An oxygen concentrator is a machine that separates room air into oxygen and nitrogen. The nitrogen is discarded, while the oxygen is stored, concentrated and delivered at 90% to 95% purity.
PLEASE NOTE: The use of this device does not reduce the oxygen in the room air because of the small amount of oxygen required.
If you are using an oxygen concentrator, you may want to notify your power company and explain to them that you have life-sustaining equipment in your home. In the event of power failure in your area, they will then know to give priority to restoring power to your home over others in the area that are not using life-sustaining equipment.
Medicare Information and Qualifications:
The patient must qualify for oxygen and then the physician will determine the type of equipment the patient will need.
General Coverage Guidelines
Home oxygen is covered and paid by Medicare if the following conditions are met:
- The patient has a severe lung disease or hypoxia-related symptoms that the physician has determined may improve with oxygen therapy.
- The patient's blood gas study meets qualifying oxygen levels.
- The treating physician tried or considered alternative treatment measures and determined them to be ineffective.
Not Medically Necessary
- For these situations, get an ABN to cover yourself, even if filing non-assigned.
- Terminal illnesses that do not affect the respiratory system.
- Angina pectoris in absence of hypoxemia.
- Dyspnea without cor pumonale (or evidence of hypoxemia).
- Severe peripheral vascular disease.
Summary: Certificates of Medical Necessity
To communicate qualifying medical necessity information to Medicare, claims must be billed with a Certificate of Medical Necessity. This is accomplished using the OMB approved form (CMS-484).
The items listed below are often sold, prescribed or needed in addition to the equipment above.
- Carrying bag
- Cart for e cylinders