200 The American Rd, Morris Plains, NJ 07950 800-287-0643 973-538-2703 athomemedical@atlantichealth.org

Order Process Overview


Medicare Oxygen Checklist

  • Progress Notes/Face to Face:
    A plan of careincluding a historical respiratory assessment, documentation that patient has been compliant with their medications and deemed ineffective prior to ordering oxygen therapy.
  • Oxygen Testing:
    88% on room air at restif the patient is below 88% on R/A @ rest- that is all the testing needed.
    • If testing the patient on exertion a 3-part test is necessary:
      • O2 sats on room air
      • O2 sats during exertion on room air
      • O2 sats during exertion with oxygen applied (include the liter flow)
      • Exertion text example: "Patient will require home o2 due to hypoxia during exertion... o2 sats 94% on R/A @ rest, 86% R/A w/ exertion, 92% w/ exertion 2LPM o2 applied. Patient will require long term home o2
  • Reminders:
    • Patients prescribed oxygen "PRN" or "as needed" do not meet coverage criteria and will not be covered for home oxygen therapy.
    • Medicare only considers long term oxygen therapy for payment; short term therapy for an acute condition is not a covered benefit.

 

CPAP/BIPAP Documentation Checklist

  1. Patient demographics
  2. Face to face chart notes -----prior to sleep study
  3. PSG,Split Study or HST (also titrated study if ordering BIPAP)
  4. Rx with description of items ordered
  5. **IF AHI is less than 15 the patient must also have one of the following diagnosis indicated in their progress notes to qualify: excessive daytime sleepiness, hypertension, impaired cognition, mood disorders, insomnia, ischemic heart disease, history of stroke
  6. If ordering home sleep test, include home sleep test instructions

 

For ordering BIPAP ALL of the above applies and the following is also required:

  1. A Cpap has been tried and proven ineffective based on a therapeutic trial conducted in either facility or in a home setting
  2. Ineffective is defined as documented failure to meet therapeutic goals using a Cpap during the titration portion of a facility-based study or during home use (i.e. proper mask fitting and selection with appropriate pressure settings)
  3. A NEW Face to Face is required for Bipap if the patient has used a Cpap for more than 3 months
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