The guidance, Change Request 12607, makes the following changes effective for claims with a date of service starting Sept. 27, 2021:
- Expansion of oxygen coverage for acute and chronic conditions (when hypoxemia exhibited).
- Expansion of oxygen coverage for short and long-term need (when hypoxemia exhibited).
- DME MACs may determine whether ordered oxygen and oxygen equipment are reasonable and necessary.
- Removal of Home Oxygen Use for Cluster Headache (240.2.2) and allowing DME MACs to make coverage determinations for patients with cluster headaches.