2025 HCPCS code QR
This modifier is used when a patient requires varying amounts of stationary oxygen during the day and night, and the average of these amounts exceeds 4 liters per minute (LPM).
Medical necessity is established by the patient’s underlying condition (e.g., COPD, CRF) and the documented need for varying amounts of oxygen to maintain adequate oxygen saturation levels at rest.
The healthcare provider is responsible for prescribing the appropriate amount of oxygen for both daytime and nighttime use.
In simple words: If you need different amounts of oxygen during the day and night while resting, and the average amount is more than 4 liters per minute, this code is used.
This modifier is used when the provider prescribes two different amounts of stationary oxygen for daytime and nighttime use for a patient at rest and the two amounts average greater than 4 L per minute. The prescribed oxygen amount depends upon the severity of disease. In severe conditions like chronic obstructive pulmonary disease (COPD) or chronic respiratory failure (CRF) the lungs fail to provide sufficient oxygen to the body tissues. Sufficient oxygen is essential for all normal physiological functions.
Example 1: A patient with severe COPD requires 5 LPM of oxygen during the day and 3 LPM at night. The average is 4 LPM, so modifier QR is used., A patient with chronic respiratory failure requires 6 LPM during the day and 2 LPM at night. The average exceeds 4 LPM, making modifier QR applicable., A patient with COPD requires 4 LPM of oxygen continuously. Modifier QR is not applicable, as the daytime and nighttime amounts are the same and a simpler code can be used.
Documentation must support the medical necessity for different oxygen flow rates during the day and night. The oxygen saturation levels at rest during both time periods should be documented.
- Specialties:Pulmonology, Respiratory Therapy, Internal Medicine
- Place of Service:Home