Long-term oxygen therapy prescribed (more than 15 hours per day) (COPD)
CPT4 code
Name of the Procedure:
Long-term Oxygen Therapy (LTOT) for Chronic Obstructive Pulmonary Disease (COPD)
Summary
Long-term oxygen therapy (LTOT) involves providing oxygen for at least 15 hours a day to patients with COPD. This treatment involves using an oxygen delivery system to ensure that the patient receives a sufficient supply of oxygen to maintain adequate blood oxygen levels.
Purpose
Long-term oxygen therapy is primarily used to treat chronic obstructive pulmonary disease (COPD), a condition characterized by chronic airflow limitation. The goals are to alleviate symptoms of breathlessness, improve quality of life, and extend patient survival by maintaining adequate oxygen levels in the blood.
Indications
- Severe and chronic low oxygen levels in the blood (hypoxemia).
- Documented evidence of PaO2 (partial pressure of oxygen) below 55 mmHg or SpO2 (oxygen saturation) below 88% during rest or exertion.
- COPD with associated pulmonary hypertension, heart failure, or polycythemia.
- Episodes of severe breathlessness affecting daily activities.
Preparation
Patients may be required to:
- Undergo blood gas analysis to assess oxygen levels.
- Complete a pulmonary function test.
- Be assessed by a respiratory specialist.
- Follow specific instructions regarding existing medications.
Procedure Description
- Assessment: Initial evaluation through diagnostic tests to determine oxygen needs.
- Prescription: A healthcare provider prescribes the amount of oxygen required (liters per minute) and the duration of daily use.
- Equipment: The patient receives portable or stationary oxygen concentrators, tanks, or liquid oxygen devices.
- Training: Patients and caregivers receive training on how to use the equipment, safety tips, and maintenance.
- Usage: Oxygen is typically delivered through nasal prongs or a face mask.
Duration
Patients are advised to use oxygen for more than 15 hours per day, often during sleep and daytime activities, as prescribed by their healthcare provider.
Setting
LTOT is generally administered at home, but initial setup and training may occur in an outpatient clinic or hospital.
Personnel
- Respiratory therapists
- Home health care provider specialists
- Primary care physicians or pulmonologists
Risks and Complications
- Nasal dryness or irritation
- Skin breakdown around the mask or nasal prongs
- Risk of fire in the presence of flammable materials
- Potential for equipment malfunction
Benefits
- Improved quality of life and reduced symptoms of breathlessness.
- Better sleep and increased energy levels.
- Enhanced ability to perform daily activities.
- Extended survival rates in severe COPD patients.
Recovery
No traditional recovery period is needed as LTOT is a long-term ongoing treatment. Patients should:
- Follow care instructions for oxygen equipment.
- Attend regular follow-up appointments to monitor oxygen levels and respiratory health.
- Adhere to safety guidelines to prevent fire hazards.
Alternatives
- Non-invasive ventilation
- Medications such as bronchodilators and corticosteroids
- Pulmonary rehabilitation
- Lifestyle changes like smoking cessation and exercise
- Each alternative has varying degrees of effectiveness and may be chosen based on the patient’s condition and response to treatment.
Patient Experience
Patients using LTOT might initially feel awkward or uncomfortable adjusting to the equipment. Most get used to it over time. Proper training helps alleviate discomfort, and many report significant improvement in their symptoms and overall quality of life. Pain management is typically unnecessary, but nasal discomfort can be managed using humidifiers or nasal sprays.