AAPC - Back to school
Results 1 to 5 of 5

Thread: Oxygen in Data Points

  1. #1

    Default Oxygen in Data Points

    AAPC: Back to School
    This is a question that was posed by one of my Pulmonary Physicians. He is treating patients with COPD and they are recieving oxygen therapy. In the assignment of the risk, would this fall into moderate, as this has to have a prescrition in order to recieve it? To me it does but I actually want to see what someone else thinks.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Use "presenting Problem"

    I don't consider "oxygen" a drug, even though a prescription is required to get the tank and equipment, etc.

    I would use the "presenting problem" part of the table of risk, as COPD is a chronic illness. It is typically progressive in nature, though can be stabilized for a time.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Join Date
    Apr 2007


    I would disagree with Tessa. I think this says that their COPD is severe. One of my anesthesia colleagues has told me that anyone on home oxygen would be an ASA class IV patient, which is a pretty sick patient.

    I would agree with moderate. And If I was using the table of risk, I would classify someone on home oxygen as increased risk when I'm determining risk for surgery.

    Thoughts anyone?

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default The PHYSICIAN must document

    I completely agree, colorectal surgeon, that COPD would be a co-morbidity for surgery (as would DM or a host of other chronic or acute conditions). HOWEVER ... this post isn't about assigning risk for surgery. It's about assigning risk for a medical E/M visit.

    More importantly ... I am not a physician, and I cannot assume that a patient's condition is worsening or unstable. The physician must document this. Even if doctor states that a patient's POX is 90, I cannot interpret that to mean the patient's COPD is worsening or exacerbated.

    This is a chief reason why MDM is so hard to code. Physicians are not always very good at documenting their thought processes. THEY know what the lab numbers mean; other physicians who may read the specialist's note will know what these numbers mean. But the coder can only code what the physician has documented. So, please, physicians - give me details. Give me differential diagnoses. Give your professional medical opinion on the severity of a patient's condition(s). Help me to help you.

    F Tessa Bartels, CPC, CEMC

  5. #5
    Join Date
    Apr 2007
    Carmel, New York

    Default Another thought...

    Has the COPD been deteriorating or exacerbating in order to warrant the oxygen therapy? If it is documented as such for the medical necessity of this treatment, then the Rx drug management is a moot point since the COPD would be worsening.

    Now, if the patient is presenting for the second, third, whatever time with the COPD and on this therapy, why is it still needed? COPD still deteriorating? A change in amounts of O2 needed because of effectiveness, side effects or other reactions? Moderate risk may still be applicable here without the use of Rx management. For medical necessity criteria, this type of documentation may be needed anyway.

    Just my thoughts...


    2016 Secretary
    Ellenville, NY Local Chapter

Similar Threads

  1. data points
    By cathyflower in forum Auditing General Discussion
    Replies: 2
    Last Post: 05-01-2012, 06:49 PM
  2. data points
    By stpat in forum E/M
    Replies: 1
    Last Post: 02-28-2011, 04:25 PM
  3. Data points???
    By mrolf in forum E/M
    Replies: 0
    Last Post: 10-20-2010, 08:22 AM
  4. Data Points
    By medicalsec in forum E/M
    Replies: 3
    Last Post: 10-18-2010, 06:28 AM
  5. e/m data points
    By kimgiz in forum E/M
    Replies: 3
    Last Post: 04-14-2010, 01:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.