[integragrl]

If a patient goes on portable before the 1yr recert date for the concentrator with sat level @ 89 do I get another new revised for the 90 days with new testing info for the portable? Also that 90 days puts me past the recert date so would I do a recert with that revised date included on the CMN from when the patient went on portable (which the most current testing info would be that 89%) or do I just create a recert that has just the initial & recert date for the concentrator?

[lsologuren]

You need a revised CMN to add the portable to the initial O2 cmn. Report the latest O2 test on or before the revised date. Set the revised cmn to expire when the original initial cmn would have expired. The recert cmn would then include both the stationary and portable O2.

[leejgbt]

Originally Posted by integragrl

If a patient goes on portable before the 1yr recert date for the concentrator with sat level @ 89 do I get another new revised for the 90 days with new testing info for the portable? Also that 90 days puts me past the recert date so would I do a recert with that revised date included on the CMN from when the patient went on portable (which the most current testing info would be that 89%) or do I just create a recert that has just the initial & recert date for the concentrator?

If the Initial CMN is for just a concentrator and the sat level was 89% the CMN is only good for 3 months or the length of the physician's whichever is less. The rule is as follows:

Group II criteria include the presence of (a) an arterial PO 2 of 56-59 mm Hg or an arterial blood oxygen saturation of 89 percent at rest (awake), during sleep for at least 5 minutes, or during exercise (as described under Group I criteria) and (b) any of the following:

1. Dependent edema suggesting congestive heart failure, or
2. Pulmonary hypertension or cor pulmonale, determined by measurement of pulmonary artery pressure, gated blood pool scan, echocardiogram, or "P" pulmonale on EKG (P wave greater than 3 mm in standard leads II, III, or AVF), or
3. Erythrocythemia with a hematocrit greater than 56 percent.

Initial coverage for patients meeting Group II criteria is limited to 3 months or the physician specified length of need, whichever is shorter. (Refer to the Certification section for information on recertification).

If you did a followup sat within this 3 month period or specified length of need then a recert CMN is done. If the portable was ordered before this recert CMN was done then a recert CMN is all that is necessary. If the reason for a revised CMN is within 90 days of a recert CMN then only a recert CMN needs to be done.

If the portable was done after the recert CMN was done then a revised to add the portable system would have to be done.