Oxygen
Oxygen and oxygen accessories are considered durable medical equipment, and coverage is subject to the member's DME benefit. Oxygen therapy is medically necessary for severe lung disease defined by a resting PaO2 below 55 mm Hg (or 60 mm Hg with heart failure), an O2 saturation below 90 percent, or symptoms of oxygen deprivation such as impaired cognitive processes, restlessness or insomnia, and for cluster headaches when other treatment fails. Oxygen therapy is not medically necessary for angina or breathlessness without evidence of hypoxemia, severe peripheral vascular disease with clinically evident desaturation, or terminal illnesses that do not affect the lungs.