Hyperbaric Oxygen Therapy

Patient had a history of prostate cancer with radiation therapy several years ago. Subsequently suffered from abdominal CA. During the Abdominal CA surgery the bladder was nicked and that bladder wound has failed to heal due to soft tissue radiation necrosis.

Patient has presented to our office for hyperbaric oxygen therapy. We are attempting to pre-cert the therapy with a commercial carrier and they are "balking" at our soft tissue necrosis due to radiation Dx code as well as "non healing wound". We have also tried 909.3 and 909.2.

I'm stumped. Can anyone offer suggestions??? This is just for pre-cert!!!

MJ Curtis

Hyperbaric oxygen pre-certification

You might try ICD-9 990. This is the approved diagnosis code for Medicare and some other carriers for radiation necrosis.