Centers for Medicare & Medicaid Services
Center for Program Integrity
Provider Compliance Group (PCG)
Special Open Door Forum:
Home Oxygen Electronic Clinical Templates October 26, 2016
3:00-4:00 pm Eastern Time Conference Call Only
PCG will host a Special Open Door Forum (ODF) to allow physicians, provider and supplier professional associations, and/or all other interested parties to provide feedback on the Home Oxygen Electronic Clinical Templates that are posted on the CMS.gov website. The suggested templates describe the data elements that CMS believes would be useful in supporting the documentation requirements for coverage of home oxygen as follows:
- Face-to-face encounter, and
- Oxygen lab results.
The Home Oxygen Electronic Clinical Templates are available on the CMS.gov websitewhich can be accessed through the link below: https://www.cms.gov/Research-
Statistics-Data-and-Systems/ Computer-Data-and-Systems/ Electronic-Clinical-Templates/ Home_Oxygen_Templates.html. The suggested clinical elements are not a form, but a tool which the physician or treating practitioner may voluntarily use to create electronic medical documentation. Once completed by the physician or other practitioner, the resulting order, face-to-face encounter note and oxygen lab result templates would be part of the medical record. In addition to developing electronic data-entry templates, CMS is also developing paper versions of these templates as well.
In fiscal year (FY) 2015, the Comprehensive Error Rate Testing (CERT) program reported an improper payment rate of 48.5 percent for home oxygen claims. Of the CERT-reviewed claim lines in error, approximately 86.2 percent were found to have errors related to insufficient documentation with a majority of these errors resulting from a lack of documentation inmedical records to justify Medicare coverage. The total projected improper payments for these claims was over 541 million dollars.
To better assist physicians in medical record documentation, for Medicare Fee for Service purposes, CMS has developed lists of clinical elements within a suggested electronic template. This development will allow electronic health record (EHR) vendors to create prompts to assist the practitioner when documenting. These three (3) Home Oxygen Clinical Templates are only the first of many on the list of topics that CMS is currently working to address. The current list can be found on CMS.gov by searching, "Electronic Clinical Templates".
Feedback and questions on our drafts can be sent to: HomeOxygenTemplates@cms.hhs.
gov. We look forward to your participation.
Special Open Door Participation Instructions: Participant Dial-In Number: 1-(800)-837-1935
Conference ID: 87665883
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.