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Hyperbaric Medicine
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Topics   Replies Score Author Latest Post
Looking for Dr. MR Reillo 1 R. Duncan Has this research been written up in a journal yet?  I do not know how to contact Dr. Reillo
by V. Ferrini
Thursday, August 23, 2012
Safety procedure videos 3 L. Cheesebrough-Pegg try http://www.emedsim.com/
by R. Byrne
Friday, August 10, 2012
Avascular necrosis treatment? in children? 0 R. Byrne I was wondering if anyone is treating AVN with HBOT?  and more specifically, if anyone is treating children with AVN?  if so, what protocol?  any results?  has insurance paid?thanks!
by R. Byrne
Friday, August 10, 2012
transverse myelitis 0 L. Golembeski has anyone ever treated a pt with transverse myelitis with HBO? Is it an indiacation of such that is covered? Any info would be greatly appreciated. Thanks. Lori G... Sarasota Memorial Hospital/ Hyperbaric dept. 941-917-1866
by L. Golembeski
Monday, August 06, 2012
Video monitoring of patients. 2 E. Voss I'm always in the same room. Due to area constraints the desk can't be located between the chambers.My desk is approximately 10 feet away. The problem is I am looking at the patients from the chamber door end. I can't see their faces. Problem, can't see facial twitching or other si igns of distress on patients faces. I am using the monitors and the video screen is located directly under my computer monitor. Their faces and chests are is crystal clear viewing. (Watching chest rise and fall when the patients are sleeping. Any other suggestions are greatly appreciated.
by E. Voss
Saturday, June 30, 2012
Bisphosphonate induced osteonecrosis of Mandible 0 S. Shah I have a patient requesting HBOT for bisphosphonate induced osteonecrosis of mandible. Is providing HBOT appropriate ? Can  someone suggest any publications in this area ? Is there a specific ICD code that can be used for Medicare billing ? Thanks   Sid Shah
by S. Shah
Saturday, May 26, 2012
TCOM protocols 2 S. Wood According to Highmark Medicare (now Novita-Soultions) in NJ, anyone undergoing HBOT for a DFU Wagner Grade III or higher must have the following criteria met: Diabetic wounds of the lower extremities in patients who meet the following three criteria: A) Patient has type I or type II diabetes and has a lower extremity wound that is due to diabetes; B) Patient has a wound classified as Wagner grade III or higher; and C) 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. 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 diabetic wounds of the lower extremity, the Wagner classification of the wound and the failure of an adequate course (at least 30 days) of standard wound therapy must be documented at the initiation of therapy: A) Documentation must demonstrate an ulcer with bone involvement (osteomyelitis), or localized gangrene, or gangrene of the whole foot. B) Documentation of standard wound care in patients with diabetic wounds per the NCD must include: assessment of a patient’s vascular status and documentation of correction of any vascular problems in the affected limb; documentation of optimization of nutritional status; documentation of optimization of glucose control; documentation of debridement by any means to remove devitalized tissue; documentation of maintenance of a clean, moist bed of granulation tissue with appropriate moist dressings; documentation of efforts for appropriate off-loading; anddocumentation of necessary treatment to resolve any infection that might be present. Usually the starting point for any DFU/Wagner III during a TCOM should be around 35mmHg - 50mmHg, that number should double or triple after the 10 minute O2 challenge.  If it starts our less than 35mmHg and does not respond after the O2 challenge they may need vascular intervention.  Also, if you can do "in-chamber" TCOMS, do them, they are very helpful.
by F. Steffich
Thursday, May 24, 2012
Prior Hx of Pneumothorax 0 J. Toth In the past, a one time CXR, PA & Lat screening study and exam was all that was required in a pt with no pre-existing lung pathology, who sustained one pneumothorax from trauma, which was small, and which spontaneously resolved within a few months. Is anyone aware of any changes to these recommendations?John Toth D.O.
by J. Toth
Tuesday, May 01, 2012
APAI approval 1 J. Castro We have several hyperbaric centers in the different states so it depends on the state. I have used the code 440.23 with and ulcer code for coverage in Ohio but in Tennessee, the CMS does not recognize that code. It makes no sense but it is the fact.Thanks Vince
by V. Ferrini
Tuesday, April 24, 2012
TCOM coding (U.S. ICD-9 for CMS) 0 A. Johnston I have been reviewing coding integrity and have come against a roadblock as to whether a normobaric TCOM with an oxygen challenge and/or an in-chamber TCOM on 100% oxygen meet the requirements for 93923 as a "provocative maneuver." Historically we have taken it to count, but all examples in coding books available to us use physical exercise examples such as toe elevations or treadmill walking, although they are obviously directing their attention toward ultrasound studies and their examples are neither stated to be exclusive or exhaustive. The only internet item I've found to specifically address the question is a blog posting from December 2010 by Dick Clarke (http://www.baromedical.com/blog_Dec2010.php) where the question is raised, but there doesn't seem to be a follow up posted. Does anyone have something in writing from any source stating an answer?
by A. Johnston
Monday, April 16, 2012
Missing Cribriform plate and HBOT 0 C. Waltz Somebody inquired if she, having nasal cancer and having had her cribriform plate removed through surgery, and now undergoing radiation therapy would be a possible candidate for hyperbaric therapy in the future (if warranted) or would it be contraindicated because of the missing plate? She will be undergoing 6.5 weeks of radiation to the nasal area.  Her surgeon told her that the pressure from the hyperbaric would travel through her sinuses and cause her brain to herniate because she is missing the cribriform plate.  Thoughts?  Connie Waltz ACHRN
by C. Waltz
Wednesday, April 11, 2012
Osteonecrosis of jaw (OJN) 1 P. Dionne I think Duke was doing a study...I don't know if that is still the case.
by K. Fowler
Monday, April 02, 2012
curious case 1 D. McCluskey We had a patient with breast implants that had similar breast pain complaints.  She did not have pain anywhere else and her pain didn't start until she had around 10 treatments. Kari
by K. Fowler
Monday, April 02, 2012
Any problems with a patient taking Taxol? 0 P. Schell We have a potential hyperbaric patient with breast cancer and taking Taxol.  Has anyone seen any problems allowing a patinet to dive taking Taxol? OakLeaf Advanced Wound Care & Hyperbaric Medicine Center
by P. Schell
Friday, March 09, 2012
Equine Chamber Explosion in Florida 0 H. Hodes Is anyone going to talk about the Equine chamber explosion in Florida where we lost a CHVT? Seems to me that this horrible accident needs some discusion. Guess I'll start it. >>>        Why is it from all the photos and videos of that system that are available on the internet does the Equine Chamber look like an accident waiting to happen? Really, 100% oxygen chamber of that size and from what I saw it was not even close to being clean enough for pumping it with %100!  If horse hoofs will chip the coating and create the spark that blew this one up, wouldn't some type of covering for the horse hoofs be required then? Also, why are there viewports low enough that an aggitated horse could kick one if it got unstable? Seems to me the viewports would be higher and have some of safety guard. And lastly, the reports say this horse was not "sedated as usual" that time, really? , Why would that not be standard operating procedures just like normal check lists used in People Vessles?   I know that we operate under the PVHO-1 standards because of the human element to our procedures, but clearly humans will always be running Class C chambers and if they fail, as did this one, humans will be around the carnage when it goes.   Hal
by H. Hodes
Friday, February 24, 2012
Purpura fulminans 0 J. Cooper Has anyone had much experience with treating purpura fulminans?  In particular I am looking for criteria for finishing with treatment.
by J. Cooper
Tuesday, February 14, 2012
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