CMS updates draft e-template for oxygen

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Friday, January 6, 2017

WASHINGTON – CMS held a Special Open Door Forum on Jan. 5 to discuss the third draft of its electronic clinical template for home oxygen therapy.

This newest draft of the template includes suggested clinical data elements and visual examples for the order, face-to-face encounter and lab test results.

CMS took into account comments to:

  • provide clear headings for related sets for data elements (e.g. beneficiary information);
  • provide a visual example of each data element and its value set;
  • add elements to the F2F encounter to capture text and specific conditions;
  • add an option to order for an oxygen conserving device;
  • and verify that the suggested elements will work for pediatric patients.

The suggested clinical data elements and visual examples are not a form, CMS says, but a tool that physicians or treating practitioners may voluntarily use to create electronic medical documentation.

CMS is pursuing an e-template for oxygen in response to the 48% improper payment rate for claims in fiscal year 2015. Of the claims in error, 86.2% were found to have insufficient documentation, mostly resulting from lack of documentation in medical records to justify Medicare coverage. The agency says the impact of these improper payments was more than $541 million.

CMS reviewed the second draft of the e-template in October.