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...
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...
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 ...
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...
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...
One of my providers asked about giving HBO at below 2.0 possibly 1.5ATA for a patient with CHF, for longer time period than 90minutes? Do you have any information related to this scenario?
87 yo patient seeking HBO for radiation injury after head/neck radiation. His extensive history of sarcomatoid sqamous cell carcinoma has demonstrated no recurrence since 2021 following cefemiplimab ...
I recently recieved a referral for treatment of Radiation proctitis in a patient who recieved 6000 cGy for HBOT. Radiation was done with Chemo for treatment of rectal adenocarcinoma. Problem is he c...
Are HBOT Trials for limb salvage covered by insurance if all appropriate pathways have been followed?
Is it possible for a patient to present with the Skin Bends during treatment in a monoplace chamber? Knowing the patient is at pressure and that no inert gas is present we are stumped on what could be...
Patient is 55 yo male with CO level of 16, Dm2, Renal failure on Dialysis presented to ER with dizziness, blurred vision, Tropinine elevated to 84.5, CT remarkable for old lacunae infarcts. EKG rate...
Hi, I have been trying to find any research related to the post-op healing duration of a compromised flap or graft regarding an appropriate window to refer to HBOT. Looking to provide education to ou...
Im hoping someone can provide some insight to some questions our podiatrist has regarding grading DFUs. We currently use the Wagner Classification system for grading diabetic foot ulcers in our clinic...
Hello. A patient was recently referred for HBOT from her radiation oncologist. Hx: In 2020, high grade urothelial carcinoma of bladder stage T2 N0. Bladder received total dose 6000 cGy at 200 Gy pe...
61 y/o male with stage 4 lung cancer with brain metastasis. His primary tumor of the RUL of the lung was removed via lobectomy. His 5.4 cm right frontal lobe brain metastatic lesion was also removed, ...
10/19/23 by
Bill Khoury,
Hello,
I am looking to see what other recommendations there are for diabetic patients and HBO in regard to hypoglycemic episodes. To clarify, I understand there are protocols for low glucose l...
Hello,
We are working up a 61 year old male for STRN, for a non-healing ulcer to the vertex of his scalp. (radiation was November 2022) He is currently on on taxol , carboplatin and Ketruda immun...
Hello,
We have a pt that will be starting HBO with the indication of Radiation cystitis secondary to ionizing radiation to his bladder. He has been taking Orgovyx (Lupron) for 8 months and will be...
Right now, I have 3 calcinosis cutis patients-one has end stage renal disease/renal osteodystrophy with secondary hyperparathyroidism; a second one has history of severe burns over 75% of his body; an...
For subsequent HBO treatments for CRAO after your initial treatment do you always titrate up starting from 2.0 ATA and stopping where there is response or do you start at the ATA that was effective wh...
I have a 90 y/o male patient who underwent thoracentesis about 3 months ago, looking for HBOT for radiation cystitis and intractable repeated urinary bleeding. Post tap cxr showed no pneumothorax, and...
Regarding criteria for chronic refractory osteo: Imaging and/or bone cultures confirming diagnosis of osteomyelitis, medical management to which the patient did not respond (4-6 weeks of abx), and sur...
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...
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...
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 ...
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...
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 ...
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
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...