CR4 Enteral or Parenteral Therapy Certification

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

Position: CR4-01 · Element: 1073 · Name: Yes/No Condition or Response Code · Type: Identifier (ID) · Requirement: Mandatory · Min: 1 · Max: 1 · Repeat: -

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.

Position: CR4-02 · Element: 1322 · Name: Certification Type Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

Code indicating the type of certification

Position: CR4-03 · Element: 355 · Name: Unit or Basis for Measurement Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: -

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

Position: CR4-04 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Conditional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR404 is estimated duration of therapy.

Position: CR4-05 · Element: 355 · Name: Unit or Basis for Measurement Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: -

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

Position: CR4-06 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Conditional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR406 is the time period covered by this certification.

Position: CR4-07 · Element: 1344 · Name: Non-Visit Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

Code indicating on what a medical evaluation is based, when not based on a physician's visit

Position: CR4-08 · Element: 355 · Name: Unit or Basis for Measurement Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: -

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

Position: CR4-09 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Conditional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR409 is age of patient.

Position: CR4-10 · Element: 355 · Name: Unit or Basis for Measurement Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: -

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

Position: CR4-11 · Element: 65 · Name: Height · Type: Decimal number (R) · Requirement: Conditional · Min: 1 · Max: 8 · Repeat: -

Vertical dimension of an object measured when the object is in the upright position.

CR411 is height of patient.

Position: CR4-12 · Element: 355 · Name: Unit or Basis for Measurement Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: -

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

Position: CR4-13 · Element: 81 · Name: Weight · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 10 · Repeat: -

Numeric value of weight.

CR413 is weight of patient.

Position: CR4-14 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR414 is the number of times the patient is fed per week for parenteral claims or the number of times the patient is fed per day for enteral claims.

Position: CR4-15 · Element: 352 · Name: Description · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 80 · Repeat: -

A free-form description to clarify the related data elements and their content.

CR415 is the product name.

Position: CR4-16 · Element: 1346 · Name: Nutrient Administration Method Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

Code indicating the method used to administer nutrient to a patient

Position: CR4-17 · Element: 1347 · Name: Nutrient Administration Technique Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

Code indicating the technique used to administer nutrient to a patient

Position: CR4-18 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR418 is total number of calories per day of all nutrients prescribed.

Position: CR4-19 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR419 is total number of calories per day prescribed for this product.

Position: CR4-20 · Element: 352 · Name: Description · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 80 · Repeat: -

A free-form description to clarify the related data elements and their content.

CR420 is the amino acid name.

Position: CR4-21 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR421 is the number of milliliters of amino acid solution used in the prescription per day.

Position: CR4-22 · Element: 954 · Name: Percent · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 10 · Repeat: -

Percentage expressed as a decimal

CR422 is percentage of concentration of amino acid used in the prescription.

Position: CR4-23 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR423 is number of grams of amino acid used per day.

Position: CR4-24 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR424 is number of milliliters of dextrose solution used in the prescription per day.

Position: CR4-25 · Element: 954 · Name: Percent · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 10 · Repeat: -

Percentage expressed as a decimal

CR425 is percentage of concentration of dextrose used in the prescription.

Position: CR4-26 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR426 is number of milliliters of lipids used in the prescription.

Position: CR4-27 · Element: 954 · Name: Percent · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 10 · Repeat: -

Percentage expressed as a decimal

CR427 is percentage of concentration of lipids used in the prescription.

Position: CR4-28 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

CR428 is the number of times per week lipids are used in the prescription.

Position: CR4-29 · Element: 352 · Name: Description · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 80 · Repeat: -

A free-form description to clarify the related data elements and their content.

CR429 is special circumstances or medical justification.