Centers for Medicare & Medicaid Services, Special Open Door Forum: Home Oxygen Clinical Data Elements

Centers for Medicare & Medicaid Services

Special Open Door Forum:

Home Oxygen Clinical Data Elements

Thursday, January 5, 2017

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 Clinical Data Elements that are posted on the CMS.gov website. CMS believes that the suggested clinical data elements that would be useful in supporting the documentation requirements for coverage of home oxygen as follows:

1. Order,
2. Face-to-face encounter, and
3. Oxygen lab results.

The Home Oxygen Clinical Data Element List and a visualization example for each are available on the CMS.gov website which 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 data elements and their examples 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 and electronic template versions.

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 in medical 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 Data Element lists 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: 37109650

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.  

A transcript and audio recording of this Special ODF will be posted to the Special Open Door Forum website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp  

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.gov/OpenDoorForums/.