The Latest in Billing & Reimbursement from Ronda Buhrmester: Main Issue with Oxygen Equipment Audits; Refill Documentation Reminder

Published in Member Communities on February 07, 2024

By Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, VGM & Associates 

Main Issue with Oxygen Equipment Audits

If your company provides oxygen equipment, you may see an issue with oxygen audits, especially at the DME MAC-targeted probe and educate (TPE) level. 

One of the requirements to get coverage of oxygen equipment is located within the policy article. The requirement states the following: 

• Evidence of qualifying test results at the time of need; and, 
• Evidence of an evaluation of the qualifying test results by a treating practitioner. 

What does this requirement mean? The expectation is to ensure the treating practitioner has actually reviewed the oxygen-qualifying test results.  

To show evidence of this being done, the treating practitioner can do one of the following three: 

1. Mention within the existing chart note language about the test results, or 
2. Add a new chart note discussing the test results (does not require a new visit), or  
3. Co-sign the actual test results. 

There have been many issues when the documentation is reviewed within the TPE audits. Included is a document designed for your referrals to assist with education on the oxygen policy that includes this particular requirement. 

In Case You Missed It: Important Update on Refill Documentation 

Be sure to check out this latest update about refill documentation, effective Jan. 1, 2024.  

For any questions regarding oxygen equipment audits or refill documentation updates, please reach out to me, Ronda Buhrmester, via email at ronda.buhrmester@vgm.com or by calling 217-493-5440.