I have been posting information from the MAC websites about audits and required documentation, particularly for HBOT since that’s a huge audit focus. I got an email from a colleague in the Palmetto jurisdiction who for many months has been fighting denials for HBOT in soft tissue radionecrosis. The auditors have stated that in order to have radionecrosis, there has to be obvious tissue necrosis. The Palmetto MAC website has a lot of detailed information about certain specific HBOT indications. The website is “cute” – you hover over the indication and can briefly see the details. The cuteness of this wears off if you want to copy the information, since you can’t do that in an efficient way.
I pasted screen shots for the information on radiation. It matters because the website clearly offers a variety of clinical signs which define soft tissue radionecrosis. If I am in a patient mood, I will go through this ridiculous screen capture process for some of the other HBOT indications. Honestly, who designs these websites?
Palmetto is the MAC for:
• Region J: Alabama, Georgia, Tennessee (Region J)
• Region M: North Carolina, South Carolina, Virginia, West Virginia (excludes Part B for the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia)
• Home Health and Hospice for: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas
https://palmettogba.com/internet/eLearn3.nsf/hyperbaricoxygentherapy/story.html
Here are links to useful materials about HBOT on the Palmetto website:
- Link to educational materials on HBOT
- Hyperbaric oxygen webinar
- Hyperbaric oxygen: Getting it right the first time
- Hyperbaric Oxygen Checklist
- Hyperbaric Oxygen reason code crosswalk
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
