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Segment
in
X12 Release 008010

CR6 Home Health Care Certification

To supply information related to the certification of a home health care patient
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
923
Prognosis Code
Identifier (ID)
Mandatory
1
1
1
Code indicating physician's prognosis for the patient
Codes (8)
02
Date
Date (DT)
Mandatory
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR602 is the date covered home health services began.
03
Date Time Period Format Qualifier
Identifier (ID)
Conditional
2
3
1
Code indicating the date format, time format, or date and time format
P0304
Codes (42)
04
Date Time Period
String (AN)
Conditional
1
35
1
Expression of a date, a time, or range of dates, times or dates and times
CR604 is the certification period covered by this plan of treatment.
05
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR605 is the date of onset or exacerbation of the principal diagnosis.
06
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
A "Y" value indicates patient is receiving care in a 1861J1 (skilled nursing) facility. An "N" value indicates patient is not receiving care in a 1861J1 facility. A "U" value indicates it is unknown whether or not the patient is receiving care in a 1861J1 facility.
Codes (9)
07
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
CR607 indicates if the patient is covered by Medicare. A "Y" value indicates the patient is covered by Medicare; an "N" value indicates patient is not covered by Medicare.
Codes (9)
08
Certification Type Code
Identifier (ID)
Optional
1
1
1
Code indicating the type of certification
Codes (17)
09
Date
Date (DT)
Conditional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
P091011
CR609 is the date that the surgery identified in CR611 was performed.
10
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
1
Code identifying the type/source of the descriptive number used in Product/Service ID (234)
CR610 qualifies CR611.
Codes (544)
11
Medical Code Value
String (AN)
Conditional
1
15
1
Code value for describing a medical condition or procedure
CR611 is the surgical procedure most relevant to the care being rendered.
12
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR612 is the date the agency received the verbal orders from the physician for start of care.
13
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR613 is the date that the patient was last seen by the physician.
14
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR614 is the date of the home health agency's most recent contact with the physician.
15
Date Time Period Format Qualifier
Identifier (ID)
Conditional
2
3
1
Code indicating the date format, time format, or date and time format
P151617
Codes (42)
16
Date Time Period
String (AN)
Conditional
1
35
1
Expression of a date, a time, or range of dates, times or dates and times
CR616 is the date range of the most recent inpatient stay.
17
Patient Location Code
Identifier (ID)
Conditional
1
1
1
Code identifying the location where patient is receiving medical treatment
CR617 indicates the type of facility from which the patient was most recently discharged.
Codes (15)
18
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR618 is the date of onset or exacerbation of the first secondary diagnosis.
19
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR619 is the date of onset or exacerbation of the second secondary diagnosis.
20
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR620 is the date of onset or exacerbation of the third secondary diagnosis.
21
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
CR621 is the date of onset or exacerbation of the fourth secondary diagnosis.
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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.