Oxygen: Simplifying Oxygen Coding and Billing Guidelines for DME Providers

Oxygen: Simplifying Oxygen Coding and Billing Guidelines for DME Providers

AccQdata’s guidance on oxygen coding and billing is intended to help providers of durable
medical equipment (DME) understand the intricacies of Medicare billing. We have simplified
the most important details from a new training film so that everyone can understand it.

Knowing the Basics

Taking effect from January 1, 2023, the Medicare Learning Network developed the N1, N2, and N3 modifiers for home oxygen use. Starting on April 1st, 2023, these modifications will be  implemented in the place of the KX modifier for oxygen rental periods.

Use of Modifiers

For the purpose of showing medical necessity or non-coverage scenarios, modifiers like GA, GY, and GZ are essential. They prevent claim denials & guarantee accurate billing.

Modifiers and Qualifying Tests

Specification of oxygen flow requirements based on at-rest qualifying tests is aided by modifiers QE, QF, and QG. Modifiers QA, QB, and QR further distinguish between oxygen flow requirements during the day and at night.

Lease and Upkeep

The maximum term for renting oxygen equipment is 36 months, during which time suppliers are in charge of all necessary supplies, add-ons, and upkeep. Monthly rentals require the RR modifier, while replacement equipment requires the RA modifier.

Replacements and Reimbursement

The rental allowance includes reimbursement for oxygen content and equipment, with payment changes made in response to a variety of circumstances, including equipment damage or loss. A fresh 36-month cap is initiated by replacement equipment.

Patient Travel and Mobility

Even if a patient moves outside of the service area, providers still need to allow for their mobility. Medicare doesn’t, however, cover services provided by airplanes.

Important lessons taught

DME providers have to be aware of Medicare’s requirements for oxygen coding and billing in order to ensure compliance and prevent claim rejections. AccQdata is committed to helping suppliers follow these rules with ease.

For more details you can check Noridian medicare DME website for latest resources. IF you are looking for DME billing Company or need and assistance in DME Billing Please do not hesitate to reach our team of DME experts.