CR5 Oxygen Therapy Certification

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

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Position

Element

Name

Type

Requirement

Min

Max

Repeat

Certification Type Code

Identifier (ID)

Optional

1

1

1

Code indicating the type of certification

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR502 is the number of months covered by this certification.

Oxygen Equipment Type Code

Identifier (ID)

Optional

1

1

1

Code indicating the specific type of equipment being prescribed for the delivery of oxygen

Oxygen Equipment Type Code

Identifier (ID)

Optional

1

1

1

Code indicating the specific type of equipment being prescribed for the delivery of oxygen

Description

String (AN)

Optional

1

80

1

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

CR505 is the reason for equipment.

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR506 is the oxygen flow rate in liters per minute.

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR507 is the number of times per day the patient must use oxygen.

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR508 is the number of hours per period of oxygen use.

Description

String (AN)

Optional

1

80

1

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

CR509 is the special orders for the respiratory therapist.

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR510 is the arterial blood gas.

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR511 is the oxygen saturation.

Oxygen Test Condition Code

Identifier (ID)

Optional

1

1

1

Code indicating the conditions under which a patient was tested

Oxygen Test Findings Code

Identifier (ID)

Optional

1

1

1

Code indicating the findings of oxygen tests performed on a patient

Oxygen Test Findings Code

Identifier (ID)

Optional

1

1

1

Code indicating the findings of oxygen tests performed on a patient

Oxygen Test Findings Code

Identifier (ID)

Optional

1

1

1

Code indicating the findings of oxygen tests performed on a patient

Quantity

Decimal number (R)

Optional

1

15

1

Numeric value of quantity

CR516 is the oxygen flow rate for a portable oxygen system in liters per minute.

Oxygen Delivery System Code

Identifier (ID)

Optional

1

1

1

Code indicating if a particular form of delivery was prescribed

Oxygen Equipment Type Code

Identifier (ID)

Optional

1

1

1

Code indicating the specific type of equipment being prescribed for the delivery of oxygen