CR5 Oxygen Therapy Certification

To supply information regarding certification of medical necessity for home oxygen therapy

Position
Element
Name
Type
Requirement
Min
Max
Repeat
CR5-01
Certification Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the type of certification
CR5-02
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR502 is number of months covered by this certification.
CR5-03
Oxygen Equipment Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the specific type of equipment being prescribed for the delivery of oxygen
CR5-04
Oxygen Equipment Type Code
Identifier (ID)
Optional
1
1
-
Code indicating the specific type of equipment being prescribed for the delivery of oxygen
CR5-05
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR505 is reason for equipment.
CR5-06
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR506 is oxygen flow rate in liters per minute.
CR5-07
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR507 is number of times per day patient must use oxygen.
CR5-08
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR508 is the number of hours per period of oxygen use.
CR5-09
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
CR509 is special orders for respiratory therapist.
CR5-10
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR510 is arterial blood gas.
CR5-11
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR511 is oxygen saturation.
CR5-12
Oxygen Test Condition Code
Identifier (ID)
Optional
1
1
-
Code indicating the conditions under which a patient was tested
CR5-13
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
-
Code indicating the findings of oxygen tests performed on a patient
CR5-14
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
-
Code indicating the findings of oxygen tests performed on a patient
CR5-15
Oxygen Test Findings Code
Identifier (ID)
Optional
1
1
-
Code indicating the findings of oxygen tests performed on a patient
CR5-16
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
CR516 is oxygen flow rate for a portable oxygen system in liters per minute.
CR5-17
Oxygen Delivery System Code
Identifier (ID)
Optional
1
1
-
Code to indicate if a particular form of delivery was prescribed

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