Hyperbaric Oxygen (HBO) Therapy (Section C, Topical Application of Oxygen)

30.2 Hyperbaric Oxygen (HBO) Therapy (Section C, Topical Application of Oxygen) (Rev.3921, Issued: 11-17-17, Effective: 04-03-17, 12-18-17) CMS considers topical oxygen therapy (TOT) to be a method whereby a local supply of oxygen is applied to a wound. I. Billing Requirements for A/B MACs (A) Claims for HBO therapy should be submitted using the ASC X12 837 institutional claim format or, in rare cases, on Form CMS-1450. II. Payment Requirements for A/B MACs (A) As of April 3, 2017, Medicare coverage of topical oxygen for the treatment of chronic wounds will be determined by the local contractors. NOTE: Regardless of whether an A/B MAC (A) has made a determination to cover this service, there shall be no coverage for any separate or additional physician’s professional services related to this procedure. III. Billing Requirements for A/B MACs (B) As of April 3, 2017, Medicare coverage of topical oxygen for the treatment of chronic wounds will be determined by the local contractors. NOTE: Regardless of whether an A/B MAC (B) has made a determination to cover this service, there shall be no coverage for any separate or additional physician’s professional services related to this procedure.