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Neighborhood Health Plan of Rhode Island Certificate of Medical Necessity Oxygen for Pediatric Members Note: This form is for age group under 19 years of age. For Adults, (19 years old and above),
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How to fill out oxygen for pediatric members

01
Ensure the oxygen source is turned on and functioning properly.
02
Attach the oxygen tubing securely to the oxygen source.
03
Adjust the oxygen flow rate to the prescribed level for the pediatric patient.
04
Place the nasal cannula or mask on the child's face securely and comfortably.
05
Monitor the child's oxygen saturation levels and adjust the flow rate as needed.
06
Regularly check the equipment for any leaks or malfunctions.

Who needs oxygen for pediatric members?

01
Pediatric patients with respiratory conditions such as asthma, bronchiolitis, pneumonia, or cystic fibrosis.
02
Pediatric patients undergoing surgery or experiencing respiratory distress.
03
Pediatric patients with low oxygen saturation levels as indicated by pulse oximetry readings.
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Oxygen for pediatric members is a type of medical treatment that provides supplemental oxygen to children who have breathing difficulties.
Healthcare providers or medical facilities are required to file oxygen for pediatric members.
To fill out oxygen for pediatric members, healthcare providers need to gather patient information, medical history, and prescribed oxygen therapy details.
The purpose of oxygen for pediatric members is to improve oxygen saturation levels in the blood and help children with respiratory issues breathe easier.
Information that must be reported on oxygen for pediatric members includes patient's name, age, medical history, prescribed oxygen flow rate, and duration of therapy.
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