Wiki 99183 Hyperbaric Oxygen Therapy

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I have had problems with Medicare denying 99183 with a diagnosis code of 909.2 Late effect radiation. I have reviewed the NCD and the listed codes approved for coverage. 909.2 is a covered code. When i called Medicare, all they would tell me is that it was denied as not covered under the NCD. I verified that I was looking at the current copy of the NCD. Anyone else having this problem? I am unsure of where to go from here.
 
I'm in jurisdiction J8 our mac has retired the LCD for 99183, also CMS states there is no NCD for 99183. but I have been using the following guide from AAPC coder to code and charge for a physician that does the HBO supervising, hope this helps: (ICD-9 ref codes at bottom)

CPT? Code 99183 Details
Code Descriptor
Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session

Notes:
0 (Evaluation and Management services and/or procedures [eg, wound debridement] provided in a hyperbaric
oxygen treatment facility in conjunction with a hyperbaric oxygen therapy session should be reported separately)
Lay Term
In this procedure, the provider attends and supervises the administration of hyperbaric oxygen therapy to patient to
treat specific conditions, like decompression sickness faced by deep sea divers, burns, ulcers, and non healing wounds.

Clinical Responsibility
With the position positioned in a hyperbaric chamber, the provider establishes the chamber settings and supervises
the session, in which the patient is exposed to oxygen at a pressure higher than the normal atmospheric pressure. The
provider attends the entire session.
Terminology
Hyperbaric oxygen therapy: Delivery of oxygen in a compression chamber at a pressure greater than normal
atmospheric pressure, thereby increasing the oxygen supply in the blood supply.

Tips
Code 99183 reports the provider services only. The procedure is reported separately.
CPT?Guidelines
No CPT Guidelines found for this code

ICD-9 Vol1 Crossref
039.1, 039.2, 039.3, 039.4, 039.9, 040.0, 040.42, 444.21, 444.81, 449, 526.89, 728.86, 730.11, 730.12, 730.13,
730.14, 730.16, 730.17, 730.18, 730.19, 903.01, 903.1, 904.0, 904.41, 927.01, 927.02, 927.03, 927.09, 927.11,
927.20, 927.21, 927.3, 927.9, 928.00, 928.01, 928.10, 928.20, 928.21, 928.3, 928.8, 929.0, 929.9, 958.0, 986, 989.0,
990, 993.2, 993.3, 996.57, 996.90, 996.91, 996.92, 996.94, 996.95, 996.96, 996.99, V45.85,
 
I was on the phone this morning with Medicare and they told me my claims were denied due to the NCD. I'm not sure what is going on with my claims. I know we have used this diagnosis in the past and had the claims paid for other patients.
 
I have a question in regards to the order in which you coded it. because the 909.2 replaced the 990 for HBO. Do you code the late effects 1st 909.2 and than the ulcer / Osteoradionecrosis/cystitis( result of radiation) 2nd.


I know if you are billing for the facility Medicare and almost all insurances only accept C1300 but for 2015 G0277 you do not use 99183.
 
HBO Therapy

I am new to billing these services for one of my physicians which now supervises these services at a wound care clinic and I'm confused as to which codes he should be billing. The clinic has both codes G0277 and 99183 and I'm not sure if the G0277 is only for the facility to bill or if I should be billing G0277 or 99183. Your assistance is greatly appreciated.
:confused:
 
terry4162 said:
I am new to billing these services for one of my physicians which now supervises these services at a wound care clinic and I'm confused as to which codes he should be billing. The clinic has both codes G0277 and 99183 and I'm not sure if the G0277 is only for the facility to bill or if I should be billing G0277 or 99183. Your assistance is greatly appreciated.
:confused:
Click to expand...

You can now bill for both. We bill Noridian Medicare for the G0277 because we own the HBOT machine and our providers also bill for the 99183. https://www.uhms.org/resources/regulatory-affairs.html
 
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