CR6 Home Health Care Certification

To supply information related to the certification of a home health care patient

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Position
Element
Name
Type
Requirement
Min
Max
Repeat
CR6-01
Prognosis Code
Identifier (ID)
Mandatory
1
1
-
Code indicating physician's prognosis for the patient
CR6-02
Date
Date (DT)
Mandatory
6
6
-
Date (YYMMDD).
CR602 is the date covered home health services began.
CR6-03
Date Time Period Format Qualifier
Identifier (ID)
Conditional
2
3
-
Code indicating the date format, time format, or date and time format.
P0304: If either CR6-03 or CR6-04 is present, then the other is required
CR6-04
Date Time Period
String (AN)
Conditional
1
35
-
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.
CR6-05
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR605 is the date of onset or exacerbation of the principal diagnosis.
CR6-06
Yes/No Condition or Response Code
Identifier (ID)
Optional
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.
CR6-07
Yes/No Condition or Response Code
Identifier (ID)
Mandatory
1
1
-
Code indicating a Yes or No condition or response.
A ``Y'' value indicates the patient is covered by Medicare. An ``N'' value indicates patient is not covered by Medicare.
CR6-08
Certification Type Code
Identifier (ID)
Mandatory
1
1
-
Code indicating the type of certification
CR6-09
Date
Date (DT)
Conditional
6
6
-
Date (YYMMDD).
P091011: If either CR6-09, CR6-10 or CR6-11 are present, then the others are required
CR609 is date that the surgery identified in CR614 was performed.
CR6-10
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
-
Code identifying the type/source of the descriptive number used in Product/Service ID (234).
CR610 qualifies CR611.
CR6-11
Medical Code Value
String (AN)
Conditional
1
15
-
Code value for describing a medical condition or procedure
CR611 is the surgical procedure most relevant to the care being rendered.
CR6-12
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR612 is the date the agency received the verbal orders from the physician for start of care.
CR6-13
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR613 is the date that the patient was last seen by the physician.
CR6-14
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR614 is the date of the home health agency's most recent contact with the physician.
CR6-15
Date Time Period Format Qualifier
Identifier (ID)
Conditional
2
3
-
Code indicating the date format, time format, or date and time format.
P151617: If either CR6-15, CR6-16 or CR6-17 are present, then the others are required
CR6-16
Date Time Period
String (AN)
Conditional
1
35
-
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.
CR6-17
Patient Location Code
Identifier (ID)
Conditional
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.
CR6-18
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR618 is the date of onset or exacerbation of the first secondary diagnosis.
CR6-19
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR619 is the date of onset or exacerbation of the second secondary diagnosis.
CR6-20
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR620 is the date of onset or exacerbation of the third secondary diagnosis.
CR6-21
Date
Date (DT)
Optional
6
6
-
Date (YYMMDD).
CR621 is the date of onset or exacerbation of the fourth secondary diagnosis.
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