A, B, Cs of new pulse ox testing technology

Friday, September 30, 2005

Q. We have been considering the use of the new technology for overnight pulse oximetry testing but have been hesitant until the recent CMS publication. In our area, there is a two month waiting list for customers to get overnight pulse oximetry studies. What key points should we be aware of before getting involved with this technology?
A. First of all, you need to contact an independent diagnostic testing facility. The facility you work with must be a Medicare approved facility, capable of billing its services to the Local Part B Medicare program. Your local Part B Carrier should be able to confirm the facility's status, and you can locate the Part B Carrier by doing a search at the following Web site: www.cms.hhs.gov/contacts. Then select your state and select carrier as the organization.
Once you have verified that the facility you are working with is approved, you need to evaluate the equipment they will be using to conduct the test. Make sure there is some type of encryption that prevents anyone other than the IDTF from accessing the test results.
CMS has clarified that you may either purchase the oximeter or use the IDTF's equipment; however, you may not instruct the patient on how to use the equipment in any way shape or form. It must be clear that the IDTF is performing the test, and they must provide all instructions and direction on the use of the equipment. Most IDTFs will provide a hotline for patient questions.
Keep in mind the physician still has to order the test, and the test results must still meet with Medicare policy. The oxygen saturation should fall to 89% or below for at least five minutes during the course of the test, and the patient must have been tested while awake and achieved a prior saturation level at or above 89%.


Andrea Stark is a Medicare consultant/billing specialist at MiraVista. Reach her at (803) 462-9959 or andrea@miravistallc.com.