Hyperbaric Oxygen Therapy Medical Policy

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Hyperbaric Oxygen Therapy (HBOT) - Medical Clinical …

https://www.aetna.com/cpb/medical/data/100_199/0172.html

Scope of PolicyThis Clinical Policy Bulletin addresses hyperbaric oxygen therapy. 1. Aetna considers systemic hyperbaric oxygen therapy (HBOT) medically necessary for any of the following conditions (with usual medically necessary number of session… See more

Hyperbaric oxygen therapy - Mayo Clinic

https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380

Hyperbaric oxygen therapy is used to treat several medical conditions. And medical institutions use it in different ways. Your health care provider may suggest hyperbaric oxygen therapy if …

FEP Medical Policy Manual - FEP Blue

https://www.fepblue.org/-/media/PDFs/Medical%20Policies/04-10-2020/20104%20Hyperbaric%20Oxygen%20Therapy.pdf

Hyperbaric Oxygen Therapy Description Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen at pressures between 1.5 and 3.0 …

Hyperbaric Oxygen Therapy and Topical Oxygen …

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/hyperbaric-topical-oxygen-therapy.pdf

Hyperbaric Oxygen Therapy (HBOT) is proven and medically necessary for the following conditions: Acute traumatic peripheral ischemia/insufficiency (i.e. crush injury, …

New medical necessity criteria | UHCprovider.com

https://www.uhcprovider.com/en/resource-library/news/2022/hyperbaric-oxygen-therapy-policy.html

Updated medical policy for hyperbaric oxygen therapy Effective Dec. 1, 2022, we will only consider hyperbaric oxygen therapy (HBOT) services for CPT® …

NCD - Hyperbaric Oxygen Therapy (20.29) - Centers for …

https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=12

HBO therapy is a valuable adjunctive treatment to be used in combination with accepted standard therapeutic measures when loss of function, limb, or life is threatened. …

Hyperbaric and Topical Oxygen Therapies - Cigna

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0053_coveragepositioncriteria_hyperbaric_oxygen.pdf

This Coverage Policy addresses the use of systemic hyperbaric oxygen (HBO) therapy (HBOT), also called hyperbaric oxygen therapy (HOT), and topical oxygen therapy …

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