Pulse Oximetry and Capnography for Home Use

Aetna covers home pulse oximetry as DME when medically necessary for chronic lung disease, severe cardiopulmonary disease, neuromuscular respiratory muscle weakness, to determine/adjust home oxygen flow for ambulation/exercise/sleep, to monitor patients on home ventilators, for short‑term (up to one month) physician‑directed oxygen‑flow adjustments, and when weaning from home oxygen. Pulse oximetry is experimental/investigational and not covered for other indications (e.g., asthma management, home CPAP teaching, routine/continuous monitoring, COVID‑19 exertional desaturation, OSA screening), is not routinely required for long‑term oxygen therapy except to assess or change the prescription, and capnography is investigational for non‑anesthesia uses and not separately reimbursed when incidental to anesthesia/sedation.

"ICD-10 codes not covered for indications listed in the CPB (pulse oximetry) (not all-inclusive): J45."