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| OXYGEN FAQs Q1. Please clarify the date of service to be used when billing maintenance and service for oxygen. Does the date of service have to be the actual date of the visit? For example: The patient has oxygen stationary equipment that capped out on 12/01/08 which would make the first allowable maintenance and service billable on 07/01/09. However, the equipment has been serviced on 06/15/09. May a supplier bill for the 06/15/09 M&S visit on 07/01/09 or do they have to wait until maintenance is required again? A1. The 2009 6-month maintenance and servicing payment for oxygen concentrators and transfilling equipment only applies when the supplier physically makes an in-home visit to inspect the equipment and the date of the visit falls on or after the 6 month anniversary date. In the example provided, the supplier would not be able to bill for an M&S payment on 7/1/09 for a service visit that occurred on 6/15/09. In this particular case, if the supplier physically makes another in-home visit to inspect the equipment between 7/1/09 and 12/31/09, they would be eligible to bill for the 6 month M&S payment. The date of service on the claim would be the date of the actual visit. Q2. If a patient is past the 36 month rental period for oxygen equipment (i.e., payment for the equipment has capped) and the patient has a stationary concentrator, stationary liquid tank, and portable liquid cylinders in the home, what code(s) may be billed? A2. Per the Oxygen Policy Article: If the patient has a stationary concentrator, portable liquid equipment, and a stationary liquid tank to fill the portable cylinders, when payment for contents begins, payment will only be made for portable liquid contents. The only code that may be billed is E0444 (portable liquid contents). Code E0442 (stationary liquid contents) must not be billed in this situation because the stationary tank is just used to fill the portable cylinders. Q3. The Oxygen LCD includes a requirement that the patient be seen and re-evaluated by the treating physician within 90 days prior to recertification. The revision of the LCD that was released in June included a change in the coverage of oxygen if the required re-evaluation was not performed within the 90 day time frame but was performed at a later date. The previous policy stated that, in that situation, payment could be made for dates of service between the scheduled recertification date and the date of the late physician visit if the blood gas study criteria were met. The revised policy states that, in that situation, coverage would end when the Initial Certification period ended and would resume beginning with the date of the late physician visit. The effective date of the LCD revision was given as 1/1/09. Did these revised coverage criteria take effect on that date? A3. Because of the short notice given for the policy revision and the change in payment rules, the effective date of this specific requirement will be claims with dates of service on or after August 1, 2009. This date is based on the June 19, 2009 public release date of the policy revision. This clarification will be incorporated in a future revision of the LCD. Q4. If the required physician re-evaluation is not performed within 90 days prior to recertification but is performed at a later date, what should be entered as the Recertification Date on the Oxygen CMN? A4. In that situation, the date of the late physician visit should be entered as the Recertification Date on the CMN. |
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