Health Information Management

Q&A: Claims for hyperbaric oxygen therapy rejected

APCs Insider, June 26, 2015

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Q: We have been receiving rejections of our claims with HCPCS code C1300 (hyperbaric oxygen under pressure, full body chamber, per 30-minute interval). We have not found a replacement code.
 
A: CMS issued a new HCPCS code for reporting hyperbaric therapy beginning January 1, 2015, replacing C1300, which was deleted. The new code is G0277 (hyperbaric oxygen under pressure, full body chamber, per 30-minute interval).
 
Four aspects of the therapy may be included in calculating the total number of intervals billable with G0277:
  1. Time spent by the patient under 100% oxygen
  2. Time of descent
  3. Air breaks
  4. Time of ascent
 
Be sure you take the total time into account and not just the time that the patient is actually receiving the 100% oxygen treatment. CMS has agreed that the treatment includes the time involved for the descent, ascent, and air breaks. The next 30-minute interval is reported when at least 16 minutes of therapy has been provided during a 30-minute interval.
 
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Fort Lauderdale, Florida, answered this question.

 

 



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