Reimbursement: Document Qualifying Test Result

Q. What do I need to document in the medical record to meet current oxygen policy requirements?

A. The current oxygen policy requires the practitioner to order and evaluate the results of a qualifying blood gas study performed at the time of need. I believe this requirement stems from the national coverage determination (NCD) but Medicare confirmed that the practitioner does not necessarily have to document that “I personally reviewed the qualify test result.”

However, the DME MACs will look for documentation of a qualifying test result in the medical record along with a discussion about the need for oxygen to improve the beneficiary’s condition in the home setting. For example, if the qualifying test result is documented in the vital of the practitioner’s progress note and the practitioner mentioned the need for home oxygen therapy, I believe this will comply with the LCD requirement.

Read the full article from HME News here.