Tips for Reporting Hyperbaric Oxygen Therapy Treatment

hyperbaric oxygen therapy, oxygen therapy, oxygen therapy side effects, oxygen chamber therapy

If you think HBO stands for Home Box Office, the cable TV network where you watch “Game of Thrones,” you’re right — but in healthcare, there’s another HBO.

For us, HBO stands for hyperbaric oxygen therapy. In this type of HBO, providers and technicians place a patient in a pressure chamber, exposing the body to oxygen under increased atmospheric pressure. A number of conditions benefit from HBO treatment, including decompression sickness, carbon monoxide poisoning, some diabetic wounds, and crush injuries, as well as reimplanted severed limbs.

HBO therapy has four primary functions:

  • Increasing concentration of dissolved oxygen in the blood, enhancing perfusion
  • Stimulating the formation of a collagen matrix in tissues, encouraging the development of new blood vessels
  • Replacing inert gases in the bloodstream with oxygen that the body can metabolize
  • Functioning as a bactericide, destroying harmful bacteria in the body.

Tips for Reporting HBO Therapy

In many cases, a provider must attend and supervise the HBO therapy, reporting this service with CPT® 99183 (Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session). Because the time of each session varies depending on the clinical condition being treated, as well as the number of sessions per day and the overall length of the HBO therapy, you will report HBO therapy on a per session basis, as the code descriptor instructs.

If the services of a registered nurse suffice for attendance at the procedure instead of a provider, use G0167 (Hyperbaric oxygen treatment not requiring physician attendance, per treatment session) instead of 99183.

If the documentation supports separately identifiable services, you can bill separately for evaluation and management procedures provided at the same encounter as 99183. E/M codes 99211 through 99215 can be reported in these cases by appending modifier 25 to the E/M service.

Check With Your Medicare Administrative Contractor (MAC) for Local Coverage

A Medicare national coverage determination (NCD) exists, and most MACs have local coverage determinations for HBO reimbursement as well. Make sure you check with your MAC for specific reimbursement guidelines for HBO including medical necessity requirements, diagnosis lists, and documentation guidelines. For example, Part B payer NGS Medicare reimburses for HBO given for 15 different conditions ranging from cyanide poisoning to diabetic wounds refractory to surgical treatments.

How About You?

Though I was familiar with HBO treatment from a great creditworthy presentation years ago, I only recently ran across my first report documenting this therapy. I was struck by how different the terminology was and how specifically the documentation described the providers attending the service. Do you work with reporting HBO therapy frequently? If you have any tips for this, please share in the comment box below!

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Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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