What are the coverage limitations for HBO therapy?
Under Medicare National Coverage Determinations Manual, Chapter 1, §20.29, program reimbursement for HBO therapy is limited to that which is administered in a chamber (including the one man unit) and is limited to the following conditions: • Acute carbon monoxide intoxication, (ICD-9 -CM diagnosis 986) • Decompression illness, (ICD-9-CM diagnosis 993.2, 993.3) • Gas embolism, (ICD-9-CM diagnosis 958.0, 999.1) • Gas gangrene, (ICD-9-CM diagnosis 0400) • Acute traumatic peripheral ischemia. HBO therapy is an adjunctive treatment to be used in combination with accepted standard therapeutic measures when loss of function, limb, or life is threatened. (ICD-9-CM diagnosis 902.53, 903.01, 903.1, 904.0, 904.41.) • Crush injuries and suturing of severed limbs. As in the previous conditions, HBO therapy would be an adjunctive treatment when loss of function, limb, or life is threatened. (ICD-9-CM diagnosis 927.00-927.03, 927.09-927.11, 927.20-927.21, 927.8-927.9, 928.00-928.01, 928.10-928.11, 92
