Medicare Compliance & Reimbursement
NCA Could Expand Oxygen Concentrator Payout
Durable medical equipment providers could influence a Medicare coverage expansion for stationary or portable oxygen tanks and oxygen concentrators - if they can provide solid evidence.
The Centers for Medicare and Medicaid Services issued a national coverage analysis on Aug. 16 for extending DME coverage associated with supplemental oxygen to more beneficiaries.
Medicare covers home oxygen for patients suffering from chronic hypoxemia, resulting from cardiac or pulmonary disease. Patients can receive home oxygen DME coverage if they have oxygen partial saturation measurements at or below 55 millimeters of mercury (mm Hg) or oxygen saturation at or below 88 percent. Patients with an oxygen partial pressure of 56-60 mm Hg or an 89-percent oxygen saturation, who have additional diseases or conditions, can also receive this coverage.
What to expect: As a part of this internally generated NCA, CMS wants more evidence supporting home oxygen coverage for beneficiaries who have arterial partial pressure measurements in the range of 56-65 mm Hg. Providers can submit comments until Sept. 16, 2005.
For more information, go to http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=169.
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