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June 20, 1986

Current Oxygen Prescribing PracticesProblems and Prospects

JAMA. 1986;255(23):3283-3285. doi:10.1001/jama.1986.03370230089038

REGULATIONS and prescribing practices dealing with long-term home and ambulatory oxygen supplementation for patients with chronic lung disease are currently in a state of flux. Clearly, the move is on to limit this modality as much as possible because of its great expense.

Changes in Oxygen Reimbursement Policy  As recently as March 1985, Petty1 recommended the following patient selection criteria: (1) stable clinical state with optimum medical therapy, eg, bronchodilator, antibiotics, corticosteroids (if indicated), and freedom from exacerbations of bronchitis or heart failure; (2) arterial blood gas analysis conducted on at least two occasions with the subject breathing room air for at least 20 minutes; (3) room-air arterial oxygen pressure (Pao2) consistently (three weeks or more) less than 55 mg Hg or consistently 55 to 59 mm Hg with clinical diagnosis of cor pulmonale, a hematocrit exceeding 55%, or both (entry criteria for the Nocturnal Oxygen Therapy Trial