I work for a DME and respiratory therapy provider and I'm taking a closer look at the Home Oxygen reporting requirements on the 837P transaction. We currently provide detailed Oxygen Certificate of Medical Necessity (CMN) information to the Medicare DMERC carriers. Reading the IG it looks like Home Oxygen information is divided between the following segments: CR5 - Home Oxygen Therapy Information (page 423) (Required on all initial, renewal and revision home oxygen therapy claims. CRC - DMERC Condition Indicator (page 432) (Required on all oxygen therapy and DME claims that require a CMN) DTP - Date - Last Certification Date (page 442) (Required if it's necessary to include supporting documentation for DMERC claims and on CMNs) DTP - Date - Oxygen Saturation/Arterial Blood Gas Test (page 449) (Required on initial oxygen therapy service lines involving CMNs.) MEA - Test Result (page 464) (Required on service lines which bill/report Concentration, Hemoglobin, Hematocrit, Epoetin Starting Dosage, Creatin and Oxygen) REF - Oxygen Flow Rate (page 480) (Required on oxygen therapy CMN claims where service line reports oxygen flow rate. PER - Ordering Provider Contact Info (page 538) (Required when service involve an oxygen therapy CMN)
The situational usage for most of these is related to the CMN, however the CR5 and MEA situational usage seems to be related to all oxygen claims, ie not just CMN and therefore not just Medicare/DMERC. The information on CR5 and MEA includes detailed clinical results which we don't collect except for Medicare patients. To my knowledge, we don't have payors looking for this information either. Questions: 1) Are the different Situational Usage definitions for these various segments an oversight by those writing the IG or was it intentional? 2) Are there any payors out there who will be looking for this information? Any help you can provide would be greatly appreciated! Thanks. Zena Jacobi Systems Analyst Specialist Apria Healthcare Phone: 949-639-2477 Fax: 949-639-6667 ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
