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Coverage Issues Manual

Section 35-10, Hyperbaric Oxygen Therapy. Hyperbaric oxygen therapy (HBO) is a modality in which the entire body is exposed to oxygen under increased atmospheric pressure. Based on evidence that we have reviewed, we are expanding coverage for the treatment of diabetic wounds of the lower extremities in patients who meet all of the following three criteria:
1. Patient has type I or type II diabetes and has a lower extremity wound that is due to diabetes;
2. Patient has a wound classified as Wagner grade III or higher; and
3. Patient has failed an adequate course of standard wound therapy.

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Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: December 27, 2002

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.