Wiki Oxygen - help please!

[fishbite2]

I understand that oxygen is considered to be included in E/M services so I need some advice on how to handle a situation. One of our ophthalmologists sees a large number of patients who are transported to the office from various nursing homes. Lately we've seen a trend of patients arriving with their portable oxygen tanks already low (not all from the same facility). By the time they see the doctor and then wait up to another hour for the transport van they have run out of oxygen and need to use ours. In addition to our concern for the patients safety, this is becoming expensive. Not only are we refilling our oxygen more often than ever before, but also it takes staff away from other patients. If it is not appropriate to bill Medicare / Insurance, would it be appropriate to bill the nursing home since they are being paid to provide oxygen? I assume that not sending reasonably adequate oxygen is a violation of patient care regulations? Please advise.
Thanks

 

[ajs]

I understand that oxygen is considered to be included in E/M services so I need some advice on how to handle a situation. One of our ophthalmologists sees a large number of patients who are transported to the office from various nursing homes. Lately we've seen a trend of patients arriving with their portable oxygen tanks already low (not all from the same facility). By the time they see the doctor and then wait up to another hour for the transport van they have run out of oxygen and need to use ours. In addition to our concern for the patients safety, this is becoming expensive. Not only are we refilling our oxygen more often than ever before, but also it takes staff away from other patients. If it is not appropriate to bill Medicare / Insurance, would it be appropriate to bill the nursing home since they are being paid to provide oxygen? I assume that not sending reasonably adequate oxygen is a violation of patient care regulations? Please advise.
Thanks

I would say that sounds like a situation for billing the nursing facilities who are responsible for providing the oxygen. I would definitely be making a call to the administrators at these facilities and making sure they are aware their staff are not checking patient portable oxygen levels prior to sending them out the door. If the situation does not improve you could then contact the state regulators who monitor nursing homes. This is a danger to the patient as well as an expense for your office!