Wiki Is Supplemental Oxygen "Prescription Drug Management?"

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koster.kris@yahoo.com

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I'm working on Practicode and have gotten different answers from the Practicode Coaches.

Specifically:

Is giving oxygen by nasal cannula to a patient in the ED count as "Prescription Drug Management" for determining Risk Level?

Is prescribing the patient supplemental oxygen considered "Prescription Drug Management?" For example, the physician documents, "COPD (Nocturnal oxygen desaturation on supplemental oxygen at 1.5-2)" in the Impression, and also documents, "Continue nocturnal oxygen supplementation and daytime as needed" under Plan.

Oxygen is technically a drug according to the FDA. But I can't seem to get a straight answer as to whether it satisfies the "Prescription Drug Management" for calculating Risk.
 
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koster.kris@yahoo.com said:
I'm working on Practicode and have gotten different answers from the Practicode Coaches.

Specifically:

Is giving oxygen by nasal cannula to a patient in the ED count as "Prescription Drug Management" for determining Risk Level?

Is prescribing the patient supplemental oxygen considered "Prescription Drug Management?" For example, the physician documents, "COPD (Nocturnal oxygen desaturation on supplemental oxygen at 1.5-2)" in the Impression, and also documents, "Continue nocturnal oxygen supplementation and daytime as needed" under Plan.

Oxygen is technically a drug according to the FDA. But I can't seem to get a straight answer as to whether it satisfies the "Prescription Drug Management" for calculating Risk.
Click to expand...

This is somewhat of a grey area, I think, and may be payer dependent.

Novitas says Oxygen "can be" Prescription Drug Management, but Noridian specifically says it is not:

Note - these links are for Office and Other Outpatient Services, not ED, but I'm sharing them as general information:


Novitas:

1730412963692.png

Noridian:

1730412918258.png
 
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sls314 said:
This is somewhat of a grey area, I think, and may be payer dependent.

Novitas says Oxygen "can be" Prescription Drug Management, but Noridian specifically says it is not:

Note - these links are for Office and Other Outpatient Services, not ED, but I'm sharing them as general information:


Novitas:

View attachment 7488

Noridian:

View attachment 7487
Click to expand...

I wasn't able to reply to this for some reason, I had to contact AAPC to fix this, but I just wanted to say thank you for your reply! I figured it must be a gray area because the Practicode Coaches didn't have consistent answers. I have reached out to the American College of Emergency Physicians (ACEP) in hopes that they can provide more clarity. Their site has been a great resource for E/M ED coding.

I realize this a broad question, but as someone who has a lot of experience in this field, are there a lot of "gray" areas like this in coding?
 
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