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Segment
in
X12 Release 003040

CR1 Ambulance Certification

To supply information related to the ambulance service rendered to a patient
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
355
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
-
Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken
P0102
Codes (719)
02
Weight
Decimal number (R)
Conditional
1
10
-
Numeric value of weight.
CR102 is weight of patient at time of transport.
03
Ambulance Transport Code
Identifier (ID)
Optional
1
1
-
Code indicating the type of ambulance transport
Codes (4)
04
Ambulance Transport Reason Code
Identifier (ID)
Optional
1
1
-
Code indicating the reason for ambulance transport
Codes (5)
05
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
-
Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken
P0506
Codes (719)
06
Quantity
Decimal number (R)
Conditional
1
15
-
Numeric value of quantity.
CR106 is the distance traveled during transport.
07
Address Information
String (AN)
Optional
1
35
-
Address information
CR107 is address of origin.
08
Address Information
String (AN)
Optional
1
35
-
Address information
CR108 is address of destination.
09
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR109 is purpose for round trip ambulance service.
10
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR110 is purpose for usage of a stretcher during ambulance service.
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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.