# Hyperbaric oxygen therapy question



## jhipler

I know when coding hyperbaric oxygen therapy you count th time of therapeutic treatment as well as ascent, descent, and time for air breaks but if the time is 102 minutes would you could 3 or 4 units?  The HCPCS code C1300 is per 30 min interval and since 102 minutes is not 4-30 minute intervals, I am incline to code 3 units.  I'm presently doing an audit on this and need to know if the coders are doing this correctly. Does anyone know? Please let me know. Thanks

Joan


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## lrhoward

In calculating how many 30-minute intervals to report, hospitals should take into consideration the time spent under pressure during descent, airbreaks, and ascent.

In general, an additional unit of service cannot be coded unless the patient is in the chamber receiving hyperbaric oxygen treatment for at least 16 minutes beyond the previous 30-minute period. To appropriately report C1300:

The first unit reported must be at least 16 minutes in length 
The second unit cannot be coded unless the session is at least 46 minutes long (first unit = 30 minutes + 16 additional minutes) 
The third unit cannot be coded unless the session is at least 76 minutes long (first and second units = 60 minutes + 16 additional minutes) 
The fourth unit cannot be coded unless the session is at least 106 minutes long (first, second, and third units = 90 minutes + 16 additional minutes.) In general, the Centers for Medicare and Medicaid Services (CMS) does not expect that a physician order for 90 minutes of HBO therapy would exceed four billed units of HCPCS code C1300.


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## ciphermed

*Related Change Request #: 3632 MLN Matters Number: MM3632*
Additional units may be billed for sessions requiring at least 16 minutes of the next 30-minute interval. For example, two units of HCPCS code C1300 should be billed for a session in duration of between 46 and 75 minutes, while three units should be billed for a session in duration of between 76 and 105 minutes. Further, four units of HCPCS code C1300 should be billed for a session in duration of between 106 and 135 minutes. 
HBO is typically prescribed for an average of 90 minutes, which hospitals should report using appropriate units of HCPCS code C1300 in order to properly bill for full body HBO therapy. In general, the Centers for Medicare and Medicaid Services (CMS) does not expect that a physician order for 90 minutes of HBO therapy would exceed four billed units of HCPCS code C1300.

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM3632.pdf

I must admit I am not sure that this is the most recent data however its from Medicare and its a start...

Hope this helps,


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## jhipler

*Hyperbaric Oxygen Therapy*

Thanks for the info. I appreciate it.


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## ritablack

*billing for more than 1 patient at a time in Hyperbaric Chambers*

I have a provider in rotation for supervision of 4 patients in the Hyperbaric Chamber at the same time.  Is this permissable with CMS? How would one bill for these patients?


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## MMAYCOCK

I bill for a three chamber HBO. There is nothing in the regulations (that I have found) to restrict the number of patients supervised. Although the facility may bill multiple units, the physician can bill only one unit -99183 per patient per day. 

So if you have 4 patients supervised, each patient would be billed with 1 unit of 99183 by the supervising physician. The usual documentation to the patient chart must be noted.


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## spuchesc

Would anyone know if a patient is looking for certification from a Hyperbaric physician in order to be approved to dive in regard to their employment, would this be considered a Consult or an office visit E&M?   Also, would v70.5 (Occupational Health exam)icd9 code be appropriate for this? Or v72.85 (other specified examination)

Any information would be greatly appeciated.


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