Home O2 Clarification Needed

[lisa41rn]

Can someone clarify the requirements for patients to leave a hospital newly needing home o2?? I believe the o2 sat needs to be less than 88% on RA. Does it need to be documented twice now?? Also, when the order is made it needs to be with the duration and flowrate, right?

When do ABG's need to be taken? Is it when a patient needs a BIPAP? I've had a situation recently for a new BIPAP order and believe I needed to have a sleep study done and ABGs done, but am a bit confused. I know the home o2 requirements have changed some, but don't think you need ABGs for that, right?? Thx.

[Mijourney]

Lisa, I don't know if you're working with a Medicare patient but check under http://www.cms.hhs.gov for a national coverage determination (NCD) for oxygen under your state. It will tell you the requirements for home use. Even if the patient you're working with is not Medicare, most carriers follow Medicare guidelines. Hope this helps.

[BahaMamamaRN]

To qualify for home O2. I usually have Respiratory Therapy document a room air Sat

For a new home Bipap order that gets difficult for me(Ltac setting) because the pt needs to have an actual sleep study not just a overnight pulse oximetry reading. We do not have a sleep center @ our facility. Most of the time the pt's have had this done before and it does not have to be recent. So, I talk to the pt and find out the facility where they had this and get them to fax the info to the home o2 company.

Once, I had to have the pt schedule the sleep study outpt before he could qualify to receive the bipap machine at home. The home O2 company would not budge even though we had the orders for settings we used in the hospital. I hope that helps a little.

[CaseManager1947]

To obtain BiPap or CPap, patient must first have an overnight sleep study in a lab set up to properly monitor, and apply supportive BiPap if pt. is flunking, You do need a gas in Kansas with a specific CO2 level, also. Sad, but thats the way of it.