FIRST COAST SERVICE OPTIONS
LOCAL COVERAGE DETERMINATION
CODING GUIDELINES
LCD Number
99183
Contractor
Name
First Coast Service
Options, Inc.
Contractor
Number
09102 – Florida
09202 – Puerto Rico
09302 – Virgin Islands
LCD Title
Hyperbaric Oxygen
Therapy (HBO Therapy)
Coding
Guidelines
CPT code 99183
Physician attendance and supervision of hyperbaric oxygen therapy, per session,
is reported for physician attendance of each session of hyperbaric oxygen
therapy. Any services and/or procedures
provided in addition to the physician attendance and supervision (eg, E & M
services, wound debridement, transcutaneous PO2 determinations) in the
hyperbaric oxygen treatment facility, in conjunction with hyperbaric oxygen
therapy should be reported separately.
E &M services
billed on the same day of HBO therapy require a significant, separately
identifiable service, unrelated to the HBO therapy or the condition which
necessitated the HBO therapy and modifer 25 must be applied to the E & M
service. Documentation must reflect the
necessity, as well as a description of services provided.
This code reflects a per session descriptor,
therefore, regardless of the time HBO therapy is performed (e.g., 1 hour, 2
hours) during each session, each unit billed equals one session.
Per CMS Manual System, Pub. 100-3, Medicare
National Coverage Determinations, Chapter 1, Section 20.29, for each of the
fifteen covered conditions, the following diagnosis should be utilized:
1.
Acute carbon monoxide
intoxication - Diagnosis 986
2.
Decompression illness -
Diagnosis 993.2, or 993.3
3.
Gas embolism - Diagnosis
958.0, or 999.1
4.
Gas gangrene - Diagnosis
040.0
5.
Acute traumatic
peripheral ischemia - Diagnosis 902.53, 903.01, 903.1, 904.0 or 904.41
6.
Crush injuries and
suturing of severed limbs - Diagnosis 927.00-927.09, 927.10-927.11,
927.20-927.21, 927.8, 927.9, 928.00-928.01, 928.10-928.11, 928.20-928.21,
928.3, 928.8-928.9, 929.0-929.9, or 996.90-996.99
7.
Progressive necrotizing
infections:(necrotizing fasciitis) - Diagnosis 728.86
8.
Acute peripheral
arterial insufficiency associated with arterial embolism and thrombosis - Diagnosis 444.21, 444.22, 444.81
9.
Preparation and
preservation of compromised skin grafts (flaps) - Diagnosis 996.52
10. Chronic refractory osteomyelitis, unresponsive to
conventional medical and surgical management - Diagnosis 730.10-730.19
11. Osteoradionecrosis as an adjunct to conventional
treatment - Diagnosis 526.89, 909.2
12. Soft tissue radionecrosis as an adjunct to
conventional treatment - Diagnosis 990, 909.2
13. Cyanide poisoning - Diagnosis 987.7 or 989.0
14. Actinomycosis, only as an adjunct to conventional
therapy when the disease process is refractory to antibiotics and surgical
treatment. - Diagnosis 039.0-039.9
15. Treatment of diabetic wounds of the lower extremities
– Diagnosis 250.70-250.73, 250.80-250.83, 707.10, 707.12-707.15, and 707.19.
Other
Comments
N/A
Revision
History
|
Date |
Revision |
|
02/02/2009 –
Florida |
Original |
Document
formatted: 12/08/2005 (JG/st)