Researchers at Johns Hopkins University Have Reported New Data on Reconstructive Microsurgery (Insurance Coverage for Hyperbaric Oxygen Therapy In Acutely Compromised Tissues): Health and Medicine – Reconstructive Microsurgery

2025 JUL 08 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Health and Medicine - Reconstructive Microsurgery. According to news originating from Baltimore, Maryland, by NewsRx correspondents, research stated, “Beyond its indication for chronic wounds, hyperbaric oxygen therapy (HBOT) is an adjunct to managing acutely compromised grafts and flaps. Because physicians have reported challenges obtaining insurance coverage for HBOT, this cross-sectional analysis reviews policy requirements and presents an algorithm to enhance the odds of successful reimbursement.”

Our news journalists obtained a quote from the research from Johns Hopkins University, “We identified the 60 largest health insurers by market share and enrollment and collected their policies on HBOT. We then conducted a dual, blind extraction of policy details (e.g., continuing and prior authorization, documentation, treatment guidelines) and compiled these data into an insurance reimbursement algorithm to assist prescribing physicians. Fifty-three health insurers (88.3%) had policies on HBOT; 47.2% ( n = 25) required prior authorization, and 61.9% ( n = 13) required continuing authorization after a set number of HBOT sessions (median: 20 sessions, interquartile range [IQR]: 12-30 sessions). Thirty-eight (71.7%) permitted clinical judgment when defining flap or graft ‘compromise,’ and 35.7% ( n = 15) considered any pressure greater than 1 atmosphere absolute to be ‘hyperbaric.’ Twenty-two insurers (41.5%) outlined documentation requirements for HBOT reimbursement; the most often requested documentation were medical records ( n = 19, 86.4%), signs of healing ( n = 12, 54.5%), images ( n = 10, 45.5%), treatment goals ( n = 8, 36.4%), and dive parameters ( n = 5, 22.7%). Most insured Americans are eligible for 12 sessions of HBOT; however, medical necessity must be established early and reconfirmed often to increase the likelihood of reimbursement.”

According to the news editors, the research concluded: “Additionally, prescribing physicians should be aware that insurers differ in their documentation, prior authorization, and continuing authorization requirements.”

This research has been peer-reviewed.

For more information on this research see: Insurance Coverage for Hyperbaric Oxygen Therapy In Acutely Compromised Tissues. Journal of Reconstructive Microsurgery, 2025. Journal of Reconstructive Microsurgery can be contacted at: Thieme Medical Publ Inc, 333 Seventh Ave, New York, NY 10001, USA. (Thieme - www.thieme.com)

The news correspondents report that additional information may be obtained from Kristen P. Broderick, Johns Hopkins University, School of Medicine, Dept. of Plastic and Reconstructive Surgery, 4940 Eastern Ave Suite A520, Baltimore, MD 21224, United States. Additional authors for this research include Matthew J. Heron, Katherine J. Zhu, Annie B. McVeigh, Siam K. Rezwan and Carisa M. Cooney.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1055/a-2616-3981. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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