Ordering Oxygen
This information was approved by Jeff Swigris, DO, and Ann Mullen, RN, (September 2017)
Summary: Ordering Oxygen
What is Required from Providers?
Complete the following events within 30 days.
Face-to-Face Evaluation
Progress Note Indicating:
Diagnosis
Symptoms
Mobility within and outside the home
Benefit of oxygen for quality of life
Flow rates and delivery type (pulse vs continuous)
Other methods have been tried and failed
Patient informed of need for oxygen
Qualifying Testing
Must have 1 of the following:
Resting sat on room air ≤ 88% (while awake)
OR
Oxygen titration walk test (must have all 3 below)
Resting sat/ABG normal
Saturation ≤ 88% with exertion (or PO2 ≤ 55)
Exertion saturation/ABG improve with addition of O2
Dispensing Order
Order Indicating the Following:
Diagnosis
Duration
Flow Rates
Stationary Flow System
Standard Concentrator
Portable Flow System
Compressed Gas
Liquid Oxygen
Portable Oxygen Concentrator
Length of Need
Indication if oxygen will be used with PAP
Certificate of Medical Necessity
Additional Resources on Oxygen
Altitude Sickness and Oxygen Therapy
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