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Oxygen order insurance requirements checklist


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.
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