Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session
CPT4 code
Name of the Procedure:
Physician or Other Qualified Health Care Professional Attendance and Supervision of Hyperbaric Oxygen Therapy (HBOT)
Summary
Hyperbaric Oxygen Therapy (HBOT) involves breathing pure oxygen in a pressurized room or chamber. The presence and supervision of a physician or other qualified health care professional ensure safety and optimize treatment outcomes.
Purpose
HBOT is used to treat various medical conditions such as decompression sickness, wounds that won't heal due to diabetes or radiation injury, and infections where tissues are starved for oxygen. The goal is to increase oxygen delivery to damaged tissues, promote healing, and improve overall outcomes.
Indications
- Decompression sickness
- Chronic non-healing wounds (diabetic foot ulcers, radiation injuries)
- Severe anemia
- Certain types of infections (e.g., necrotizing soft tissue infections)
- Air or gas embolism
- Carbon monoxide poisoning
Preparation
- Patients may need to avoid certain medications and smoking before the procedure.
- Diagnostic tests such as imaging or blood tests may be required.
- Patients should wear cotton clothing and avoid bringing any flammable materials into the chamber.
Procedure Description
- The patient is placed in a hyperbaric chamber, either a monoplace (single person) or multiplace (multiple people) chamber.
- The chamber is gradually pressurized to the prescribed level (often 2-3 times normal atmospheric pressure).
- The patient breathes 100% oxygen through a mask or hood.
- Sessions usually last about 90 minutes to 2 hours.
- The physician or other qualified health care professional monitors the patient throughout the session, adjusting pressure and addressing any issues.
Duration
Typically, each session lasts between 90 minutes to 2 hours. The number of sessions varies depending on the condition being treated.
Setting
HBOT is typically performed in specialized hospitals or clinics equipped with hyperbaric chambers.
Personnel
- Hyperbaric medicine physicians
- Trained technicians and nurses
- Respiratory therapists, if needed
Risks and Complications
- Ear or sinus pain due to pressure changes
- Temporary vision changes
- Oxygen toxicity (rare but serious)
- Claustrophobia
- Barotrauma (injury caused by pressure changes)
Benefits
- Accelerated wound healing
- Reduced risk of infection
- Enhanced recovery from certain conditions like decompression sickness
- Potential reversal of some effects of radiation therapy
Recovery
- Patients can usually resume normal activities immediately after each session, though some may feel lightheaded or tired.
- Follow any specific instructions given by the healthcare professional, including attending all scheduled sessions for maximum benefit.
Alternatives
- Standard wound care for chronic wounds
- Medications or surgery for decompression sickness and infections
- High-flow oxygen therapy for carbon monoxide poisoning
- Each alternative comes with its own set of risks and benefits compared to HBOT.
Patient Experience
- During the procedure, the patient may feel a sensation of fullness in the ears similar to that experienced during a flight.
- Patients typically lie comfortably and can listen to music or watch TV.
- Minimal discomfort is expected; however, pain management options are available if needed.