Imagine you or a loved one being told that your foot or leg
had to be amputated. You’d be shocked. Most likely, you would look into medical
treatments to save your quality-of-life. Luckily for those in the know, there is an
accepted, well-researched and documented medical treatment that has been proven
to help save limbs – and lives.
Hyperbaric Medicine has been in use for over a hundred years, with
countless scientific studies, articles, textbooks and conferences on the
subject. Many people consider insurance
reimbursing for Hyperbaric treatment (as long as certain criteria are met) as
the biggest, most positive factor tipping the scales in favor of this
modality. Currently, in the United
States, the Centers for Medicare and Medicaid Services (CMS) approve Hyperbaric
treatment for fifteen (15) medical indications.
Most commercial insurance carriers follow CMS guidelines for Hyperbaric
treatment reimbursement. (See below for
a list of “CMS Indications for Hyperbaric Oxygen Treatment”.)
For many clinical indications, Hyperbaric treatment may not
even be considered if the doctor is not versed in its use, or if the hospital,
nursing home or rehabilitation facility does not have a Hyperbaric chamber. One example is that of a non-healing wound,
something that is relatively common among diabetics. CMS defines a non-healing wound as one in
which there is “…no measurable signs of healing for at least 30 consecutive
days.” (For complete CMS definition, see below: “CMS Indications for Hyperbaric
Oxygen Treatment”.) In many cases, these
wounds can result in limb amputation if not treated more with the use of Hyperbaric
Medicine as an adjunct to standard wound care (antibiotics, proper nutrition,
surgical debridement of the wound, etc.).
With the addition of Hyperbaric Medicine to the treatment regimen, the
wound can be helped to heal, and limb amputation may be avoided. It may take 20-60 hyperbaric treatments, or
more, to completely heal a wound or save a limb.
From a patient’s perspective, a hyperbaric treatment
regiment may seem like a miracle when all else has failed.
From a healthcare professional’s standpoint, it is immensely
rewarding to help save a patient’s limb from amputation, to help cure a
non-healing wound, and to help heal other maladies.
“CMS Indications for Hyperbaric Oxygen Treatment (HBO)”
"Program reimbursement for HBO [hyperbaric oxygen] therapy will be 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,
- Decompression illness,
- Gas embolism,
- Gas gangrene,
- Acute traumatic peripheral ischemia. HBO therapy is a valuable adjunctive treatment to be used in combination with accepted standard therapeutic measures when loss of function, limb, or life is threatened.
- Crush injuries and suturing of severed limbs. As in the previous condition, HBO therapy would be an adjunctive treatment when loss of function, limb, or life is threatened.
- Progressive necrotizing infections (necrotizing fasciitis),
- Acute peripheral arterial insufficiency,
- Preparation and preservation of compromised skin grafts (not for primary management of wounds),
- Chronic refractory osteomyelitis, unresponsive to conventional medical and surgical management,
- Osteoradionecrosis as an adjunct to conventional treatment,
- Soft tissue radionecrosis as an adjunct to conventional treatment,
- Cyanide poisoning,
- Actinomycosis, only as an adjunct to conventional therapy when the disease process is refractory to antibiotics and surgical treatment,
- Diabetic wounds of the lower extremities in patients who meet the following three criteria:
- Patient has type I or type II diabetis and has a lower extremity wound that is due to diabetes;
- Patient has a wound classified as Wagner grade III or higher; and
- Patient has failed an adequate course of standard wound therapy.
The use of HBO therapy is covered as adjunctive therapy only
after there are no measurable signs of healing for at least 30 –days of
treatment with standard wound therapy and must be used in addition to standard
wound care. Standard wound care in patients with diabetic wounds includes:
assessment of a patient’s vascular status and correction of any vascular
problems in the affected limb if possible, optimization of nutritional status,
optimization of glucose control, debridement by any means to remove devitalized
tissue, maintenance of a clean, moist bed of granulation tissue with
appropriate moist dressings, appropriate off-loading, and necessary treatment
to resolve any infection that might be present. Failure to respond to standard
wound care occurs when there are no measurable signs of healing for at least 30
consecutive days. Wounds must be evaluated at least every 30 days during
administration of HBO therapy. Continued treatment with HBO therapy is not
covered if measurable signs of healing have not been demonstrated within any
30-day period of treatment.”
For more information see:
Life Support Technologies group – Advanced Wound Care,
Hyperbaric Medicine and Life-Safety Engineering
Centers for Medicare and Medicaid Services (CMS)
www.CMS.gov
About the Life Support Technologies Group (LST)
The Life Support Technologies Group (LST) is a Tarrytown,
NY-based medical and life-support engineering company specializing in Advanced
Wound Care and Hyperbaric Medicine Services to hospitals in the NY, NJ, CT region. LST has been in business for 20 years and
currently provides services to 9 hospitals.
Glenn
Butler, CEO
Life
Support Technologies Group
(914)
333-8412
