Item Covered Denied CMN SOP Item Information
• Oxygen System Ordered for > 4 LPM

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Covered by Medicare same as Oxygen System. However, due to the fact that Medicare reimburses at a higher monthly rental amount for oxygen flow rates greater than 4 liters per minute (LPM), it is necessary to submit blood results obtained while the patient is breathing oxygen at 4 LPM in order to demonstrate the need for the higher flow rate. Using the same blood gas levels as those listed under basic oxygen coverage (1-4 LPM), if the results obtained on 4 LPM do not justify the higher flow rate, then only the basic oxygen rental amount will be allowed.

See OXYGEN SYSTEM