Hi, I have a patient with a wagner 4 DFU in need of HBO to reduce her risk of amputation as she had a failed revascularization attempt, pulmonary disease. CT showing mild bronchiectasis, no blebs, PFT...
Can we get this covered for HBOT despite not being related to radiation? Using code M27.8 Other specified diseases of the jaw? Further research leads me to "medication-related osteonecrosis of the ja...
Hello,
Was wondering what your guideline was regarding treating a pt with a hx of Cisplatin chemotherapy for HBOT. Pt last dose was March of 2022. Thank you for any information
I wanted to know if there are any know or potential issues with patient's undergoing HBO with the Watchman device.
Thanks,
Bill Khoury
Patient is a 74-year-old with an extensive history of juvenile rheumatoid arthritis. Patient went off her treatment for rheumatoid arthritis in 2021. Since then she has developed several chronic ulcer...
Patient is an 83-year-old female with past medical history of hypertension, diabetes, hyperlipidemia, neuropathy, and CVA. Patient developed bilateral foot cellulitis due to diabetic ulcers 2 years ag...
86y/o female who presents with a right inner thigh stage 3 pressure ulcer x 1 year. Patient is wheelchair bound. Prior treatment include weekly debridement and Santyl, Prisma, Xeroform, Mepilex. We th...
94 yo male with an unstageable left heel wound that occurred in October 2022; unknown etilogy of wound. Wound with moderate amount of serous drainage, exudate, and "wet eschar" that is firmly attache...
71 y.o. female with nearly circumferential venous stasis ulcers present for multiple years that had received multiple different dressings. Dressings that have been tried include: Aquacel AG (but only ...
12/29/22 by
Sarah Hintz,
92 year old female. Wounds have been present since Feb 2022. Has had 2 surgical debridements. Treatments so far have failed. Used Acetic Acid, Santyl and currently Metro gel has failed. Ultra Mist has...
Hello,
I am looking for advice on treatment of a patient for STRN with history of CML (Chronic myelocytic leukemia) diagnosed about 4 year ago. He is currently being treated with Gleevac (imatinib m...
We currently do not take photos of wounds on inpatients. Our hospitalist staff is wanting us to consider starting. We have the newest version of Meditech as our EMR for inptatient and outpatient clini...
Pt has hx of prostate CA, with radiation therapy in 2016, was given 40 treatmensts of HBO 2 years ago with indications of gross hematuria with resolution.
2 months ago, his gross hematuria has retu...
Hi Wound Reference Leaders,
I was sent a pre-surgical skin flap patient for HBO. The surgeon is very concerned about flap failure because after cosmetic leg lengthening surgery he suffered skin ne...
89 year old with wound across chest that began as a small wound in left breast and spread over the past 9 months to right breast, she has breast cancer, treating with comfort measures now, I would lik...
How can one eradicate biofilm with non-antimicrobial dressings?
When coding and billing for CTP am I right that wound code is first like an L97 or and E11.621. Then a Q code ie. Q4159 how many units are used and JW if wasted. Then you add the application codes 152...
11/23/22 by
Kim Harris,
Having a discussion on what is now gold standard for wound cultures. I believe tissue biopsy is the gold standard however, it was discussed that in an outpatient setting DNA testing is best. Would lov...
11/11/22 by
Kim Harris,
ED patient yesterday with infection of colostomy diagnosis. Started on antibiotics. There is a <1 sq cm area of erosion on the stoma, periostomal skin is intact. What is the advice to the patient reg...
We have a patient being evaluated for HBO for radiation cystitis secondry to ionizing radiation of the bladder. He has Atelectasis from 1993 and it is intact but flaccid and does not significantly e...
We have a pt. who is 53 y.o. female with no past medical history who was admitted on 10/17/22 with DKA, hypokalemia, undiagnosed DM, and cellulitis to the posterior neck. Her DKA and electrolyte imbal...
Is compromised flap a CMS reimbursable diagnosis for HBO? DPM referring a non-diabetic patient s/p TMA w/ dehiscence, NCD20.29 no longer specifically lists failed flap, only failed graft as a covered...
We have a male patient with radiation cystitis with gross hematuria and clot retention requiring multiple cystoscopies, fulguration and episodes of inpatient CBI. He completed 60 HBOT on 8/22/22, thou...
Hi,
I have a radiation cystitis patient that had cataract surgery on one eye on August 24. He needs to start HBO asap but I don't remember how long a patient needs to wait post-op to begin HBO. Tha...
The insurance has authorized additional therapies beyond 60 sessions. The podiatrist for the HMO wants him to continue. He received 40 sessions March through June 2022. Then 20 more sessions August.
...
I am trying to get an accurate idea of the total amount of wound care clinics and wound care providers there are in the United States. Specifically addressing the number of outpatient clinics, and th...
Is it true that CMS does not cover Chronic Proctitis d/t Late Effects of Radiation because it is a muscle and not a soft tissue?
I am hoping to get some information on healing rates post MOHS procedures when patients are referred to a wound clinic versus the wound being managed by dermatology. Any published articles or data wou...
Hello we have a patient diagnosed with Buerger's disease. Would this qualify the patient for HBO under Arterial insufficiency?
Thank you in advance.
Can a compression dressing/wrap (ACE Wrap, 2 Layer, 4 Layer) be worn or kept on while using a Lymphedema Pump? Our service rep for the company we use to order Lymphedema Pumps states it is safe to lea...
Hi, just a safety HBO question. We have a patient being evaluated for HBO for ORN, with CT findings of mild bronchiectisis and bronchiolectisis. No blebs and assuming pulmonary function tests are not ...
Our Chief Medical Officer has asked me to provide "some scholarly/clinical articles about the clinical improvements noted with ABI information." Does anyone have anything that would satisfy this requ...
I just finished a new formulary for my hospital and was wondering if anyone knew of or has a basic dressing selection algorithm that I can use as a guidance for physicians and nurses that that can be ...
Hello! Is there a certain timeframe to wait after a pt has cataract surgery prior to starting HBO?
Hello I was reading the Evidence-based indications accepted by the UHMS and Medicare, and it mentioned < 4,000cGy of radiation. If one is unable to obtain radiation treatment notes does this not qual...
Hello,
This might be a silly question. I tried to research it, but when using an alginate dressing a superficial wound do you cut to fit or overlap? If it is draining large amounts I cannot imagin...
I am attempting to create a MDRPI prevention/management protocol for the hospitals that I manage. Is there anyway that I can receive guidance on creating an EBP protocol for MDRPI prevention/managemen...
Hello,
For small wounds that require a wound vac and have a tunnel, what is the best method for foam application? Is it best to not pack the tunnel if it is not deep or pack with white foam and bla...
Can a patient go into the hyperbaric chamber safely with a Dexcom sensor pad left in place?
I have a DM patient with an ulcer to the bone at the lateral malleolus level. Can I use the Wagner classification system? (Or does the ankle not count). I would like to do HBO on this patient. Than...
Hi,
I just have a general question regarding CMS guidelines for using the Marx protocol 20:10 for dental tooth extraction for a high risk patient, under the diagnosis of STRN. Has there been any issu...
Hello
I have a patient that has a severe case of Hidradenitis suppurativa along with Psoriasis. In 4/2021 he had a case of Fournier's gangrene that was surgically treated and closed with a wound vac...
Hello,
We have an HBO candidate (ORN)
Pt was taking Cis-Platin and Bleomycin
Both were D/C in February of 2021
Also pt has a lesion in mouth that they suspect is cancer, (it is at the same i...
Hello, we have a new pt referral for osteo, but he has an implanted BioMonitor 2 AF. All BIOTRONIK CRM devices are not recommended for HBO due to the potential for damage or impaired function of the...
We have a patient with a history of squamous cell carcinoma of the right head and neck who completed radiation therapy on 10/15/2021. She presented to otolaryngology with three week history of pain ...
We have a new referral for hyperbaric treatments (necrosis of bone and soft radiation) with history of SCC of scalp with two large open wounds. One wound measures 15x13x0.3 cm with 5.3x5.5 cm of expo...
We have a patient who has been receiving HBO in a monoplace chamber. The wound was not showing progress, so Podiatrist took into surgery and debrided the involved bone and resected the cuboid. She pla...
I saw a patient today with pyoderma gangrenosum for a Palliative Care consult. She has a very rare presentation of occasionally having mucosal lesions that are located in her throat that are quite pai...
What is the role of pentoxifylline (Trental) in venous stasis ulcers? Wound Reference is recommending 400 mg TID in addition to compression therapy to promote ulcer healing. Is it commonly used in w...
