How should PTs bill for "non-skilled" wound care treatments, for treatments that don't require sharp debridement, compression, or wound vac? I'm thinking specifically a pt visit where a simple dressi...
6/5/23 by
Adam Copp,
Patient is here regarding worsening of the left lateral ankle ulcer no fever or chills. The patient is present with his wife. The ulcer has been present since 12/2019 per patient. The patient started ...
Has anyone ever heard of increased fluid or fluid shift in cancer patients during HBO? An oncologist told me he has seen it happen several times. I have a post radiation cysitis/proctitis patient wit...
HX: chronic wound ulcers on BLE, since September 2022 for right leg, left leg was present since July 2022. She got bit or broke down her left outer ankle and eventually healed. However, the wound has ...
I was approached last week by our infectious disease specialist who request HBO therapy for an HIV patient who has had persistent desquimation of his feet. The problem was felt to be due to antiretro...
There is controversy as to whether Benzocaine (Hurricane) should be used prior to bedside debridement. Any insight to this and what are other clinic's using.
Thank you!
82yo male patient with STRN and ORN of the mandible (diagnosis SCC of lip 2016 w/radiation from 2016-2017) - the workup on this patient indicated a small right basilar pleural effusion on 3/21/2023 (k...
Hello,
We have a 85 yr old male with radiation cystitis scheduled to start HBOT soon. He has a prosthetic R eye. First initial prosthetic eye was in 1951, with aprox 6 replacements. Any informat...
If a patient has DFU G3 or CROM along with arterial disease, would it be appropriate to dive these patients prior to bone debridement's/Amputation, given the patient has passed the TCOM challenge and ...
I have a patient who completed HBO for ORN #31 last April. His oncologist is requesting 10 additional dives due to patient having a tooth #31 extraction scheduled. There is a 10mm dept surrounding the...
Hello! New patient for HBOT. Hx metastatic renal cell carcinoma. Has not come in for a full evaluation yet and currently limited medical records. History of thoracentesis for past pleural effusions. H...
We have a 87 yr old male who has been ordered 40 HBO treatments for STRN (radiation cystitis). Pt has sleep apnea, CHF, and afib. His CXR findings: Heart is mildly enlarged. There is calcification of ...
Hi,
I'm looking to provide further education to staff regarding CXR prior to HBOT. I could not find chest imaging recommendation directly addressed within Wound Reference. What data does Wound Refe...
Patient: 66y/o male who had a radical prostatectomy for prostate cancer. Margins were positive as were the seminal vesicles. He then underwent external beam radiation to a total of 6800 CentiGrey. ...
As far as the Implantable Cardioverter Defibrillator (ICD) on the Use with Caution in a Monoplace Chamber Material List, the concern is the device withstanding pressure in the tank, per the list. Is ...
(in acute care setting) I have a 50 y.o. morbidly obese man with poorly controlled type 2 DM, recent A1c of 9.4 and came in with glucose >500. He has history of perineal abscess w/I&D back in 2020. Fo...
Hello! We have a patient with recent treatment for bladder cancer with Mitomycin instillation to the bladder that is referred for HBOT for CROM of the mandible due to side effects of Bisphosphonate me...
82yo male patient with STRN and ORN of the mandible (diagnosis SCC of lip 2016 w/radiation from 2016-2017) - the workup on this patient indicated a small right basilar pleural effusion on 3/21/2023 (k...
I have multiple questions regarding this solution.
Would it be appropriate to use Dakins in a surgical incision on post op day 4? Would Dakins break down fascial sutures? and if there were to be any...
Hello,
We have and HBO candidate with radiation cystitis bladder/perineum that has a history of seizures. His last seizure was 1 year ago (in that year he states he had 4 seizures). He is now on ...
Can you apply negative pressure to a wound caused by calciphylaxis after it has a debridement?
88, F, PMH of lymphedema, vascular disease, Hx of PE, Chronic embolism and thrombosis of other veins, long term Xarelto use, Lipoid dermato-arthritis, Hyperlipidemia, HTN, osteoarthritis. Patient has...
Hi! I have an incoming patient with an oncologist planning to start Liposomal-doxorubicin. The oncologist advised it is a distant little cousin to the usual Doxorubicin. It is much milder and the sid...
Are there any specific guidelines or parameters for blood pressure before starting hbot?
83 year old gentleman who was diagnosed with prostate cancer in 2012. He underwent external beam radiation.
Pt has already received 2 courses of HBO (37 session the first time then 25 additional sev...
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...
