CR4 Enteral or Parenteral Therapy Certification

To supply information regarding certification of medical necessity for enteral or parenteral nutrition therapy

Position
Element
Name
Type
Requirement
Min
Max
Repeat
CR4-01
Yes/No Condition or Response Code
Identifier (ID)
Mandatory
1
1
-
Code indicating a Yes or No condition or response.
CR401 is enteral or parenteral indicator. A ``Y'' value indicates enteral. An ``N'' value indicates parenteral.
CR4-02
Certification Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the type of certification
CR4-03
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
P0304: If either CR4-03 or CR4-04 is present, then the other is required
CR4-04
Quantity
Decimal number (R)
Conditional
1
15
-
Numeric value of quantity.
CR404 is estimated duration of therapy.
CR4-05
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: If either CR4-05 or CR4-06 is present, then the other is required
CR4-06
Quantity
Decimal number (R)
Conditional
1
15
-
Numeric value of quantity.
CR406 is the time period covered by this certification.
CR4-07
Non-Visit Code
Identifier (ID)
Optional
1
1
-
Code indicating on what a medical evaluation is based, when not based on a physician's visit
CR4-08
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
P0809: If either CR4-08 or CR4-09 is present, then the other is required
CR4-09
Quantity
Decimal number (R)
Conditional
1
15
-
Numeric value of quantity.
CR409 is age of patient.
CR4-10
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
P1011: If either CR4-10 or CR4-11 is present, then the other is required
CR4-11
Height
Decimal number (R)
Conditional
1
8
-
Vertical dimension of an object measured when the object is in the upright position.
CR411 is height of patient.
CR4-12
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
P1213: If either CR4-12 or CR4-13 is present, then the other is required
CR4-13
Weight
Decimal number (R)
Optional
1
10
-
Numeric value of weight.
CR413 is weight of patient.
CR4-14
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR414 is number of times per day that the patient was fed.
CR4-15
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR415 is the product name.
CR4-16
Nutrient Administration Method Code
Identifier (ID)
Optional
1
1
-
Code indicating the method used to administer nutrient to a patient
CR4-17
Nutrient Administration Technique Code
Identifier (ID)
Optional
1
1
-
Code indicating the technique used to administer nutrient to a patient
CR4-18
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR418 is total number of calories per day of all nutrients prescribed.
CR4-19
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR419 is total number of calories per day prescribed for this product.
CR4-20
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR420 is the amino acid name.
CR4-21
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR421 is the number of milliliters of amino acid solution used in the prescription per day.
CR4-22
Percent
Decimal number (R)
Optional
1
10
-
Percentage expressed as a decimal
CR422 is percentage of concentration of amino acid used in the prescription.
CR4-23
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR423 is number of grams of amino acid used per day.
CR4-24
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR424 is number of milliliters of dextrose solution used in the prescription per day.
CR4-25
Percent
Decimal number (R)
Optional
1
10
-
Percentage expressed as a decimal
CR425 is percentage of concentration of dextrose used in the prescription.
CR4-26
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR426 is number of milliliters of lipids used in the prescription.
CR4-27
Percent
Decimal number (R)
Optional
1
10
-
Percentage expressed as a decimal
CR427 is percentage of concentration of lipids used in the prescription.
CR4-28
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR428 is the number of times per week lipids are used in the prescription.
CR4-29
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR429 is special circumstances or medical justification.

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