New CMS code for Undersea and Hyperbaric Medicine in 2019: D4

Undersea and Hyperbaric Medicine practitioners, you have a new CMS code next year: D4.

Through the joint efforts of several individuals in the Undersea and Hyperbaric Medical Society and the American College of Hyperbaric Medicine, physicians who specialize in Undersea and Hyperbaric Medicine have been assigned a unique specialty code by the Centers for Medicare and Medicaid Services. That specialty code is D4. The code goes into effect on January 1, 2019.

Current CMS regulations state that if a patient has been seen by another provider in the same specialty within the past 36 months, you may NOT bill an E/M for a new patient evaluation, but, must use a follow-up evaluation and management CPT code (e.g., if you are a surgeon practicing hyperbaric oxygen therapy, and another surgeon refers a patient with necrotizing fasciitis to you, you cannot bill for a new patient evaluation if that surgeon has seen the patient in the past 36 months. This rule prevents you from obtaining reimbursement for a lengthy new patient evaluation. Similarly, if you are an emergency physician and are referred a diver or CO poisoning patient from the ER, you cannot bill for a new patient evaluation.)

The new code will eliminate that restriction.

This may also affect physicians under the Merit-Based Incentive Payment System. Since cost will be factored into the MIPS score from now on, calculations that reflect cost attribution may be linked to specialty codes. For example, Family Practice physicians who designate as FP will be compared to other FPs. If those same physicians practice hyperbaric medicine and wound care and designate themselves D4, they should be compared to other D4s regardless of primary specialty. Since so many of the products and services provided by hyperbaric and wound care physicians are costly, comparison to non-HBO2/WC physicians would be unfair. Hopefully, this new specialty code will allow a more equitable comparison of cost as we move away from a fee-for-service model.

Those who would most benefit from this change are physicians who solely practice UHM. If you are a physician who practices part-time, you may or may not want to change your specialty code. Since Medicare specialty codes are self-designated, this will have no effect on Medicare fee schedules, only on the ability to bill for a new patient exam as described above.

Existing enrolled providers who want to update their specialty to reflect the new specialty code must submit a change of information application to their Medicare Administrative Contractor (MAC). Providers may submit within 60 days of the implementation of the new specialty code, which goes into effect on January 1, 2019. Physicians who are newly enrolling should submit a Medicare enrollment application (CMS-8551 or CMS-8550) form.

HFA Application/Presurvey Questionnaire launches on August 1, 2018

The UHMS Hyperbaric Facility Accreditation Program (HFA) announces the launch of the new secure online platform for electronic submission of all facility accreditation survey documentation. It will be located on the HFA page on the UHMS website along with the instructions.

We will be launching HFA Application/Presurvey Questionnaire (HFA SA/PQ) on August 1, 2018.

You will now be able to submit the application, presurvey questionnaire, and additional required documents in one place.We will receive them once the “submit” button is clicked.

You will no longer have to submit multiple files via email! After August 1, 2018, we will no longer accept submission via email. If you have already provided your documentation for surveys scheduled after August 1, 2018, you will nothave to resubmit.

For further information, please contact:

Derall Garrett, HFA Director, (210) 404-1553, 877-533-8467 x106:

Beth Hands, HFA Coordinator, (210) 404-1553, 877-533-8467 x105:



CUHMA Announces 2018 Annual Scientific Meeting

The Canadian Undersea and Hyperbaric Medical Association (CUHMA) has announced its annual meeting for 2-4 November in beautiful Quebec City.

We have an interesting scientific program and will be offering a Hyperbaric Emergency Training Simulation course at our hyperbaric facility in Lévis as a pre-conference workshop.

For more info, see:



TBI PROGRESS REPORT: A new paper on hyperbaric oxygen therapy for traumatic brain injury has been published

The Department of Defense-sponsored clinical trial on hyperbaric oxygen for mild traumatic brain injury has yielded promising findings for future research.

The Emmes Corporation of Rockville, Maryland, recently announced that scientists and health professionals from Emmes; LDS Hospital in Salt Lake City, Utah; Lovelace Biomedical Environmental Research Institute in Albuquerque, New Mexico; and the U.S. Army Medical and Materiel Development Activity at Fort Detrick, Maryland, have completed a multiyear clinical trial testing hyperbaric oxygen as an intervention for U.S. military service members who have suffered mild traumatic brain injuries with persistent symptoms.

Eleven researchers, as well as members of the study team, collaborated to write a paper that summarized these most recent comprehensive findings in the series of studies. ‘Hyperbaric oxygen for post-concussive symptoms in United States military service members: a randomized clinical trial’ was published in March-April 2018 issue of Undersea and Hyperbaric Medicine, the bimonthly member publication of the Undersea and Hyperbaric Medical Society

The Department of Defense-sponsored study included both active-duty soldiers and veterans in the military who suffered from mild traumatic brain injuries.

Millions of people in the United States deal with traumatic brain injuries, and combat military personnel have increased risk for persistent post-concussive symptoms. This clinical research studied military personnel with post-concussive symptoms occurring three months to five years after mild traumatic brain injury. The randomized clinical trial evaluated participants’ specific symptoms, as well as a range of other assessments such as quality of life, sleep, cognitive processing, as well as auditory, visual and neuroimaging traits.

Hyperbaric oxygen produced short-term improvement in self-reported post-concussive and post-traumatic stress disorder (PTSD) symptoms, as well as some cognitive processing speed and sleep measures, in comparison to a control group. These improvements regressed after six months, however. One notable finding was that improvements were most significant in trial participants suffering from both traumatic brain injury and PTSD.

“Results suggest that hyperbaric oxygen may have a favorable effect that merits further study in service members, especially in those with PTSD,” said Dr. Lindell Weaver, principal investigator and a member of the Hyperbaric Medicine Department of LDS Hospital. “This could be a promising avenue for further research.”

“We are planning to produce more in-depth papers on the findings of this study,” noted Dr. Steffanie Wilson, Emmes biostatistician and principal investigator of Emmes’ data analysis and management center for the research team. Wilson added that additional research could address such issues as dosing, length of treatment and patient selection.

According to Dr. Anne Lindblad, president and chief executive officer of Emmes: “We learned a great deal from this research, from design to outcomes to logistics. This will be extremely helpful in developing more efficient clinical trials in the future and ultimately more effective ways to treat brain injuries and PTSD.”

About the paper

The paper was published in the March/April 2018 issue of the Undersea and Hyperbaric MedicineJournal. Members can access the paper by logging into the website at

Non-subscribers can access the paper fora nominal fee at

About the Contract

This material is based upon work supported by the Department of Defense under Contract No. W81XWH-15-D-0039-0003. The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation. In the conduct of the protection of human subjects as prescribed by Code of Federal Regulations (CFR) Title 45, Volume 1, Part 46; Title 32, Chapter 1, Part 219; and Title 21, Chapter 1, Part 50 (Protection of Human Subjects).

UHMS moves to Manuscript Manager editorial platform

To:  All UHMJ contributors and reviewers

Re:  Change in editorial platform for online paper submissions and reviews:

Dear Contributors and Reviewers to the UHM Journal:

Effective immediately UHMS is moving to Manuscript Manager editorial platform for all new submissions. Current authors and reviewers are aware of the change.

Make all new submissions at

As for pending submissions/papers in progress, all remaining papers will be dealt with directly from Dr. Camporesi’s and my respective desks.

Besides the platform change, we have kept our basic guides and requirements.

We will do our very best to make this transition smooth for you (and us). Please be patient with us during this move.

If you have questions, please send them to


UHMS welcomes Derall Garrett as new UHMS Hyperbaric Facility Accreditation Director

Derall Garrett has joined the Undersea and Hyperbaric Medical Society as Hyperbaric Facility Accreditation Director. His appointment became effective Monday, December 4, when he began work with retiring accreditation director Tom Workman and HFA coordinator Beth Hands.

Mr. Garrett has been working in the field of hyperbaric medicine for more than a decade. He is a graduate of the College of Oceaneering, certified as a commercial diver and a diver medic. He is a Certified Hyperbaric Technician through the National Board of Diving Hyperbaric Technologist since 2000.

Garrett has experience working with both Class A and B hyperbaric systems in a variety of settings. He is certified by two hyperbaric chamber manufacturers to provide service and maintenance to their Class B hyperbaric systems.

“Derall is uniquely qualified for the position of Director of the HFA department,” noted UHMS Executive Director John Peters. “His years of experience as an accreditation surveyor will benefit the department and the UHMS greatly.

“Tom has done a remarkable job preparing the position for Derall,” added Peters. “With assistance from HFA Coordinator Beth Hands, UHMS Accreditation Council Chair Dr. Brett Hart, and myself, Derall will have a dedicated support system as he comes up to speed.”

In addition, Tom Workman will provide an expanded department orientation beyond his December 31 retirement date.

Derall Garrett joined Diversified Therapy in 2002 as the Safety Director for the Wound Care and Hyperbaric Medicine program at University Community Hospital – Carrollwood, Tampa, Florida. In 2006, Mr. Garrett became the VP of Hyperbaric Services for Innovative Healing Systems until 2012. From 2012 to now, he has been working under his own branded hyperbaric consulting and service company, providing services globally.

A resident of Melbourne Beach, Florida, Mr. Garrett has been a UHMS member since 2003 and UHMS HFA surveyor since 2013 and has completed numerous surveys over the years.

For more information on UHMS accreditation, see

Increase your credits: UHMS ASM 2017 poster presentations are ready to review

The Undersea and Hyperbaric Medical Society is making it even easier to increase your CME credits online through its CME Portal.

The 2017 Annual Scientific Meeting poster presentations are now available at the UHMS Online CME Portal at the following link:

This access is available to everyone, not just ASM 2017 attendees. Just log in to the UHMS Online CME Portal to find the presentations. Registered 2017 ASM Participants received a coupon code to access at no charge.

You can create an account if you haven’t already registered at the UHMS Online CME Portal, then log in. You can access this program as well as many other educational opportunities. Plus, the portal is available to everyone, although UHMS members receive substantial discounts on all programs.

How it works
This educational program includes reading 90 poster presentations that were presented at the 2017 UHMS Annual Scientific Meeting in Naples, Florida. This program offers an opportunity to review the latest research and science on topics relevant to undersea medicine, hyperbaric medicine and/or wound care in a poster PDF format.

The participant is expected to answer one question for each of the 90 poster presentations. CME credit will be granted if an overall passing score is achieved. Partial credit is not offered per session, but the CME/CEU credit certificate will be provided after each session provided all conditions are met.

Note: NBDHMT approved only some posters for credit. NBDHMT participants participating for Category ‘A’ credit should answer only the questions designated for them in each session marked to include the following posters:
B7, C1, C2, C3, C9, C15, C16, C17, C19, C20, D13, D15, D18, E1, E2, E4, E5, E6, E8, E11, E13, E14 E15, E16, E17, F2, F3, F5, F6, F11, F14, F16, F19

Target audience
Physicians, Scientists, Nurses, CHTs, Students and anyone with an interest in undersea medicine, hyperbaric medicine and/or wound care.

2017 UHMS ASM registered attendees to the general session: FREE
UHMS Regular Member: $393.75
UHMS Associate Member: $281.25
Non-Member: $506.25

Accreditation statement
The Undersea and Hyperbaric Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physician.

All faculty members and planners participating in continuing medical education activities sponsored by UHMS are expected to disclose to the participants any relevant financial relationships with commercial interests. Full disclosure of faculty and planner relevant financial relationships will be made at the activity.

Designation statements
Physician CME: The Undersea & Hyperbaric Medical Society designates this enduring material for a maximum of 22.50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
MOC ABPM: The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 22.50 LLSA credits towards ABPM MOC Part II requirements.
Nursing/RRT: This enduring material is approved for 22.50 contact hours provided by Florida Board of Registered Nursing/RRT Provider #50-10881.
NBDHMT: This enduring material is approved for 8.25 Category A credit hours by National Board of Diving and Hyperbaric Medical Technology, 9 Medical Park, Suite 330, Columbia, South Carolina 29203

For full course information and to access today, please visit this page:

The information provided by this CME material is for Continuing Medical Education purposes only. The lecture content, statements or opinions expressed however, do not necessarily represent those of the Undersea and Hyperbaric Medical Society (UHMS), its affiliates or its employees.

~ Reported by Stacy Harmon, UHMS CME Coordinator

It’s FUHM time.

PRESSURE Jan-Feb 2016.indd

UHMS is accepting Fellow of Undersea and Hyperbaric Medicine applications through the end of the year.

How to nominate your candidate
Log in to the member site at and paste the following link in your web browser address bar:

Or log in to the UHMS website and then paste these links in your browser:



What’s in a name?
Becoming a FUHM is a special honor, an acknowledgment of achievement and of the high standards of expertise, practice and contribution to the field of UHM. Here’s the scoop.

Policy and purpose
Recognition as a Fellow of Undersea and Hyperbaric Medicine is awarded to individual members of the Society whose professional activities and standing are judged to be worthy of recognition. The Undersea and Hyperbaric Medical Society Board of Directors confers this recognition based upon the criteria and procedures set forth in the policy document at

Who can be a FUHM?
Candidates considered eligible for the FUHM award will be members of the Society in good standing who have devoted significant time and effort to the practice or advancement of Undersea and Hyperbaric Medicine (UHM), achieved the highest level of expertise in their field, and demonstrate professional and ethical standards consistent with the aims and expectations of the UHMS.

What does it mean to be a FUHM?
Although FUHM recognition is not an academic qualification or specialty certification, FUHMs may utilize their award to demonstrate advanced achievement and expertise in Hyperbaric and/or Diving Medicine through, for instance, display of their FUHM award certificate, use of appropriate post-nominals, and inclusion of information regarding their award in CVs, résumés and analogous documents.

Once awarded, FUHM status is not automatically retained, but is contingent upon the continued good standing of the individual and membership in the UHMS. Consequently, the BOD may rescind FUHM recognition in accordance with the procedures listed.

What is the application process?
Please review all the requirements for application on the UHMS website.

  • All applicants must be nominated for FUHM recognition by current FUHM awardees, BOD members, or the FUHM Committee.  
  • The deadline for the nomination letter and application is January 1, 2018, with no exceptions.
  • There are no self-nominations allowed.
  • Once the nomination letter has been reviewed by the Committee and the nominee is determined to have met all criteria for FUHM status, an application will be sent to the nominee.
  • Nominees interested in pursuing formal FUHM recognition must then submit an application requesting consideration for FUHM award no later than February 1, 2018.
  • For applicants meeting criteria, letters of support and any other documentation required by the FUHM Committee will be due by March 1, 2018. The material will then be reviewed by the FUHM Committee and advanced to the Board of Directors for a final decision.

Know a deserving person? Of course you do. Start your nomination process today.


UHMS announces position statement on low-pressure, soft-sided hyperbaric chambers

The Board of Directors of the Undersea and Hyperbaric Medical Society recently approved a new position statement addressing low-pressure, soft-sided hyperbaric chambers.

The gist: The marketing and operation of portable low-pressure fabric hyperbaric chambers for indications other than acute mountain sickness is considered off-label.

The use of the low-pressure fabric hyperbaric chambers is commonly called mild hyperbaric therapy (MHT or mHBOT). Marketing and use of these devices as clinical hyperbaric chambers is also common, and consumers should use caution. Using mHBOT with air as designed, will deliver no more oxygen to the body than breathing oxygen by mask at sea level pressure. We are not aware of any reliable clinical evidence that mild compression to less than 1.4 ATA has any therapeutic effect. Mild Hyperbaric therapy is being offered in clinical chambers as well as the low pressure fabric hyperbaric chambers. The UHMS does not recommend the use of mHBOT for any medical purpose other than acute mountain sickness.

For details as well as reference materials, see the attached PDF.

Low Pressure – Soft Chamber UHMS Position Statement Final