Baltimore
CMS is allowing at-home oxygen testing using a specific product, a development that could help clear logjams at the nation's Independent Diagnostic Testing Facilities (IDTFs).
In an April 23 letter to Brighton, Mich.-based Oximetry Co., LLC, John Warren, a health insurance specialist at CMS' Division of Medical Review, said: “Medicare covers home oxygen therapy for a beneficiary when a qualified provider or supplier of laboratory services performs a blood gas study that was ordered by a physician; and that study indicates that the patient's blood oxygen levels meet Medicare criteria.
“The Program Integrity Group [at CMS] has determined that the Power-Ox system does not violate any portion of the Local Medical Review Policy or National Coverage Determination for home oxygen therapy. Test results obtained using the Power-Ox system are acceptable for qualifying patients for home oxygen therapy, so long as the testing meets all applicable Medicare guidelines.”
Oximetry Co., an IDTF, processes test results from the Power-Ox, a home oxygen testing device manufactured by Michigan-based Newco Holdings and distributed by The Letco Companies, Decatur, Ala. Industry observers say such technology, accepted by CMS, could give providers a competitive edge while eliminating delays at IDTFs, where it sometimes takes weeks for patients to obtain test results.
“Early providers utilizing this program have found it to be a resounding success,” according to billing and reimbursement specialist Jane Bunch, CEO of JB&CS, Atlanta. “Most DME providers experience long waits for a local IDTF — if there is one left — to qualify their patients and also experience lost revenues since they are unable to bill Medicare until they receive IDTF qualification.” However, Bunch advises, providers should consult with their health care attorney on use of the device.
While in the patient's home after delivery, the HME provider enters patient and physician information into the device. Then, the patient signs on the device — which uses signature technology similar to what UPS uses for package deliveries — verifying that the test results will be downloaded to the IDTF, and that the IDTF is authorized to bill Medicare on the patient's behalf.
The next day, the provider retrieves the system and sends the collected patient data, encrypted for HIPAA security and to prevent tampering, over the Internet directly to the testing facility. Once the provider returns to the office, he can log on to a secure Web site to view the results. According to Letco President Mickey Letson, these results, together with a completed and signed CMN from the treating physician, can be used to meet IDTF requirements to bill Medicare for oxygen.
“This entire process takes 24 hours or so,” Letson said, adding that the results are valid for patients in all 50 states.
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