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Hyperbaric Medicine
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Topics   Replies Score Author Latest Post
Implantaed Contact Lenses 0 E. Slisher We have a patient being evaluated for HBO who has had implanted contact lenses for last 30 years.  Has anyone had HBO patient with these lenses?  I appreciate any input :-) Thanks!  
by E. Slisher
Tuesday, August 20, 2013
Pneumothorax 0 D. Humphrey Is there a time frame that is considered safe to begin HBO after a pneumothorax?
by D. Humphrey
Monday, July 29, 2013
Humidification levels inside the chamber 6 S. Bourbonnais Oops.  Correction, the floor wax is conductive not nonconductive. 
by L. Cheesebrough-Pegg
Thursday, May 30, 2013
Radiation-induced haemorrhagic cystitis 1 A. Salyers Here's one I found: http://www.redjournal.org/article/S0360-3016(11)03760-6/abstract
by R. Byrne
Monday, May 20, 2013
ARNP/ PA in Hyperbarics 1 C. Wreford-Brown I am a midlevel clinician (NP) working in a hyperbaric clinic. We also have a PA working here as well.  We don't seem to have any issues billing for the 99183 code.  Do you have any specific questions?Rosemary
by R. Byrne
Monday, May 20, 2013
TCOM Reimbursement 0 L. Cheesebrough-Pegg I have a question regarding the performance of TCOM studies in your units. Our Local Coverage Determination (LCD):Noninvasive Vascular Testing (N.I.V.T.) states: ...must be performed by a physician who is competent in diagnostic vascularstudies or under the general supervision of physicians who have demonstrated minimum entry level competency by being credentialed in vascular technology, or...How do you interprete this requirement for reimbursement? Does the physician have to be a vascular doc or one who has minimum crediantals in vascular technology? Or, is a phsyician credentialed in any area of medicine (i.e. an internal medicine or emergency medicine doc) able to perform TCOMs and receive reimbursement? Cuarrently we only have on CHT at my unit and am wondering if this person should be performing all TCOMS.Thanks for responses.
by L. Cheesebrough-Pegg
Monday, May 20, 2013
TCOM Reimbursement 0 L. Cheesebrough-Pegg I have a question regarding the performance of TCOM studies in your units. Our Local Coverage Determination (LCD):Noninvasive Vascular Testing (N.I.V.T.) states: ...must be performed by a physician who is competent in diagnostic vascularstudies or under the general supervision of physicians who have demonstrated minimum entry level competency by being credentialed in vascular technology, or...How do you interprete this requirement for reimbursement? Does the physician have to be a vascular doc or one who has minimum crediantals in vascular technology? Or, is a phsyician credentialed in any area of medicine (i.e. an internal medicine or emergency medicine doc) able to perform TCOMs and receive reimbursement? Cuarrently we only have on CHT at my unit and am wondering if this person should be performing all TCOMS.Thanks for responses.
by L. Cheesebrough-Pegg
Monday, May 20, 2013
Blood glucose monitoring 0 V. Hall The Accu-Chek Advantage blood glucose meter was approved for use under pressure and we have used it successfully in our multiplace chamber for years.  Unfortunately, this model is no longer manufactured and no other Accu-chek models are approved for use under pressure.  Does anyone know of an alternative meter that has been cleared for use under pressure?
by V. Hall
Friday, May 03, 2013
Hyperbaric ventilators 6 C. Wreford-Brown Does anyone have an update on the USA version of the Maquet Servo-i HBO ventilator and the 510K process? 
by W. Gossett
Friday, May 03, 2013
osteochondritis dessicans 0 K. Simmons A patient with osteochondritis dessican of the knee, still having avascular defect, even though has had lesion treated with pins and revascularization drilling of lesion.  Any one treated similar patient with HBO, or know of literature to support this treatment?
by K. Simmons
Friday, April 26, 2013
marx protocol 0 G. Karras 44 y/o female w history squamous cell carcinoma soft pallet. Received XRT about a year ago. Last month underwent tooth extraction of one of her molars. She received the Marx protocol...10 dives prior to the tooth extraction then 10 dives post. She has done well. She completed her last dive about 2 weeks ago. She calls now saying she may need a root canal on one of her other teeth.My question: does she need more HBO2 treatments post root canal and is there any data on how long into the future the effects of the Marx protocol will last in patients like this? Thank youGeorge Karras
by G. Karras
Wednesday, April 24, 2013
STRN of the head and neck HBO treatment 0 B. Freymiller Question about returning patients for STRN prophylaxis. If the patient had undergone the Marx protocol in the past do they need to repeat the full 20 or 30 pre and 10 post or can they just do the 10 post treatments? If the 10 treatments is sufficient should they be pre or post extraction? Thanks for responses.
by B. Freymiller
Monday, April 22, 2013
Cardiac Function 1 W. Palko-Schraa I agree with your cardiologist.  I have treated multiple patients with low ejection fractions.  As long as the patient does not show up with signs of heart failure i.e. SOB, chest pain, etc., I have not had a problem with these patients.  This is my personal experience.  I have not caused a patient to go into acute failure secondary to HBOT. Vince 
by V. Ferrini
Monday, March 25, 2013
Marx Protocol 1 J. Whitlark I can't say what the recommended time frame is for patients having extractions post last HBO treatment. If the oral surgeon and the hyperbaric physician are concerned about the down time and the patient has established ORN then the 30/10 protocol may be an option for you? Honestly, I can not offer much more info about this but I have sent your question to my medical director to see what she thinks.  http://www.ncbi.nlm.nih.gov/pubmed/10023268
by J. Cormier
Thursday, March 07, 2013
Concussions 1 D. Denham The clinical trials that are on-going right now are looking at post-concussion treatment with 60 mins of 100% O2 at 1.5 ATA.  I believe they are doing 5 sessions/week for 40 sessions.  Here's a link to the clinical trial: http://clinicaltrials.gov/show/NCT01105962. The preliminary data is impressive.We have treated a few patients with post concussion symptoms and have had some good results. Unfortunately, insurance does not cover this indication.
by R. Byrne
Tuesday, March 05, 2013
VP Shunt 0 M. O'Donnell Anyone with experience with treating TBI patient with programmable shunt?
by M. O'Donnell
Tuesday, February 26, 2013
Amiodarone 1 E. Slisher Yes we treat, but we follow the Healogics recommendations of 400 mg daily, due to the risk of pulmonary issues. We have had no problems doing this mutiple times. P Benson MD
by P. Benson
Monday, February 25, 2013
Potential HBO patients with recurrent eye cysts? 1 S. Sherr Unless they are air filled cysts, then they should not be affected.  Keep in mind all of our patients are diving with two fluid filled cysts, namely their eyeballs. P Benson MD
by P. Benson
Monday, February 25, 2013
idiopathic sudden sensorineural hearing loss 12 R. Byrne We treat 6 days a week for 15 treatments total.  If you are only open 5 days a week, that is fine.  Try to start them as soon as possible after the onset of symptoms.P Benson MD
by P. Benson
Monday, February 25, 2013
Physician agreement 3 D. Denham Do you have a medical director?  This is the medical director's role.  If you do not have a medical director, then you need to make sure all of your doctor's are at least educated on the requirements of your payors and especially the CMS LCD or NCD that you are covered by.  If you don't have a medical director, perhaps you have a contracted group that staffs your unit (healogics, paragon, etc?)  In any case, your doctors having varying definitions of what is an indication for treatment is putting themselves as well as your clinic at risk for audits, denials, and demand for return of reimbursement. P Benson MD 
by P. Benson
Monday, February 25, 2013
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