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Health Conditions under Which Oxygen Therapy Coverage Applies

Oxygen therapy is a supplementary supply of oxygen given to people who cannot breath it enough naturally. Most of the disturbance in breathing oxygen naturally is caused by one or another kind of respiratory disorder. It is indicated by a rapid breathing pattern, coughing, wheezing, and even changed color of the patient’s skin.

There are many health conditions in which people require oxygen therapy. Most of the patients of Chronic Obstructive Pulmonary Disorder need it to breathe properly, especially in the advanced stages of the disease. Basically, the lungs are not in a healthy enough condition to absorb enough oxygen on their own. It is also needed in severe cases of asthma, pneumonia, health failure, sleep apnea, lung cancer, some other kind of lung disease, cystic fibrosis, bronchopulmonary dysplasia, trauma or damage to the respiratory system, etc.

There are various kinds of oxygen therapies that are given under different health conditions. These include:

  • Long-term Oxygen Therapy
  • Ambulatory or Portable Oxygen Therapy
  • Nocturnal Oxygen Therapy
  • Show-Burst Oxygen Therapy
  • Palliative Oxygen Therapy
  • Hyperbaric Oxygen Therapy
  • High Concentration Oxygen Therapy
  • Low Concentration Oxygen Therapy

Medicare Coverage for Oxygen Therapy
The medical coverage provided by Medicare includes for chronic obstructive pulmonary disease, bronchiectasis, cystic fibriosis, and neoplasm that is widespread. It also includes coverage for finding that are related to hypoxia, for instance, pulmonary hypertension, cognitive function impairment, congestive heart failure that is recurrent and cause by cor pulmonale, restlessness at night, morning headaches, and erythrocytosis.

How Does Medicare Cover for Oxygen Therapy
Medicare requires proper documentation and proof of the problem or disease due to which an individual is seeking Medicare coverage. It provides coverage for the rental of oxygen treatment equipment prescribed by your doctor. This equipment also includes accessories. In case you already own the equipment needed for therapy, Medicare would help in the payment of oxygen contents as well as supplies for the delivery of required oxygen. However, it is conditional to a few things. These include:

  • That your doctor credits that you indeed have been diagnosed with a severe lung disease and are in need of supplementary oxygen as your lungs are not able to absorb enough on their own. 
  • There are chances of improvement if oxygen therapy is provided.
  • Your levels of arterial blood gas have been found to be below a certain range
  • Other treatments and facilitation methods have been tried but they have failed or have not given any satisfactory results. 

In order to verify the claims and to determine the status of the patient’s health, a number of tests are administered. Most commonly the patient performs an overnight oximetry test through an IDTF.  It helps in a number of situations where oxygen therapy is needed to be given. For instance people with sleep apnea, COPD, and traumatic brain injury.