How to Qualify for Home Oxygen Therapy

Here is what to know about home oxygen therapy and how to qualify for it.

What is home oxygen therapy?

Essentially, it’s supplemental oxygen for your home. Supplemental oxygen is when you inhale more oxygen than what is in room air. Room air is the air in the room around you. It contains about 21% oxygen. So, supplemental oxygen would involve inhaling more than 21%.1

Home oxygen therapy involves inhaling supplemental oxygen at your home. This usually involves giving you an oxygen concentrator. This is a device that makes pure oxygen from room air. It also involves oxygen tanks. These are tanks that contain pure oxygen. These are then used to attach oxygen devices onto.

There are many devices used for inhaling supplemental oxygen. Some people may benefit from different types of oxygen masks. Although, the most common device is a simple nasal cannula. This is a simple oxygen tubing that is hooked up to a concentrator or tank. The other end folds behind your ears and over your cheeks. Prongs are inserted into your nose. These are simple to wear and are generally considered comfortable. They allow low flows to be used, or 1-6 LPM.1

Some people supplemental oxygen during exertion. Others need it only while sleeping while others may benefit from inhaling oxygen all day. There are three different tests used to determine if you need oxygen and whether you qualify for home oxygen therapy.

What is an oxygen qualification test?

This involves one of two tests. One is an invasive blood draw called an arterial blood gas. The other is an invasive test using a pulse oximeter.

Arterial Blood Gas

Also called an ABG, it involves drawing blood from one of your arteries. The most common artery used is the radial artery. This is an artery close to the surface on the thumb side of the inside of your wrist. This test determines your PO2. This is a value that is considered the most accurate oxygen level. It’s accurate because it’s determined using a small sample of your arterial blood. A PO2 of 60 or higher is considered normal. A PO2 of 55 or less will qualify you for home oxygen therapy.1

This is the most accurate test, so this is all the testing that is needed. This is the preferred test to qualify you for home oxygen. Still, it is more invasive so it’s not always ordered.

Pulse Oximetry Test

This test involves a little more work. But, it also doesn’t involve an invasive blood draw. What it does involve is a pulse oximeter. This is a small device that slips over your finger. It determines your SpO2. This is a percentage. It’s the percentage of oxygen that you inhale that makes it to your arterial blood. An SpO2 of 90% or higher is considered normal. An SpO2 of 88% or higher is considered acceptable. So, an SpO2 of 87% or lower means you might benefit from home oxygen therapy.1

First, you will sit in a chair. A pulse oximeter will be slipped over your finger. A resting SpO2 on room air is determined. Less than 88% means you may benefit from oxygen. Then you go for a walk while your SpO2 is monitored. If it drops to below 88% you may qualify for home oxygen therapy.1

Further testing must be done to assure that supplemental oxygen benefits you. We know if it benefits you IF your SpO2 improves while wearing oxygen. So, now you will go for a second walk. Only this time you will be wearing a nasal cannula. The flow will be set from 2-6 LPM, whatever is needed to maintain your SpO2 of 88% or better. If your SpO2 stays above 88% while you are walking, this shows that you benefit from it. This means you qualify for home oxygen therapy.1

Both of the above tests are tests I personally do in the hospital setting. It is part of the job of being a respiratory therapist. Still, there is one other test called a sleep study test.

What is a sleep study test?

This is a test that I do not personally do. There are two ways to do this testing.

Titration Polysomnogram

This is a test performed if your doctor also suspects you might have obstructive sleep apnea. It requires that you go into a sleep lab. Here a technician monitors your SpO2 while you are sleeping. Of course, the technician will also hook you up to a variety of other monitors. An environment is created allowing you to fall asleep.1

If your SpO2 drops below 88% while you are sleeping, you qualify for home oxygen therapy. In this setting, you may be asked to wear a nasal cannula to see if that helps. You may also be asked to try a CPAP or BiPAP to see if that helps. Oxygen can also be connected to these devices if necessary. In either case, this test can determine if you qualify for home oxygen therapy. Of course, it may also determine if you benefit and qualify for CPAP or BiPAP.1

Overnight Sleep Oximetry

This is a similar sleep study test that can be done by you at your home. Here you basically slip a monitor over your finger. Your SpO2 is monitored while you’re sleeping. If your SpO drops while you’re sleeping you qualify for home oxygen therapy.1

Home oxygen recap

So, there are four different ways to qualify for home oxygen therapy. Which one you use may be determined by a conversation between you and your physician. In a future post, I will describe "Oxygen Delivery Devices." Stay tuned!

Note: The values and ranges in this article are based on those set by the Centers of Medicare and Medicaid Services (CMS). They were determined by using best practice medicine. These same values and ranges, I believe, are also followed by most insurance companies. If you qualify, what specific equipment you get to use is determined by your location, your insurance provider, and the home oxygen provider that you use. This information is valid only for people living within the U.S.

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