Standard Wound Therapy
Walking boot, crutches, wheelchair, Total Contact Cast can all be utilized for what component of Standard Wound Therapy?
What is off-loading?
What is the minimal Wagner grade that the diabetic ulcer needs to be to qualify for HBO treatments?
What is Wagner grade 3 or higher?
How many days does there need to be of Standard Wound Therapy with NO signs of healing before HBO treatments can begin.
30 days
The HCPCS code for HBO therapy is_____?
G0277
ABI, TBI, arterial doppler, duplex scan, angiogram, etc. are utilized for what component of Standard Wound Therapy?
What are vascular studies?
Where does the diabetic ulcer need to be located to qualify for this project?
Lower extremity.
From the first day a patient starts HBO treatments, how many days do you have to see some type of measurable improvement in the ulcer/wound before treatments would need to be stopped.
30 days
How many LCD's are pertinent to this project?
2 LCD's: L35021 and L36504
What reason code would be used if the documentation did not state anything about the patient's nutritional status for diabetic wound management?
What is reason code HBO2Y?
What Wagner grade is an ulcer that has deeper extension into tendons, bones, or joint capsule, which may be exposed?
What is Wagner grade ll
How often do wound evaluations need to be done during HBO?
at least every 30 days
How many LCA's are pertinent to this project?
3 LCA's: A55788, A56714, and A57800
What reason code would be used if an infection was present but there was no treatment or intervention documented.
What is reason code HBO3l?
There are 5 different types of debridement's that can be used for removing dead tissue and slough from wounds? True or False
True. There is biological, autolytic, enzymatic, mechanical, and surgical debridement.
HBO is a modality in which the entire body is exposed to oxygen under increased atmospheric pressure. The patient is enclosed in a pressure chamber breathing 100% oxygen at greater than 1 atmospheric pressure. True or False?
True
If there is an ABN present in the claim AND a GA modifier was billed, the reviewer should______?
Submit a consult
How many components need to be addressed in order to meet sufficient documentation for Standard Wound Therapy?
There are 7 components of Standard Wound Therapy. Vascular status, nutritional status, glycemic control, debridement, moist wound bed with appropriate moist dressings, offloading, and infection.
A patient has a diabetic grade 3 ulcer on the right foot at the start of their wound care but a few weeks into their wound care the ulcer turns to gangrene and an amputation is performed of that foot, would this patient still qualify for HBO treatments?
No, once the ulcer has been removed by amputation it is now considered a surgical wound.
If there was no documentation regarding ascent time, descent time, air breaks, ATA, & PSI, this would be a reason to deny the claim. True or False?
False-we will not be reviewing for this
If documentation of an ulcer is described as superficial ulceration, but without penetration to deeper tissues and is documented as a Wagner grade 3 is this acceptable?
No-the description must match the Wagner grade 3 documented.