{"id":2668,"date":"2023-02-13T15:20:51","date_gmt":"2023-02-13T15:20:51","guid":{"rendered":"http:\/\/hfhpulm.com\/info\/?p=2668"},"modified":"2023-02-13T15:20:51","modified_gmt":"2023-02-13T15:20:51","slug":"medicare-oxygen-coverage-change","status":"publish","type":"post","link":"https:\/\/hfhpulm.com\/info\/?p=2668","title":{"rendered":"Medicare Oxygen Coverage Change"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">There is an update to Medicare guidelines for coverage of oxygen. This is being adopted by most DME(Including HART) and should make the process easier. These went into effect 1\/1\/23. This is a summary of the discussion with HART. I am certain there will be nuances that come up through the year.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Key changes<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Removal of medical necessity forms (This may still need to be completed for prior O2 but will likely phase out in 2023) <\/li><li>Removal of language (eg alternative treatments have been tried or considered)<\/li><li>Changing \u201cchronic stable state\u201d language to \u201ctime of need\u201d (eg 3 months, lifelong)<\/li><li>Allowing for coverage on acute and chronic conditions<\/li><li>Patients new to oxygen will need repeat Oxygen testing 61-90 days after initiating (even if known to need lifelong), however a face to face is not required.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"> There are 4 groups<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Group 1<\/strong>&#8211; Hypoxemic patients. All patients covered if Sat of 88% or below or PaO2&lt;55mmHg. Example if patient in for PNA and needs oxygen can be covered but needs repeat O2 dose in 61-90 days to continue.<\/li><li><strong>Group 2<\/strong>&#8211; Sat 89% with dependent edema suggestive of heart failure, Pulmonary hypertension or Cor Pulmonale, Erythrocythemia with HCT &gt; 56%<\/li><li><strong>Group 3<\/strong>&#8211; chronic cluster headaches without hypoxemia<\/li><li><strong>Group 4<\/strong>&#8211; Diagnosis <strong>not covered<\/strong><ul><li>Angina Pectoris without hypoxemia<\/li><li>Dyspnea without cor pulmonale or hypoxemia<\/li><li>Severe Peripheral vascular disease without hypoxemia<\/li><li>Terminal illnesses that do not affect the ability to breath<\/li><\/ul><\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>There is an update to Medicare guidelines for coverage of oxygen. This is being adopted by most DME(Including HART) and should make the process easier. These went into effect 1\/1\/23. This is a summary of the discussion with HART. I am certain there will be nuances that come up through the year. Key changes Removal [&hellip;]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[6,17],"tags":[],"class_list":["post-2668","post","type-post","status-publish","format-standard","hentry","category-clinic","category-f2"],"modified_by":"Patrick Bradley","_links":{"self":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts\/2668","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2668"}],"version-history":[{"count":7,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts\/2668\/revisions"}],"predecessor-version":[{"id":2675,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/posts\/2668\/revisions\/2675"}],"wp:attachment":[{"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2668"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2668"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2668"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}