Lower Extremity Wound Care

Electrostimulation and Electromagnetic Therapy for Wounds

CMS will allow for coverage for the use of electrical stimulation and electromagnetic therapy for chronic Stage III and Stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers when certain conditions are met

For more detailed information, see the CMS Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds National Coverage Determination (NCD).

Hyperbaric Oxygen (HBO) Therapy for Hypoxic Wounds and Diabetic Wounds of the Lower Extremities (CAG-00060N)

For claims submitted on/after April 1, 2000, HBO therapy in the treatment of diabetic wounds of the lower extremities will be covered in patients who meet each of the following three criteria. Patient has:

  • Type I or Type II Diabetes and has a lower extremity wound that is due to diabetes;
  • A wound classified as Wagner grade III or higher; and has
  • Failed an adequate course of standard wound therapy (defined below).

The use of HBO therapy will be covered as adjunctive therapy only after there are no measurable signs of healing for at least 30-days of treatment with standard wound therapy and must be used in addition to standard wound care.

Failure to respond to standard wound care occurs when there are no measurable signs of healing for at least 30 consecutive days. Wounds must be evaluated at least every 30 days during administration of HBO therapy. Continued treatment with HBO therapy is not covered if measurable signs of healing have not been demonstrated within any 30-day period of treatment.

For more information about HBO therapy for diabetic wounds of the lower extremities, see the CMS Hyperbaric Oxygen Therapy NCD.


Last Updated Nov 03 , 2022