Medically Unlikely Edits (MUE)
    What are Medicare Medically Unlikely Edits (MUE)? This post explains what MUE are important to wound care and hyperbaric programs and provides tips on how to deal with them.
  • Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for osteoradionecrosis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Compromised Grafts and Flaps
    Topic for patients and caregivers. This topic on hyperbaric oxygen therapy for compromised grafts and flaps can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Nutritional Screening for Wound Care and Hyperbaric Oxygen Therapy
    One of the keys to a successful patient outcome is assessing nutritional status. One out of three patients treated at hyperbaric services can be at risk of malnutrition. This blog post describes the importance of a nutritional assessment and plan for HBOT patients, from both clinical and reimbursement perspectives.
  • MIPS in Wound Care and Hyperbaric Medicine - Improvement Activities
    The MIPS Improvement Activities Category is one of the four categories comprising the Centers for Medicare and Medicaid Services (CMS)'s Merit-based Incentive Payment System (MIPS). MIPS is part of the CMS Quality Payment Program (QPP), in which eligible clinicians are required to participate during 2019 to avoid a negative impact on the physician fee payment for the year of 2021. This blog post provides a summary on the
  • Documentation: Hyperbaric Treatment Notes by the CHRN and CHT
    To ensure audit-readiness and smooth reimbursement, facility and physician charges related to wound care and hyperbaric oxygen services must be validated with documentation from both physician AND non-physician providers (i.e.,Certified Hyperbaric Registered Nurses and Certified Hyperbaric Technologists). The CHRN or CHT note is proof and validation that a treatment was provided and billed by the facility (G0277). This topic provides a template for hyperbaric treatment records documented by non-physician providers.
  • Designation of Hyperbaric Safety Director
    This topic elaborates on the role of a Hyperbaric Safety Director, including aspects related to designation, training/education and a sample policy and procedure. Authors also explain the rationale behind having a formally designated and specifically trained Safety Director in each hyperbaric medicine facility. Designation of the Safety Director in writing and an appropriate job description for the role are paramount to hyperbaric facility safety.
  • CMS HBO Non-Emergent Denial Reason Codes and Statements
    Instructions: 1. Select number of entries (rows) to be displayed on the table. 2. Click on the header of each column to sort (e.g., click on "Product Hyperbaric Registered Nurse
    Job Title: Hyperbaric Registered Nurse
  • Staff Minimum Qualifications and Training for HBOT
    Regardless of the the purpose and scope of the hyperbaric facility, inadequate knowledge of applicable gas laws, chamber fire safety, potential risks, side effects, and contraindications of hyperbaric medicine, may result in dangerous situations that risk patients' and personnel's well-being. This topic elaborates on the minimum qualifications and training/education for hyperbaric staff, and provides policies that can be adjusted and adopted by hyperbaric programs.
  • Internal Medical Documentation Auditing
    Payers frequently audit providers. Internal medical documentation audits are necessary to determine areas that require improvements and corrections. To be ready for audits by payers, the documentation, including HBO consultation note, physician orders and daily HBO progress note must meet medical necessity requirements. This topic provides a lean protocol on how to conduct internal medical documentation audits to help ensure audit-readiness.
  • Hyperbaric Oxygen Therapy And Congestive Heart Failure
    Background There are a number of known risks and side effects of hyperbaric oxygen treatments most of which are either rare or of minimal consequence. One such complication is an exacerbation of congestive heart failure. When pulmonary edema occurs, it is typically noted in the latter half of a 90-minute treatment and, though rare, this complication can be significant. Patients may do well with simple decompression. Some may require a diuresis while others may require hospitalization
  • Termination of Relationship: Patient-Provider And/Or Patient-Wound Care And Hyperbaric Service
    Providers should use caution when terminating a patient-provider relationship and ensure it does not constitute abandonment. Healthcare providers also have the right to terminate relationships with patients for a variety of reasons. This topic lists these reasons, provides legal/ risk management considerations, documentation and operational guidance for a standardized approach. Includes sample patient dismissal letter.
  • Safety and Hyperbaric Oxygen Therapy
    Creating and maintaining an environment of safety in the hyperbaric facility is achieved through proactive planning and attention to detail. Lack of proper safety protocols and procedures causes accidents, and, unfortunately, loss of life. While we never want to have a disaster, we learn from safety analysis of them. This topic provides a summarized update on Safety in the Hyperbaric Facility. The topic also provides guidance and resources that will help you build an excellent hyperbaric safety program. Resources include safety guidelines, job descriptions, go-no-go lists, go-no-go risk assessment tool, and emergency procedures.
  • Patient Education in Wound Care and Hyperbaric Oxygen Therapy
    Patient and caregiver education is central to patient-centered, value-based care. It can be a differentiating factor for wound care and hyperbaric oxygen therapy (HBOT) services looking to offer the highest standards of clinical practice. This topic provides an update on the importance and benefits of patient education in wound care and HBOT, current gaps, commonly used methods, and resources to develop patient education programs in wound care and HBOT. It lists 5 tools that can be implemented today to streamline patient education at the point-of-care, and provides a downloadable framework with best practices on patient education in wound care and HBOT.
  • Patient Education - Hyperbaric Oxygen Therapy for Chronic Refractory Osteomyelitis (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for chronic refractory osteomyelitis can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Compromised Grafts and Flaps (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for compromised skin grafts and flaps can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Diabetic Foot Ulcer (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for diabetic foot ulcers can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Global Surgical Transfer of Care to the Wound Clinic
    Wound physicians must be aware of the surgical global packaging rules as they relate to the transfer of care from one provider to another. Documentation and proper billing methods are essential to meet CMS compliance standards and to ensure the rules are followed. Failure to do so could make the wound care provider a target for audit and denials. This topic provides guidance and a protocol for global surgical transfer of care. Normal 0
  • Patient Education - Hyperbaric Oxygen Therapy for Osteoradionecrosis (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for osteoradionecrosis of the mandible can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Patient Education - Hyperbaric Oxygen Therapy for Soft Tissue Radiation Injury (Spanish)
    For patients and caregivers, in SPANISH. This topic on hyperbaric oxygen therapy for soft tissue radiation injury can be shared by email, or its PDF (attached to the topic) can be printed as a patient handout and handed directly to patients at the point-of-care.
  • Operational Policy: Advanced Wound Care Program Scope of Service
    This topic serves as a basis for Wound Care Programs to adopt a Policy on Advanced Wound Care Program Scope of Service. The purpose of this Policy is to enable the Wound Care Program that adopts it to offer its services to patients whose medical needs can be met within the capability of the Wound Care Program's staff and facilities, and to ensure that all patients treated will receive high quality care in an expedient and professional manner.
  • Errors and Healthcare
    Patient safety is a serious public health issue. Like obesity and motor vehicle crashes, harms caused during care have significant mortality, morbidity, quality-of-life implications, and adversely affect patients in every care setting. This topic provides a snapshot of current patient safety facts, helpful definitions in Patient Safety, factors that lead to errors, liability in Wound and Hyperbaric Oxygen Therapy Programs, and actions that can be implemented to improve Patient Safety and reduce errors.
  • Billing 101 for Hyperbaric Providers
    INTRODUCTION99183- Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per sessionG0277- Hyperbaric oxygen under pressure, full body
  • Telemedicine/ Televisit Implementation Playbook - Part 1
    Telemedicine can be a plausible option to do more with less in wound care. The purpose of the first part of this playbook is to guide healthcare professionals in assessing the benefits telemedicine can bring to their practices.
  • Hyperbaric Certification and Continuing Education for Technologists & Nurses
    This blog post provides an overview on the importance of Hyperbaric Certification for Technicians and Nurses, as well as recertification and continuing education requirements
  • Webinar: Unwrapping Venous Ulcers - Assessment and Management
    Sign up for a Free Basic Account to watch this webinar co-produced by MidAmerica Wound Healing Society and Wound Reference.
  • Cleaning and Disinfection of Hyperbaric Oxygen Monoplace Chamber
    Policy for disinfection of acrylic monoplace chambers
  • 3 Ways Telemedicine Can Help Wound Care Clinicians Combat the New Coronavirus (COVID-19)
    Find out how wound care and HBOT clinicians can leverage telemedicine to continue to care for their patients in a safe manner.
  • Telemedicine/ Televisit Implementation Playbook - Part 2
    Telemedicine can be a plausible option to do more with less in wound care. This is the second installment of the Telemedicine/ Televisit Implementation Playbook. The first installment guides healthcare professionals in assessing the benefits telemedicine can bring to their practices. This topic provides a practical pathway for implementation of telemedicine solutions.
  • HBOT and COVID - 19
    Here what we know and what we don't know about HBOT and COVID-19Synopsis: UHMS Hyperbaric Oxygen Therapy Committee Meeting on COVID-19 and HBO2. This is a synopsis of a conference call between invited members of the Hyperbaric Oxygen Therapy committee, the American College of Emergency Physicians’ Section on Unders
  • Webinar: Transforming Best Practice in Wound Care with Telehealth
    Sign up for a Free Basic Account and watch this webinar produced by WoundReference and presented on Wounds Research.  Click HERE to watch the webinar  Supervision of HBOT by Advanced Practice Providers
    INTRODUCTIONIt is crucial that nurse practitioners have a clear understanding of how their state laws and regulations impact their scope of practice. Nurse practitioners fall under the following scopes of practice environments: Depending on the state in which they practice, they may be able to work independently, with a reduced practice, or with a restricted practice. The difference between "reduced" and "restricted practice is the amount of oversight that is nee
  • HBOT for Compromised Flaps and Grafts - An Overview
    What is Hyperbaric Oxygen Therapy? The Undersea and Hyperbaric Medical Society defines hyperbaric oxygen therapy as an intervention in which an individual breathes 100% oxygen intermittently while inside a hyperbaric chamber that is pressurized to greater than sea level pressure (1 atmosphere absolute, or ATA). For clinical purposes, the pressure must equal or exceed 1.4 ATA while breathing near 100% oxygen.  How Hyperbaric Oxygen Therapy Works
  • HBOT for Osteoradionecrosis of the Mandible - An Overview
    What is Hyperbaric Oxygen Therapy? The Undersea and Hyperbaric Medical Society defines hyperbaric oxygen therapy as an intervention in which an individual breathes 100% oxygen intermittently while inside a hyperbaric chamber that is pressurized to greater than sea level pressure (1 atmosphere absolute, or ATA). For clinical purposes, the pressure must equal or exceed 1.4 ATA while breathing near 100% oxygen.  How the Intervention Works
  • HBOT for Diabetic Foot Ulcer - An Overview
    This topic is part of a series for clinicians who are considering referring patients to a hyperbaric oxygen therapy (HBOT) center for treatment consideration. It provides an overview on adjunctive HBOT for diabetic foot ulcers. A printable PDF that can be customized with the facility contact information is included.
  • HBOT for Soft Tissue Radiation Necrosis - An Overview
    his topic is part of a series for clinicians who are considering referring patients to a hyperbaric oxygen therapy (HBOT) center for treatment consideration. It provides an overview on adjunctive HBOT for soft tissue radiation necrosis. A printable PDF that can be customized with the facility contact information is included
  • HBOT for Chronic Refractory Osteomyelitis - An Overview
    This topic is part of a series for clinicians who are considering referring patients to a hyperbaric oxygen therapy (HBOT) center for treatment consideration. It provides an overview on adjunctive HBOT for chronic refractory osteomyelitis. A printable PDF that can be customized with the facility contact information is included.
  • Webinar: Adding Patient-Centered Telehealth to Your Wound Care Practice
    Are you considering telehealth for your wound practice? If you already use telehealth, have you ever wondered if you are maximizing its potential? MidAmerica Wound Healing Society and Wound Reference invite you to get the latest in telehealth for wound care. Boost your practice by attending this session!
  • Coding and Billing Essentials in Wound Care
    In the U.S., it is estimated that about US$ 32 billion are spent on chronic wounds per year.[1] Patients with chronic wounds frequently receive care at different settings across the continuum of care. Coverage policies and documentation requirements not only are frequently updated, but also vary according to the reimbursement model in each of those care settings. This topic provides an overview of wound care coding, coverage and reimbursement for wound care providers and revenue cycle management professionals. To help achieve optimal reimbursement, frequent access to the most common aspects of billing and coding for wound care provided in this topic is highly encouraged.
  • Provider Supervision of HBOT
    Do physicians need to directly supervise hyperbaric oxygen therapy services (HBOT)? It is helpful to first review the definitions of the different types of level of supervision (CFR Title 42, Chapter IV, Part 410) (i) General supervision means the procedure is furnished under the physician's overall direction and control, but the physician's pre
  • Telehealth in Wound Care - Evidence and Best Practices
    Telehealth has become an important tool in the management of chronic wounds. This topic explains the differences among telehealth modalities and their indications, provides evidence-based recommendations, and summarizes best practices and tips for telehealth in wound care.
  • Staffing, Productivity and Acuity Tool for Wound Care and HBOT Centers
    INTRODUCTIONOverviewBenchmarking tools may help understand staffing needs for each center. The staffing tool created by Larson-Lohr for wound care and hyperbaric medicine centers incorporates elements of both patient acuity and staff productivity and provides suggestions on number of full-time employees (FTEs), more specifically nurses, to cover patient demand in a wound and hyperbaric center.
  • How to Perform An Ankle Brachial Index
    DEFINITION Resting ankle–brachial index (ABI) is the most commonly used test in screening for and detection of PAD in clinical settings. The ankle brachial index (ABI) is the ratio between the blood pressure in the ankles and the blood pressure in the arms. Blockage in the arteries of the legs causes less blood flow to reach the ankles. This reduces the blood pressure in the ankle. The ankle brachial index is lower as peripheral artery disease is worse.  The severity of peripher
  • How to Assess HBOT Prohibited Items: The Go/No-Go Risk Assessment Tool And The Burman Scoring System
    The NFPA recommends that hyperbaric facilities utilize the NFPA Risk Assessment Algorithm for assessment of dressings and items that have not been evaluated or deemed safe for use in the hyperbaric chamber. However, several challenges (as described above) prevent widespread use of the NFPA Risk Assessment Algorithm. The Go No-Go Risk Assessment Tool combines the NFPA Risk Assessment Algorithm and the Burman Risk Scoring System. This combination of the two approaches and a user friendly digital interface provide the hyperbaric facility with a robust go/ no-go documentation and risk mitigation tool. This topic provides step-by-step instructions on how to conduct this risk assessment process.
  • Chronic Wounds Essentials - Quick Reference
    Quick Reference Tool Chronic Wounds - The Essentials (Assessment). Printable.
  • Wound Culture - Swabs, Biopsies, Needle Aspiration
    ABSTRACTCLINICALOverviewWound infection has been regarded as the one of the most important causes of delayed healing of chronic wounds.[1] On the other hand, overuse and inappropriate use of antibiotics and/or topical antimicrobial agents on non-
  • Understanding the NFPA 99 Chapter 14 Hyperbaric Facilities: Administration and Maintenance Part 1
    INTRODUCTIONOverviewThe review of NFPA 99 Chapter 14 is intended to provide insight as to how it relates to daily hyperbaric operations, as this chapter applies to all hyperbaric facilities regardless of occupancy (Class A, Class B or Class C). Regulatory/accrediting agencies (FDA/ UHMS) and Authorities Having Jurisdiction (AHJ) reference NFPA 99 chapter to set hyperbaric operational criteria). The 2012 edition of the National Fire Protection Association (NFPA) H
  • Hyperbaric Oxygen Therapy - Patient Guide (Spanish)
    ¿QUÉ ES LA TERAPIA DE OXÍGENO HIPERBÁRICO?La Terapia de Oxígeno Hiperbárico (TOHB) es un modo de terapia no invasivo e indoloro. Un paciente que recibe TOHB respira oxígeno al 100 %, a una presión superior al nivel del mar, mientras se encuentra en un recinto cerrado a presión. Esto da como resultado una elevación dramática del oxígeno en la sangre, tejidos y fluidos corporales. TOHB puede resulta
  • Wound Care Patient Discharge Checklist
    INTRODUCTION"An evidence-based hospital discharge checklist that starts at admission might improve safe transition from hospital to home." REF The sample checklist below was created by a multidisciplinary consensus panel of experts (in acute, chronic, home, and long-term care and in rehabilitation medicine). It may be adapted to each organization Policies and Procedures, and completed during a typical hospitalization. DISCHARGE CHECKLIST
  • Gas Laws And The Therapeutic Effects of HBOT
    History Boyle’s, Dalton’s and Henry’s law have significant implications in the use of hyperbaric oxygen therapy. As gases are compressible, they are subject to three inter-related factors: volume, pressure, and temperature. [7] The first documented usage of hyperbaric medical therapy was in 1662. A British physician created the "domicilium" which consisted of a pressurized airtight chamber in which pressure could be increased using a bellows. Numerous aff
  • Skin Substitutes - What's New in 2023? Are Major Updates Coming Up?
    J. Payment for Skin Substituteshttps://www.federalregister.gov/d/2022-14562/p-10281. BackgroundIn the CY 2022 PFS final rule, we finalized an approach for payment of synthetic skin substitutes in the physician office setting. We also announced that we had established a unique HCPCS code for each of ten products for which we had received a HCPCS Level II coding application, and we finalized that those products would be payable in the physician off
  • The Modifier Dilemma - Navigating Through Wound Care and HBOT
    Procedure codes may be modified under certain circumstances to more accurately represent the service or item rendered. For this purpose, modifiers are used to add information or change the description of service in order to improve accuracy or specificity.
  • Fire Triangle/ Tetrahedron and Fire Extinguisher Classification
    A fire extinguisher is an item that hyperbaric personnel rarely think about until needed or asked about during an inspection or site visit. Choosing the correct extinguisher type for a specific fire or for purchasing can be made simple by reviewing a few basic concepts.
  • How to Apply a Multilayer Compression Bandage
    Practical guidance with step-by-step pictures, protocol and tips on how to apply different types of cellular and/or tissue products (CTPs), also known as skin substitutes
  • Standard of Care: Foundations for Wound Management
    Standard of Care: The Foundation of Wound Care The standard of care is a diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. In other words, this is the level of care widely accepted in the medical community. (1) In the wound community, we are quite familiar with the term standard of care as it was
  • Skin Substitutes - What's New in 2024? Preparing for a Phased Approach
    Summary on the current status of CMS regulations involving payment for skin substitutes/CTPs and HCPCS Level II Coding in 2024, grouped by relevance to Physician/ qualified healthcare professional (QHP) offices and hospital outpatient departments (HOPDs):
  • Qualified Healthcare Professional Credentialing Guidelines
    BackgroundQualified Healthcare Professionals engaged in the practice of hyperbaric medicine range across the entire spectrum of clinical specialties.  The practice of hyperbaric medicine involves the delivery of 100% oxygen at pressures above normal atmospheric conditions. This is achieved by the use of a pressurized (hyperbaric) chamber. Chambers are designed to accommodate a single patient (monoplace) or several patients simultaneously (multiplace).Hyperbaric Oxygen thera
  • Supervision of HBOT by Providers - Overview
    INTRODUCTIONOverviewThe following hyperbaric medicine treatment protocol is based upon the recommendations of the Hyperbaric Oxygen Committee of the Undersea and Hyperbaric Medical Society. Clinical protocols and/or practice guidelines are systematically developed statements that help physicians, other practitioners, case managers and clients make decisions about appropriate health care for specific clinical circumstances.  
  • Important Call to Action: Influence Medicare Coverage for Cellular and/or Tissue Based Products
    Urgent Call to Action for the Wound Care Community: Influence Medicare Coverage for Cellular and Tissue Based Products/Skin Substitute GraftsThe Centers for Medicare & Medicaid Services (CMS) has recently announced that the Medicare Administrative Contractors (MACs) issued the collaborative proposed local coverage determination (LCD) “Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers (DFUs) and Venous Leg Ulcers (VLUs)”. The reason
  • Hyperbaric Oxygen Therapy Medical Necessity and Coding
    INTRODUCTIONIn this video, Tiffany Hamm, RN, BSN, CWS, ACHRN, UHMSADS, Wound Reference's Co-Founder and Chief Nursing Officer, provides an overview on how to leverage WoundReference's resources to support and document medical necessity for hyperbaric oxygen therapy. Target audience:Care se
  • Debridement
    Debridement is an important step in optimizing a wound or ulcer for functional healing. This evidence-based topic provides clinical, coverage and reimbursement updates on debridement methods in wound management (e.g., surgical, sharp conservative, mechanical, autolytic, enzymatic, larval, hydro-mechanical, etc). Includes indications, contraindications, GRADE recommendations, documentation guidance, links to Medicare coverage determinations by each Medicare Administrative Contractor.
  • Physician Medical Director - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Physician Medical Director - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Physician Medical Director - Wound CareEmployee:Date:Reports to: Status: [   ] Exempt   [   
  • Advanced Practice Provider (NP, CNS, PA) - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Physician - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Non-Physician Provider - Wound CareEmployee:Date: Registered Nurse - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Wound Care Registered Nurse in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Wound Care Regis
  • Manager - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Wound Care Manager in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Wound Care ManagerLocation
  • Wound Care - Job Descriptions
    Hyperbaric Oxygen Therapy Job descriptions and training guidelines
  • Understanding CPT Code 99211: Billing and Documentation Guidance for Wound Care Programs
    CPT® 99211 “NURSING VISIT”- DEFINITION AND CMS REQUIREMENTS CPT® code 99211 Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal.(2)This was part was deleted In January, 2022.  Providers were trying to use 99211 as quick visits with patients, was potentially shortchanging them since 99212 is for s
  • Wound Assessment, Documentation and Photography
    Policy and Procedure: Wound Assessment (manual), Documentation, and Quality Tracking Policy Overview: All wounds will be assessed upon admission or occurrence, at least weekly, with significant changes, and upon transfer or discharge. Procedure: Documentation Parameters: A. Anatomic Location: The specific location of skin breakdown. B. Etiology (Type): The cause or type of skin breakdown. C. Classification: Pressure
  • Wound Management
    Policy and Procedure: Wound Management Policy Overview: A wound treatment plan will be initiated for a patient at the time of admission or upon development of a wound. The patient's treatment plan will be evaluated at least every week thereafter and revised as necessary, based on the principles outlined below. Procedure: A. Establishing Goals: Collaborate with the patient, family, caregivers, and providers to establish realistic goals relate
  • Resources for Wound Care and HBOT Policies and Procedures
    Resources for Wound Care Policies and ProceduresPeriodic reviews of policies should be conducted to ensure it aligns with best practices and any changes in local regulations or standardsWound Care Center OperationsScope of Service
  • Podiatrist - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Podiatrist - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.
  • Physician - Wound Care
    INTRODUCTIONThis topic provides a sample job description for the role of Physician - Wound Care in the United States. It serves as a starting point for organizations to tailor according to their specific needs and care settings.JOB DESCRIPTIONJob Title: Physician - Wound CareEmployee:Date: Patient Education - Smoking and Wound Healing
    OverviewWe understand that you have a history of smoking, and we want to help you heal as quickly and safely as possible. Here are some important things to know: No bandage or treatment can fix the damage smoking does because healing happens inside your body.Sometimes, insurance companies won't pay for your treatment if you keep smoking.Your wound healing team will be your biggest supporters and will guid
  • Avascular Necrosis (Aseptic Osteonecrosis)
    Hyperbaric oxygen therapy (HBOT) protocol for Idiopathic Sudden Sensorineural Hearing Loss, with evidence-based graded recommendations, sample documentation statements, physician order template, checklists.
  • Skin Substitutes - What's New in 2025? Key CMS Updates
    Summary on the current status of CMS regulations involving payment for skin substitutes/CTPs and HCPCS Level II Coding in 2024, grouped by relevance to Physician/ qualified healthcare professional (QHP) offices and hospital outpatient departments (HOPDs):
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