clincial validation of acute respiratory failure
We have a new pulmonologist that we have to query often for clinical validation of acute respiratory failure which usually means we have to meet face to face. She's never too happy that we challenge her on this as you can imagine. She only orders supplemental oxygen on patients that are less than 89% and if they are on oxygen assumes that at some point they had dropped below 88% and and diagnoses the patient with acute resp failure, even if they have no symptoms such as labored breathing. She stated that according to Medicare guidelines, supplemental oxygen is only to be used under 89% and this is respiratory failure, even if absent of symptoms. I explained that the definition we have educated our hospitalists to use is the one explained in the CDI pocket guide and in articles written by Dr . Pinson. She was adamant about the Medicare guidelines. I tried finding this guideline but was unsuccessful. Anyone familiar with this guideline?