Medicare Oxygen Checklist
- 1. Progress Notes/Face to Face:
- A qualifying respiratory diagnosis, a plan of care including a respiratory assessment, and documentation that patient has been compliant with their medications.
- Notes need to indicate previous treatments were tried and/or deemed ineffective.
- Notes need to mention patient requires home oxygen.
- 2. Oxygen Testing: 88% on room air at rest if 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 at rest
- O2 sats during exertion on room air
- O2 sats during exertion with oxygen applied (include the liter flow)
Example: “Previous treatment no longer effective, patient will require home O2 due to COPD …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.
- 3. Reminder:
- Medicare will not cover oxygen prescribed “PRN” or oxygen for an acute condition. ie: COPD exacerbation or PNA.
- Medicare only considers long term oxygen therapy for payment; short term therapy for an acute condition is not a covered benefit.