TRADITIONAL INDICATIONS FOR HBOT:
| Decompression sickness | Intracranial abscess |
| Air embolism | Necrotizing soft tissue infections |
| Carbon monoxide poisoning | Osteomyelitis |
| Gas gangrene | Delayed radiation injury |
| Crush injury and compartment syndrome | Compromised skin grafts |
| Selected problem wounds | Thermal burns |
| Exceptional blood loss anemia | |
There are 13 officially approved indications for HBOT in this country. This approval is given by the Undersea and Hyperbaric Medical Society (UHMS). A committee in that organization meets annually to review the indications and make decisions about adding new ones. The indications on this list are generally covered by most (but not all) insurance providers.
Note that there are no neurologic indications on this list. That is a point of some contention amongst hyperbaric practitioners. Many physicians have little doubt that HBOT can be beneficial in a number of conditions not on “the list.”
UHMS has not embraced treatment of stroke and traumatic brain injury because they say there is not enough scientific evidence to prove that it is a cost-effective therapy. That is music to the ears of health insurers. They certainly don’t want to pay for anything they don’t have to.
Most hyperbaric therapy units are associated within hospitals, usually within the purview of a wound care center. The most common usage of HBOT in the USA is in the treatment of certain types of wounds. This generally means wounds (most commonly in diabetics) that are life or limb-threatening.
I would say in our region, the next three most common indications would be: (1.) delayed radiation injuries, (2.) compromised grafts and surgical wounds, and (3.) crush injuries.
The proportion of treatment indications likely varies in different regions of the country. For example, coastal areas are more likely to see scuba diving accidents (air embolism and the “bends”), while the colder, northern states have a higher incidence of carbon-monoxide poisoning.
In the South, we commonly see Brown Recluse Spider bites, which may cause serious wounds that are difficult to heal. Many wound-care specialists feel that HBOT is the most effective treatment for serious Brown Recluse bites. This usually can be covered by insurance.
While The HBO Clinic was established primarily to treat “off-label” indications for HBOT, we certainly have the willingness, the experience and the equipment to treat the traditional indications, if needed. If a patient has insurance that would cover their treatment, we would refer them to a nearby wound center for treatment.
If a patient has the need for HBOT and does not have insurance or has insurance whose benefits do not cover HBOT, we would be happy to evaluate and treat the patient using the same price structure discussed elsewhere in this website.
