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Segment
in
X12 Release 003030

CR5 Oxygen Therapy Certification

To supply information regarding certification of medical necessity for home oxygen therapy
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
1322
Certification Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the type of certification
Codes (3)
02
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR502 is number of months covered by this certification.
03
Oxygen Equipment Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Codes (6)
04
Oxygen Equipment Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Codes (6)
05
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR505 is reason for equipment.
06
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR506 is oxygen flow rate in liters per minute.
07
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR507 is number of times per day patient must use oxygen.
08
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR508 is number of hours per day of oxygen use.
09
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR509 is special orders for respiratory therapist.
10
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR510 is arterial blood gas.
11
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR511 is oxygen saturation.
12
Oxygen Test Condition Code
Identifier (ID)
Optional
1
1
-
Code indicating the conditions under which a patient was tested
Codes (7)
13
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
-
Code indicating the findings of oxygen tests performed on a patient
Codes (3)
14
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
-
Code indicating the findings of oxygen tests performed on a patient
Codes (3)
15
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
-
Code indicating the findings of oxygen tests performed on a patient
Codes (3)
16
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR516 is oxygen flow rate for a portable oxygen system in liters per minute.
17
Oxygen Delivery System Code
Identifier (ID)
Optional
1
1
-
Code to indicate if a particular form of delivery was prescribed
Codes (5)
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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.