Pulse Oximeters

With a 1500 daily patient census, my agency has 1 pulse oximeter per branch/5 total as not seeing a request for this service by doctors in our area.

Remember MUST have physician order to perform this diagnostic test BEFORE test performed.

Reasons why NOT to purchase own device: buying a pulse ox of my own?

My client's current DME supplier states that they must pay for the rental of their pulse oximeter out of pocket because the doctor did not write the order in the manner required for medicaid to pay for it. Can anybody enlighten me on how this order needs to be rewritten to get medicaid to reimburse for this equipment?

All homecare agencies that supply equipment or have nurses use LABORATORY equipment -which pulse oximeter is, must follow CLIA testing standards which include periodic testing for calibration of devices.

Each states Medicaid program has differing requirements for what they will pay for regarding DME. Call a competitor DME and ask what RX needs to state in order for it to be covered. I suspect Dr wrote blanket state "Pulse oximetry as needed" --not good enough.

When my homecare agency had DME, we requested RX:

DX: Apnea of newborn

Continuous pulse oximetry testing x 60 days, report Pulse Ox less than 92 to MD.

DX: Bronchopulmonary dysplasia

"Pulse ox Q 8-13 hours and PRN X 90 days. Report Pulse Ox less than 88 while on Oxygen 1/2 liter"

Often missed was length of time equipment needed to be used and frequency of testing. Need new letter of medical necessity (LMN) prior expiration date of order eg 60 or 90 days.... chronic children could have up to 6 months....all what state MA will permit.

One states MA provider regs: http://www.dhhs.state.nc.us/dma/physician/1a3.pdf

Thanks NRSKaren for your response to my question. You have such a wealth of knowledge and experience that I know I can always rely on. Too bad I can't get my questions answered by my supervisors at work!