Chronic Resp Failure w/ Home 02 ONLY at night

Pt with h/o COPD, home 02 use- but only at night. Appropriate to query for chronic resp failure? Or do they need to be on it 24/7?

Comments

  • Generally it's 24/7 usage.

    Jeff

  • My understanding is that most 3rd parties, such as Medicare, require 24/7 as an indicator it meets criteria.
  • Its not "failure" if they don't need oxygen during the day....sounds more like a sleep apnea issue so I would not query for chronic without oxygen 24/7

    The way I view "resp failure" is if they were not on whatever oxygen they were on, would they be able to sustain adequate gas exchange.  Since the pt does not require oxygen during the day, I would say it's not chronic resp failure.


    Hope that helps.

    Dawn Valdez RN, LNC, CDIP, CCDS


  • Thanks everyone! I agree, just wanted to verify :)
  • just to throw this out here for discussion purposes- I worked with a pulmonologist that taught me that sleep apnea requiring CPAP at night did allow for the diagnosis of chronic respiratory failure. His rational was that respiratory failure is a disruption in the respiratory process- the passage of oxygen and CO2 gases in and out. an inability to maintain one's airway is failure. Sleep apnea is a chronic inability to maintain one's airway- (even if only at night). I had providers that would give me chronic respiratory failure based on this rational. It was not questioned by payers (but this was years ago). So using that rational, if oxygen is required at night to maintain oxygen levels then it may qualify for chronic respiratory failure. it might be worth a conversation with your providers about what constitutes chronic respiratory failure. I know this is not a commonly accepted definition but I do think sometimes thinking outside the box is a good exercise.  Other clinical indicators to look for besides the traditional home oxygen criteria is polycythemia and of course a compensated acidosis.
  • Great discussions....I’d imagine there is a lot of variation among payers regarding the accepted indicators various 3rd parties accept for this issue.
Sign In or Register to comment.