Hey Greg,
Having studied this topic in detail with several experts since 2006, I'm well aware of your problem obtaining home oxygen therapy as an abortive for your CH.
I suspect your Rx for oxygen therapy wasn't written properly. The Rx must clearly state oxygen at a flow rate of 15 to 25 liters/minute with a non-rebreathing mask for cluster headache. Otherwise, home oxygen providers are spring-loaded to assume the Rx is needed to treat COPD and ask for blood oxygen saturation test results, as you've already discovered. The Rx should also state Administer STAT for at least 15 minutes up to 12 times/day with Refills for six (6) months for episodic CH or refills for one (1) year for chronic CH.
In addition, your doctor can also get very specific by using the appropriate Dianostic Treatment and Healthcare Common Procedure Coding System (HCPCS) codes:
Diagnostic and Treatment Codes: ICD-9-CM Diagnosis Codes:
Episodic Cluster Headaches – 339.01
Chronic Cluster Headaches – 339.02
ICHD-II Codes:
Episodic Cluster Headaches – 3.1.1
Chronic Cluster Headaches – 3.1.2
ICD-10 NA Codes:
Episodic Cluster Headaches – G44.01
Chronic Cluster Headaches – G44.02
Healthcare Common Procedure Coding System (HCPCS) Codes for Home Oxygen Therapy:
Equipment:
E0424-E0425 Stationary compressed gaseous oxygen system (M-Size cylinders at home)
E0430-E0431 Portable gaseous oxygen system (E-Size cylinders when not at home)
Contents:
E0441 Oxygen contents, gaseous, 1 month’s supply = 1 unit
Modifiers:
QG - Prescribed amount of oxygen is greater than four liters per minute (LPM)
Accordingly, for an episodic CHer needing home oxygen therapy as a CH abortive, the Rx should read:
“Oxygen therapy at flow rate of 15 to 25 lpm with non-rebreathing mask as abortive for episodic cluster headache. Administer STAT for 15 minutes up to 12 X per day - ICDM-9 339.01/ICDH-II 3.1.2/ICD-10 G44.02/HCPCS - E0424-E0425, E0430-E0431, E0441 - 12, QG.”
For a chronic CHer, the Rx should read:
“Oxygen therapy at flow rate of 15 to 25 lpm with non-rebreathing mask as abortive for chronic cluster headache. Administer STAT for 15 minutes up to 12 X per day - ICDM-9 339.02/ICDH-II 3.1.1/ICD-10 G44.01/HCPCS - E0424-E0425, E0430-E0431, E0441 - 6, QG.”
If the Rx is written this way, you beat the dirty rotten bastards at their own game using their own rules. Moreover, there's no way the home oxygen provider can confuse this Rx for COPD. Give your neurologist a copy of this post.
If the home oxygen provider makes any changes to this Rx, be bold, remind them "it's against the law to change an Rx without consulting with the physician who wrote the Rx. Then ask for the name of the Physician who has attempted to change the Rx so you can report that physician to the State Medical Board legal department. Rationale, A strong offense is the best defense and telling them this usually puts them back on their heels.
What's the name of your medical insurance provider and state? In many cases you can go over the Internet and look up the policy regarding "coverage" (they pay) for oxygen therapy. Most medical insurance companies do cover home oxygen therapy for cluster headache. That said, if you're on MEDICARE and do not have supplemental medical insurance that covers home oxygen therapy for cluster headache, don't waste your time, you'll need to take up Oxy-Acetylene welding and buy your own welder's O2 cylinder. (Just don't tell the welding supply people how you intend to use it.)
Oxygen therapy for a CHer on MEDICARE is not covered because the unelected idiot weasel bureaucrats at the Centers for Medicare & Medicaid (CMS/OCQ) have made a most egregious non-coverage determination in 2010 (a no coverage rule so they don't have to pay for the oxygen) for home oxygen therapy for cluster headache sufferers on MEDICARE. This is another example of Big Government run amuck. They had a lot of help.
If you follow the money, you'll find that Big Pharma does not want you to use oxygen therapy as a CH abortive and instead buy one or more of their patented pharmaceuticals costing upwards of $100 a pop, so they paid Lobbyists on K-street to write legislation for idiot members of Congress, who couldn't write a coherent sentence if they tried, that makes it more difficult for a physician to prescribe home oxygen therapy than write an Rx for opiates. Moreover, in order to get this legislation passed, Big Pharma pays its K-street lobbyists to make donations to the applicable Political Action Committee (PAC) for corrupt members of Congress so they will vote in favor of this terrible legislation.
If you've any questions, just let me know. There are no rules in a knife fight... and I'm a cranky old Navy fighter pilot... who loves a fight like this.
Take care and happy hunting.
V/R, Batch