Billing and Coding: Topical HBO and Physician Related Service Billing and Coding Guidelines

CMS removed the National Coverage Determination for topical oxygen therapy for chronic wounds, leaving coverage decisions to local MACs. Regardless of MAC coverage, Medicare does not allow separate or additional payment for physician professional services related to topical oxygen therapy; topical oxygen HCPCS codes E0446 and A4575 are DME jurisdiction and specific billing instructions (including entering '99199-related to Topical HBO' on Part B claim comment fields) must be followed.

"Topical oxygen therapy for chronic wounds is not covered by a National Coverage Determination; coverage determination is made by the local Medicare Administrative Contractor (MAC)."

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