Does Pulse Ox require a Doctor's Order?

Pulse Oximetry or O2 Sats are a normal part of treating patients in the home. If you are treating in California so are the requests for acquiring a physician's order to perform this diagnostic tool. What we wanted to know was if Medicare Requires a physicians order to perform pulse oximetry?

The answer is NO...

The common home health myth that you must have a physicians order to perform pulse oximetry is a falicy.

To further explore this common place mis-understanding you have to look at the root of the cause. Each home health agency goes through audits on patients charts, through Medicare, as well as the Health Department, and their respective regulating bodies, JACHO, CHAP etc. In one of these audits most likely it was identified that the HHA had placed in their "Policies" that performing pulse oximetry should have an order from the physician. Once the company places this in their "Policies" they must follow the policy.

So it has trickled down to the therapists, that were are no required to perform pulse oxmetry only with a physician order. Not because of a Medicare Law, but a company policy. None the less....

YES most home health agencies require the therapist to acquire an oder to be compliant.

THE TAKE AWAY... How do we stay compliant? If you decide you need to take a patient's pulse ox on the initial evaluation, you must call and document that you obtained a verbal order from the physicain after he approves your request to take the patient's O2 sats. If you decide that you do not need to take the patient's pulse ox on the intial evaluation but you would like to take it periodically, just make sure you indicate that in your plan of care that the physician will be signing off on.

Ex: Pulse Ox as needed.


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