Segment
X12 EDI Release 00504
To supply information regarding certification of medical necessity for home oxygen therapy
Elements
  • CR5011322Certification Type Code
    ID
    O可选(Optional)

    Code indicating the type of certification

    Codes (15)
  • CR502380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR5031348Oxygen Equipment Type Code
    ID
    O可选(Optional)

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

    Codes (6)
  • CR5041348Oxygen Equipment Type Code
    ID
    O可选(Optional)

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

    Codes (6)
  • CR505352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • CR506380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR507380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR508380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR509352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • CR510380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR511380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR5121349Oxygen Test Condition Code
    ID
    O可选(Optional)

    Code indicating the conditions under which a patient was tested

    Codes (7)
  • CR5131350Oxygen Test Findings Code
    ID
    O可选(Optional)

    Code indicating the findings of oxygen tests performed on a patient

    Codes (3)
  • CR5141350Oxygen Test Findings Code
    ID
    O可选(Optional)

    Code indicating the findings of oxygen tests performed on a patient

    Codes (3)
  • CR5151350Oxygen Test Findings Code
    ID
    O可选(Optional)

    Code indicating the findings of oxygen tests performed on a patient

    Codes (3)
  • CR516380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • CR5171382Oxygen Delivery System Code
    ID
    O可选(Optional)

    Code to indicate if a particular form of delivery was prescribed

    Codes (5)
  • CR5181348Oxygen Equipment Type Code
    ID
    O可选(Optional)

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

    Codes (6)