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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Form Approved OMB No. 0938-0534 CERTIFICATE OF MEDICAL NECESSITY CMS-484 OXYGEN SECTION A DME 484.03 Certification

How to fill out portable oxygen concentrator

How to Fill Out Portable Oxygen Concentrator:

1. Start by ensuring that the portable oxygen concentrator is turned off and disconnected from any power sources.
2. Locate the oxygen port on the concentrator and insert the oxygen tube or cannula firmly into the port until it locks in place.
3. If using a humidifier bottle, fill it with distilled water to the recommended level indicated on the bottle. Attach the filled humidifier bottle to the oxygen port on the concentrator.
4. Connect the other end of the oxygen tube or cannula to the fitting on the other side of the humidifier bottle, if applicable.
5. Make sure the filter on the concentrator is clean and in good condition. Replace it if necessary.
6. Inspect the oxygen tubing for any damage or blockage. Replace it if needed.
7. Once everything is properly connected, turn on the portable oxygen concentrator according to the manufacturer's instructions. It may take a few moments to start generating the oxygen flow.
8. Adjust the oxygen flow rate to the prescribed level recommended by your healthcare provider.
9. Regularly check the oxygen concentration indicator on the concentrator to ensure it remains within the desired range.
10. Finally, ensure that the portable oxygen concentrator is securely positioned and that you are comfortable with the oxygen delivery system before use.

Who Needs Portable Oxygen Concentrator:

1. Individuals with chronic obstructive pulmonary disease (COPD): COPD is a progressive lung disease that can cause breathing difficulties. Portable oxygen concentrators are often prescribed to help relieve shortness of breath and improve oxygen levels in individuals with COPD.
2. People with other respiratory conditions: Portable oxygen concentrators can also benefit individuals with conditions such as asthma, pulmonary fibrosis, or cystic fibrosis, where supplemental oxygen therapy can enhance breathing and overall lung function.
3. Those with heart conditions: Certain heart conditions, such as congestive heart failure, may lead to reduced oxygen supply to different organs. Portable oxygen concentrators can provide additional oxygen support to individuals with heart conditions.
4. Individuals with sleep apnea: For individuals with sleep apnea who require continuous positive airway pressure (CPAP) therapy, portable oxygen concentrators can be used to provide the necessary oxygen alongside the CPAP machine to ensure uninterrupted and effective therapy during sleep.
5. Outdoor enthusiasts: Portable oxygen concentrators are also beneficial for those who enjoy outdoor activities and need supplemental oxygen while hiking, traveling, or engaging in physical exertion at high altitudes.

Note: It is important to consult with a healthcare professional to determine if a portable oxygen concentrator is suitable for your specific needs and to receive proper instruction on its usage.

For pdfFiller’s FAQs

What is portable oxygen concentrator?

A portable oxygen concentrator is a medical device that concentrates oxygen from the air and delivers it to the patient in need of supplemental oxygen.

Who is required to file portable oxygen concentrator?

Patients who require supplemental oxygen therapy may be required to use and file portable oxygen concentrators.

How to fill out portable oxygen concentrator?

To fill out a portable oxygen concentrator, the user must follow the manufacturer's instructions for proper usage and maintenance.

What is the purpose of portable oxygen concentrator?

The purpose of a portable oxygen concentrator is to provide a convenient and reliable source of supplemental oxygen for patients with respiratory conditions.

What information must be reported on portable oxygen concentrator?

The information that must be reported on a portable oxygen concentrator includes patient details, device specifications, and usage logs.

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