Fee Navigator®

    Health Service Code 13.99I

    Hyperbaric oxygen therapy detention time, full 15 minutes or major portion thereof for the first call when only one call is claimed

    NOTE:

    May only be claimed when a physician personally and continuously attends a patient with the following conditions: air/gas embolism, severe CO poisoning, clostridial myonecrosis (gas gangrene), decompression sickness, necrotizing soft tissue infections, chronic diabetic leg and/or foot ulcers resistant to all forms of conventional therapy, radiation tissue damage (osteoradionecrosis), osteoradionecrosis (mandible), osteomyelitis (refractory), skin grafts and flaps (compromised), therapeutically irradiated patients requiring osseointegrated implants (dental implant following radiotherapy).

    Category:V Visit
    Base rate:$48.76

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    CALLM151 - 16For Each Call Pay Base At100%
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82

    Governing Rules:

    • 6.7.2

      When more than one procedure with a "V" category is provided at the same encounter only the greater benefit may be claimed.

    • 15.9

      The unscheduled service benefit (modifier SURC) may be claimed for the services outlined in GRs 15.9.1 through 15.9.3.

    • 15.9.1

      selected "V" category code services:

      1. consultations, including telehealth (except those provided using store and forward videotechnology);
      2. intensive care unit visits (HSC 03.05A);
      3. psychiatric mental status determination requiring complete mental health status examination and investigation (HSC 08.11A);
      4. for complex patient, requiring complete mental status examination and investigation (HSC 08.11C);
      5. certification under the Mental Health Act (HSC 08.12A);
      6. trauma assessment, multiple trauma, severely injured patient (HSC 13.99GA);
      7. hyperbaric oxygen therapy detention time (HSC 13.99I);
      8. medical emergency detention (HSC 13.99J);
      9. management of complex labor, per 15 minutes (HSC 13.99JA);
      10. donor maintenance prior to cadaveric harvesting of organs (HSC 13.99L);
      11. examination and crisis counseling for sexual/physical abuse (HSC 13.99V);
      12. attendance at delivery (HSC 87.98E).