Insurance-Approved Indications

Air/Gas Embolism

Air or gas bubble is introduced inadvertently into the arterial circulation during surgical procedures, diving accidents, or diagnostic monitoring. HBOT reduces bubble volume and increases gas absorption.

Carbon Monoxide Poisoning

Colorless, odorless gas causing injury/death. Early diagnosis and HBOT treatment essential to prevent neurological complications.

Compartment Syndrome/Crush Injury

Fluid develops in injured muscle, interrupting blood flow. HBOT reduces damage by oxygenating tissue and reducing edema.

Decompression Sickness/Illness (Bends)

Inert gas bubbles trapped in tissue/blood from rapid decompression during diving or hyperbaric chamber exposure. Hyperbaric oxygen therapy is the only treatment for this disorder.

Diabetic & Selected Wound Problems

Non-healing wounds result from tissue hypoperfusion and infection. HBOT serves as adjunct to medical/surgical treatment.

Exceptional Blood Loss (Anemia)

Severe blood loss compromises oxygen delivery. HBOT supplies oxygen when transfusion impossible for medical/religious reasons.

Gas Gangrene

Clostridial myositis/myonecrosis — severe acute infection in compound fractures. HBOT combined with surgery/antibiotics is preferred treatment.

Intracranial Abscess

High morbidity/mortality infections. HBOT may inhibit infection, reduce brain swelling, enhance defense mechanisms.

Necrotizing Soft Tissue Infection

Caused by aerobic/anaerobic bacteria. HBOT inhibits bacterial growth and enhances neutrophils to kill bacteria.

Osteoradionecrosis (ORN) & Radiation Tissue Damage

Radiation injuries months/years post-exposure. Hyperbaric oxygen therapy is used to enhance neovascularization in irradiated hypoxic tissue.

Osteomyelitis (Refractory)

Chronic bone inflammation. HBOT serves as adjunct therapy with surgical/infectious disease treatments.

Skin Grafts & Flaps (Compromised)

Tissue compromised by irradiation or decreased perfusion. HBOT maximizes viability of compromised tissue.

Thermal Burns

Serious burns (>20% body surface), partial/full thickness, or involving hands/face/feet/perineum. HBOT improves survival, reduces hospital stay, lessens surgery need.

Insurance Plans & Coverage Details

Molina Healthcare - Covered Conditions

  • Actinomycosis
  • Gas gangrene
  • Diabetes mellitus
  • Peripheral vascular disease
  • Chronic ulcers
  • Necrotizing fasciitis
  • Chronic osteomyelitis
  • Crushing injuries (head, neck, chest, abdomen, extremities)
  • Air embolism
  • Carbon monoxide toxicity
  • Cyanide toxicity
  • Decompression sickness
  • Skin graft complications

Aetna - CPT & HCPCS Codes

CPT Codes Not Covered

  • Vaporous hyperoxia therapy (VHT)

HCPCS Codes Covered

  • Hyperbaric oxygen under pressure, full body chamber, per 30-minute interval

HCPCS Codes Not Covered

  • Topical hyperbaric oxygen chamber, disposable
  • Topical oxygen delivery system, not otherwise specified

ICD-10 Codes Covered (Selection)

  • Septicemia due to anaerobes
  • Gas gangrene
  • Iron deficiency anemia from blood loss
  • Acute posthemorrhagic anemia
  • Diabetes with circulatory complications
  • Central retinal artery occlusion
  • Sensorineural hearing loss (bilateral)
  • Sudden idiopathic hearing loss (within 3 months)
  • Atherosclerosis with non-healing ulcers
  • Arterial embolism/insufficiency
  • Varicose veins with ulceration
  • Radiation proctitis
  • Chronic ulcers of lower limb
  • Necrotizing fasciitis
  • Chronic osteomyelitis
  • Radiation cystitis
  • Carbon monoxide poisoning
  • Cyanide poisoning
  • Radiation sickness/necrosis
  • Caisson disease (decompression sickness)
  • Traumatic compartment syndrome
  • Skin graft complications
  • Crushing injuries
  • Traumatic amputations

ICD-10 Codes NOT Covered (Selection)

  • Cancer/malignancies
  • Sickle cell crisis
  • Lupus/antiphospholipid syndrome
  • Depression/PTSD
  • Parkinson's disease / Alzheimer's
  • Multiple sclerosis
  • Epilepsy/seizures
  • Migraine/cluster headaches
  • Heart disease/ischemia
  • Stroke/cerebrovascular disease
  • Emphysema/COPD
  • Crohn's disease/ulcerative colitis
  • Arthritis
  • Traumatic brain injury
  • COVID-19

ICD-10 Codes Contraindicated

  • Viral infections
  • Respiratory disease (including untreated pneumothorax)
  • Hereditary spherocytosis
  • Premature infants (birth before 37 weeks)
  • High fever

Medi-Cal Coverage Guidelines

Medi-Cal covers hyperbaric oxygen therapy for conditions recognized by the Undersea and Hyperbaric Medical Society (UHMS). Coverage follows similar guidelines as listed in the approved indications above. Contact our office for specific Medi-Cal coverage verification.

Commonly Covered Conditions

  • Actinomycosis
  • Gas gangrene
  • Diabetes with circulatory complications
  • Chronic non-healing wounds
  • Necrotizing fasciitis
  • Chronic osteomyelitis
  • Air embolism
  • Carbon monoxide poisoning
  • Decompression sickness
  • Compromised skin grafts
  • Radiation necrosis

Why Choose HBO Therapy?

Hyperbaric oxygen therapy offers significant clinical benefits for patients with qualifying conditions. As an adjunct treatment, HBOT can:

  • Promote wound healing in chronic non-healing wounds
  • Reduce infection risk in compromised tissue
  • Enhance tissue oxygenation and revascularization
  • Support recovery from radiation injury
  • Serve as the definitive treatment for decompression sickness
  • Prevent limb amputation in diabetic patients

Have a Question? Ask Away!

Get in touch with our team to discuss your insurance coverage or schedule your first appointment.