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Segment
in
X12 Release 008010

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
1
Code indicating the type of certification
Codes (17)
02
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR502 is the number of months covered by this certification.
03
Oxygen Equipment Type Code
Identifier (ID)
Optional
1
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
1
Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Codes (6)
05
Description
String (AN)
Optional
1
80
1
A free-form description to clarify the related data elements and their content
CR505 is the reason for equipment.
06
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR506 is the oxygen flow rate in liters per minute.
07
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR507 is the number of times per day the patient must use oxygen.
08
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR508 is the number of hours per period of oxygen use.
09
Description
String (AN)
Optional
1
80
1
A free-form description to clarify the related data elements and their content
CR509 is the special orders for the respiratory therapist.
10
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR510 is the arterial blood gas.
11
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR511 is the oxygen saturation.
12
Oxygen Test Condition Code
Identifier (ID)
Optional
1
1
1
Code indicating the conditions under which a patient was tested
Codes (7)
13
Oxygen Test Findings Code
Identifier (ID)
Optional
1
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
1
Code indicating the findings of oxygen tests performed on a patient
Codes (3)
15
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
1
Code indicating the findings of oxygen tests performed on a patient
Codes (3)
16
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR516 is the oxygen flow rate for a portable oxygen system in liters per minute.
17
Oxygen Delivery System Code
Identifier (ID)
Optional
1
1
1
Code indicating if a particular form of delivery was prescribed
Codes (5)
18
Oxygen Equipment Type Code
Identifier (ID)
Optional
1
1
1
Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Codes (6)
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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.