Topical Oxygen Therapy

This A/B MAC LCD states topical oxygen therapy (TOT) is not covered due to insufficient evidence of efficacy and lack of controlled clinical trials; CMS removed the NCD exclusion but allowed local contractors to make coverage determinations, though this LCD is non‑coverage. The policy lists multiple contraindications (eg, inadequate perfusion, necrotic wounds with eschar, acute thrombophlebitis, Raynaud’s, fistulae/deep sinus tracts) and notes potential adverse effects and regimen variations for intermittent and continuous TOT devices.

"This A/B MAC LCD states topical oxygen therapy (TOT) is non‑covered; there are no covered indications under this LCD."

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