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Hyperbaric Treatment Coding

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  • jyamisha
    I need some help regarding coding for Hyperbaric treatment. We use hyperbaric oxygen chambers to treat wounds... burns, and some people w/ brain/nerve damage.
    Message 1 of 2 , Jan 18, 2002
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      I need some help regarding coding for Hyperbaric treatment.

      We use hyperbaric oxygen chambers to treat wounds... burns, and some
      people w/ brain/nerve damage. This is still considered "experimental"
      by many insurance companies. (We are a diagnostic center, NOT a
      hospital, and we are located throughout NJ and NY state.)

      Here is my question: Currently, the only codes we are successful in
      using are 99183 and 35950 (8x-- this code is for a 15 min. treatment,
      and we perform 2 hour treatments.)

      Does anyone out there have any experience w/ Hyperbaric treatment, or
      other forms of oxygen therapy? Are there any other codes I can try
      using? I know that hospitals use codes other than those 2, but I am
      not sure whether a diagnostic center is allowed to use those codes.

      Any help would be appreciated.

      -Jonty Yamisha
    • jyamisha
      Hi, I have a question on Hyperbaric treatment coding, specifically, and one on facility vs. professional centers, generally. I m in charge of the billing for a
      Message 2 of 2 , Mar 13, 2002
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        Hi, I have a question on Hyperbaric treatment coding, specifically,
        and one on facility vs. professional centers, generally.

        I'm in charge of the billing for a chain of Hyperbaric treatment
        centers. We currently use the CPT code 99183 for HBO services.
        Services are typically performed by a tech or nurse, but under the
        orders and/or supervision of an attending physician (M.D.)

        Here is my first question: Are we allowed to bill for a doctor's
        office visit (initial and followup consultations) for each of these
        visits? What other codes are we legally allowed to use?

        My second question: We tried submitting a facility use code, but kept
        getting shot down. Reason being that we're not a facility (like a
        hospital), so we're limited only to professional fees. There is a
        code that is widely used among hospital-based HBO treatment centers,
        and we're not able to use that code. That code was 35950. What other
        options do we have?

        There are not too many HBO centers in our area, and even fewer non-
        hospital based centers. I really don't know where else to turn.

        Right now, I'm going under the assumption that HMOs are looking at
        the 99183 code as a global fee, but given the low rate of
        reimbursement that they're giving us (as low as $150 for a 2 hour
        treatment), that simply can't be right.

        (Sorry for the long post, but I wanted to give as much detail as
        possible.)

        Does anyone have any thoughts/comments that might help me out?

        -Jonty Yamisha
        Co-founder & Principal
        Medical Partners Group
        www.medicalpartnersgroup.com
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