Medicare will require Prior Authorization of Non-Emergent (HBO) Therapy in 2015

Originally posted on HYPERBARIC tech blog (hbotechblog.com):

-By Roque Wicker

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CMS has just announced that starting March 2015 three states (Illinois, Michigan, and New Jersey) will be required to get “Pre-authorizations” for the next three years for non-emergent hyperbaric treatments for the following indications:
1. Chronic refractory osteomyelitis
2. Diabetic lower extremity wounds (Wagner 3 and above).
3. Osteoradionecrosis.
4. Preparation and preservation of compromised skin grafts and flaps.
5. Soft tissue radionecrosis.
6. Actinomycrosis.
The decision was made due to “high incidences of improper payments for these services”.

Authorization times will vary from 10-20 business days and as little as 2 days for “imminent” treatment for a life or limb threatening indication.

According to the memo A provisional affirmative prior authorization decision, justified by the beneficiary’s condition, may affirm up to 36 treatments in a 12-month period.

To read more about this please click the links below:
Insurance news HBO article

CMS prior auth process

CMS…

View original 5 more words

Medicare will require Prior Authorization of Non-Emergent (HBO) Therapy in 2015

-By Roque Wicker

IMG_0176.JPG
CMS has just announced that starting March 2015 three states (Illinois, Michigan, and New Jersey) will be required to get “Pre-authorizations” for the next three years for non-emergent hyperbaric treatments for the following indications:
1. Chronic refractory osteomyelitis
2. Diabetic lower extremity wounds (Wagner 3 and above).
3. Osteoradionecrosis.
4. Preparation and preservation of compromised skin grafts and flaps.
5. Soft tissue radionecrosis.
6. Actinomycrosis.
The decision was made due to “high incidences of improper payments for these services”.

Authorization times will vary from 10-20 business days and as little as 2 days for “imminent” treatment for a life or limb threatening indication.

According to the memo A provisional affirmative prior authorization decision, justified by the beneficiary’s condition, may affirm up to 36 treatments in a 12-month period.

To read more about this please click the links below:
Insurance news HBO article

CMS prior auth process

CMS prior auth (PA) HBO presntation

Say goodbye to nitrogen narcosis?

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Another discovery in the diving word eh?  Or perhaps an incentive for risk taking divers to go to the extremes – who knows.  It is fascinating to see that someone has created a “gummy bear for the deep”.

From SporkDiver.UK: Nitrogen narcosis, or the ‘Raptures of the Deep’, as Jacques-Yves Cousteau called it, is the disorientating effect and altered state of mind caused by breathing nitrogen at a high partial pressure. The deeper a diver descends, the higher the partial pressure of nitrogen and other gases in his air will be. For this reason, nitrogen narcosis is usually thought of as a function of depth. The deeper a diver goes, the greater the narcosis.

Read whole article here

Does your patient REALLY understand you?

HEAR YOU copyThis isn’t a language barrier question, this is a medical literacy question. Did you know that 9 out of 10 patients do not receive health information in a way they can use or understand?

 “Nothing, not age, income, employment status, educational level and race or ethnic group affects health status more than literacy skills”

Studies have shown that 40-80 percent of the medical information patients receive is forgotten immediately and nearly half of the information retained is incorrect. One of the easiest ways to close the gap of communication between clinician and patient is to employ the “teach-back” method, also known as the “show-me” method or “closing the loop.” Teach-back is a way to confirm that you have explained to the patient what they need to know in a manner that the patient understands. Patient understanding is confirmed when they explain it back to you. It can also help the clinic staff members identify explanations and communication strategies that are most commonly understood by patients.

Best Publishing has been kind enough to post a podcast interview about the teach back method as well as patient education.

Here is the link

Decompression Sickness in Miami

We just heard about a friends daughter getting 8 hyperbaric treatments for what sounds like at least a type 2 DCS or possibly an AGE (she is completely paralyzed on one side) and symptoms have not subsided. We are unsure about what type of chamber was used but it was at a FL hospital, nor do we know how long the treatments were or the depth of each treatment.

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It’ll be interesting to see if the patient was treated with any US NAVY Dive Tables (not monoplace modified tables).

Any comments on this would be great.
If if your facility does receive such symptoms without any dive information (if patient doesn’t recall any of the depths and dive times) how would you treat this patient? How deep, how long?