Summary
Systemic hyperbaric oxygen pressurization may be considered medically necessary for non-healing diabetic wounds of the lower extremities that meet all three criteria, acute traumatic ischemia, decompression sickness, acute gas embolism, acute cyanide poisoning, acute carbon monoxide poisoning, soft-tissue radiation necrosis and osteoradionecrosis, pre- and post-treatment for dental surgery (non-implant related) of an irradiated jaw, gas gangrene, profound anemia with exceptional blood loss when transfusion is impossible or must be delayed, and chronic refractory osteomyelitis. Topical hyperbaric oxygen therapy is considered investigational. Systemic hyperbaric oxygen pressurization is considered investigational in all other situations, including compromised skin grafts or flaps, acute osteomyelitis, acute thermal burns, acute surgical and traumatic wounds, and chronic wounds other than diabetic wounds that meet the stated criteria.
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