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Just Breathe

HomeCare (10/08) Bunch, Jane
 
For home care providers confused about the capped rental model for oxygen tanks, here are some tips on how to bring about the necessary changes within the business environment and how to comprehend new guidelines for coverage. Policies for reimbursement of oxygen have not changed; it is still covered for those with advanced lung disease or hypoxia-related symptoms. To qualify, a patient must be in either Group I or Group II.
 
The new guidelines call for the implementation of audit procedures to guarantee that the provider has a copy of all necessary documentation, including labs and progress notes. Group I patients will need to undergo a CMN before coverage can go into effect. The results of this test must be available within 30 days preceding the date of the first delivery, and must be shared with the intake staff.
 
On the one-year anniversary of the start date, the patient must acquire a one-year recertification CMN. A patient with a length of need spanning a lifetime, or 99 months, does not need any additional retests for coverage. However, if the patient has received a retest in the previous 12 months, then the latest test result has to be recoded on the CMN.

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