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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: