[hsopcak]

This is a new situation for me...

I have a sleep lab that wants to order o2 for a medicare patient. The only
dx provided are: hypersomnia & hypertension. Pt did have an over night pulse ox done in the home. There has been sats recorded below 89% for at least 5 minutes. Is oxygen covered in this case even though there is no respiratory dx?

[Regina]

I double-checked the LCD and there are no diagnoses listed, so this doesn't appear to be a diagnosis driven policy. I think as long as the pateint qualifies it should be ok. I would get an ABN. I hope someone else jumps in with an opinion.

[Sleeping410]

I would ask the Doctor to add Hypoxemia as a diagnosis code to the order since it is evidenced by the <89% O2 sat for over 5 minutes.