Medical Billing Guide

Before we get into the record specifications for billing oxygen claims, we’re going to briefly discuss what is involved with oxygen billing and what it covers. In spite of what a lot of people think, it’s more than just the oxygen itself. Oxygen billing, as a part of medical billing itself, is one of the most widely billed items.

Part of the reason for this is because of the number of smokers we have in the United States, which is where these billing specifications are meant for. Unfortunately, one man’s suffering is another’s prosperity. The number of smokers in this country who ultimately end up with chronic respiratory disease are the main contributors to the oxygen billing industry. It is estimated that if smoking didn’t exist, at least 75% of the number of oxygen claims could be avoided. While nobody has actually proven this statistic, certainly the overall problems that have been uncovered because of smoking, do at least partially support this theory. Hopefully, the day will come when smoking is a thing of the past and these theories can be proven.

However, until that happens, oxygen billing will be big business. And as was stated up above, it is more than just billing oxygen. There are a number of pieces of equipment that go along with a patient who is on oxygen. All of these items are billable and come with quite a high price tag. And everybody wants to get a piece of the pie, from the manufacturers of the equipment itself to the doctors to the forms makers to the billers. It’s no wonder that medical costs are so sky high. And of course as is true with just about everything else, where the demand is the greatest, the costs are also the greatest. In comparison to other billable items, oxygen therapy ranks up towards the top.

The actual items that are billable cover quite a range of things. There is of course the oxygen itself, which they literally bill by the liter. Every breath is costing somebody a fortune. And of course the oxygen has to be contained in something and also distributed via some means.

Probably the most common way for oxygen to be administered to a patient is through a device called a concentrator. And make no mistake about it, these things cost a pretty penny. Concentrators are made up of a number of parts, all of which can easily break down. So concentrator repairs also add to the cost of these claims. In some cases the concentrators are under warranty, but for patients who are on oxygen long term, such as patients who have serious lung diseases, these warranties are usually only good for a year. After that, any repairs have to come out of the patient’s pocket.

Of course none of this even touches on the complexities of oxygen billing, which require calculations and conversions in order to bill the exact amount of oxygen the patient must get per every 30 days or so. This also is added to the cost of billing and the ultimate cost to the patient or insurance company, which ultimately leads to higher premiums.

In our next installment, we’ll begin our coverage of the GX records, which are used for medical billing of oxygen claims via electronic media.

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Medical Billing