[Treatment] FYI: Home Oxygen Therapy Medicare Coverage Checklist - Printable Version +- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums) +-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area) +--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum) +--- Thread: [Treatment] FYI: Home Oxygen Therapy Medicare Coverage Checklist (/Thread-Treatment-FYI-Home-Oxygen-Therapy-Medicare-Coverage-Checklist) |
FYI: Home Oxygen Therapy Medicare Coverage Checklist - Gideon - 10-17-2022 I have heard many different requirements for Oxygen while under CPAP with Sleep Apnea, I did some digging. the short story is Medicare says "≤ 88% for a total of 5 minutes" (which need not be continuous) which is a much shorter period of time than is typically thrown around. https://www.nwrespiratory.com/uploads/document-library/e838649079bc052809c259880246347a.pdf Quote:5. Obstructive Sleep Apnea (OSA) Diagnosis Requirements https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33718 Quote:Coverage of home oxygen therapy requires that the beneficiary be tested in the “chronic stable state.” Chronic stable state is a requirement of the National Coverage Determination (CMS Pub. 100-03, Section 240.2) and is one of the key criteria when determining coverage of home oxygen therapy. The NCD defines chronic stable state as “…not during a period of an acute illness or an exacerbation of their underlying disease.” Based on this NCD definition, all co-existing diseases or conditions that can cause hypoxia must be treated and the beneficiary must be in a chronic stable state before oxygen therapy is considered eligible for payment. In addition, the beneficiary must have a severe lung disease, such as chronic obstructive pulmonary disease, diffuse interstitial lung disease, cystic fibrosis, bronchiectasis, widespread pulmonary neoplasm, or hypoxia-related symptoms or findings that might be expected to improve with oxygen therapy (see Oxygen LCD for additional information). For beneficiaries with OSA to be considered in the chronic, stable state, OSA must be sufficiently treated such that the underlying severe lung disease is unmasked. This must be demonstrated before oxygen saturation results obtained during polysomnography are considered qualifying for oxygen therapy. RE: FYI: Home Oxygen Therapy Medicare Coverage Checklist - Jay51 - 10-18-2022 Thank you very much Gideon for researching and posting this information. RE: FYI: Home Oxygen Therapy Medicare Coverage Checklist - upsman - 10-18-2022 Good info, Gideon. Thanks. Since I have COPD, I'll likely have to move to this phase of treatment eventually. |