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CMS upends oxygen CMN

Monday, February 19, 2018 @ 09:02 AM  posted by jbuytaert

by: Liz Beaulieu

- from the HME News

Friday, February 16, 2018

WASHINGTON – CMS has changed the guidelines for reporting a patient’s oxygen flow rate on a CMN, a move that will have two serious implications for providers, particularly those servicing the critically ill, says Andrea Stark.

First, through new modifiers laid out in a Feb. 15 joint DME MAC publication, CMS has instructed that for patients whose oxygen use differs between day and night, the average flow rate, not the highest flow rate, must be reported on question 5 of the CMN.

“They say this is going to simplify the process, but it makes things ten times more complicated,” said Stark, a reimbursement consultant for MiraVista LLC.

CMS has added three new modifiers, set to go into effect April 1: QA (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute); QB (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute and portable oxygen is prescribed); and QR (prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute).

Second, by modifying existing modifiers QE, QF and QG, CMS has instructed that patients must now need more than 4 liters of oxygen per minute “at rest,” not at exertion, to qualify for a high-volume adjustment that increases reimbursement from $70.74 per month to about $106 per month.

“This will exclude patients who previously qualified for high-volume adjustments,” Stark said.

The reimbursement difference for a patient considered standard volume and high volume is about $20 to $30, a change that may be hardly worth the savings when you consider the upheaval to the documentation process and the possible threats to patients, Stark says.

“With the existing reimbursement cuts, this is just one more blow,” she said. “These high-liter-flow patients are the most expensive patients to take care of, and providers aren’t going to be paid nearly enough.”

Cold Weather and Your Lungs

Friday, January 19, 2018 @ 12:01 PM  posted by jbuytaert

From the American Lung Association: January 4, 2018

Cold weather, and particularly cold air, can play havoc with your lungs and health. With much of the U.S. currently facing frigid temps, be sure to follow these tips and tools to help you through the winter weather without putting your lungs at risk.

Cold air is often dry air, and for many, especially those with chronic lung disease, that can spell trouble. Dry air can irritate the airways of people with asthmaCOPD or bronchitis. This can cause things that get in the way of winter fun, like wheezing, coughing and shortness of breath. To help protect yourself from cold, dry air:

With cold weather comes cold and flu season. Take some common precautions to avoid getting and spreading a cold, the flu, and even the more serious pneumonia.

  • Get your flu shot. Immunization is your best protection.
  • Wash your hands. As a good rule of thumb, get rid of germs by scrubbing your hands under warm, soapy water for about 30 seconds, or long enough to sing the “Happy Birthday” song twice in your head.
  • If you have chronic lung disease, such as COPD or asthma, stay away from people with colds and flu.

“It now seems that grandma was right after all, getting a chill can predispose a person to respiratory infection including pneumonia,” says American Lung Association Senior Scientific Advisor Norman H. Edelman, M.D. “As she would have recommended, dress warmly, keep your feet dry and your head covered.”

Although a wood-burning fireplace may seem like the perfect place to warm up, the smoke and fumes from fireplaces can be very irritating to people with allergies or lung disease. An alternate heat source and a warm blanket might be the best choice for beating the chill.

Keep the following tips in mind as you head outside:

  • Loosely wrap a scarf around your nose and mouth to warm the air before it enters your lungs. Breathe in through your nose and out through your mouth.
  • Monitor air quality forecasts to stay healthy. Air pollution can be very high in the winter, especially in areas with a lot of wood burning. Those with asthma and other lung diseases are at higher risk for being harmed by air pollution.
  • If you have asthma or COPD, always keep quick-relief medications with you. Stop activity and use your quick-relief medicine as soon as you begin to have symptoms.
  • Keep others informed of your activity plan and whereabouts in case of emergency.

With just a little care and planning, you can increase your chances of staying healthy and safe this winter.

Wednesday, January 17, 2018 @ 10:01 AM  posted by jbuytaert

Enriching Lives: Lisa Michaels

Tuesday, January 16, 2018 @ 09:01 AM  posted by jbuytaert

Lisa Michaels was at an evaluation today and the client was having a hard time reading things. She asked Lisa if she could borrow her reading glasses, and Lisa gave them to her to keep.

The little things Lisa does for clients is amazing, and for her to give up her own reading glasses was a wonderful thing to do. We never know how much our clients can afford or get out to shop and Lisa made her day!