CR4 Enteral or Parenteral Therapy Certification

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

Position
Element
Name
Type
Requirement
Min
Max
Repeat
CR401
Yes/No Condition or Response Code
Identifier (ID)
Mandatory
1
1
1
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.
CR402
Certification Type Code
Identifier (ID)
Optional
1
1
1
Code indicating the type of certification
CR403
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
1
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
CR404
Quantity
Decimal number (R)
Conditional
1
15
1
Numeric value of quantity
CR404 is the estimated duration of therapy.
CR405
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
1
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
CR406
Quantity
Decimal number (R)
Conditional
1
15
1
Numeric value of quantity
CR406 is the time period covered by this certification.
CR407
Non-Visit Code
Identifier (ID)
Optional
1
1
1
Code indicating on what a medical evaluation is based, when not based on a physician's visit
CR408
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
1
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
CR409
Quantity
Decimal number (R)
Conditional
1
15
1
Numeric value of quantity
CR409 is the age of the patient.
CR410
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
1
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
CR411
Height
Decimal number (R)
Conditional
1
8
1
Vertical dimension of an object measured when the object is in the upright position
CR411 is the height of the patient.
CR412
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
1
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
CR413
Weight
Decimal number (R)
Conditional
1
10
1
Numeric value of weight
CR413 is the weight of the patient.
CR414
Quantity
Decimal number (R)
Optional
1
15
1
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.
CR415
Description
String (AN)
Optional
1
80
1
A free-form description to clarify the related data elements and their content
CR415 is the product name.
CR416
Nutrient Administration Method Code
Identifier (ID)
Optional
1
1
1
Code indicating the method used to administer nutrient to a patient
CR417
Nutrient Administration Technique Code
Identifier (ID)
Optional
1
1
1
Code indicating the technique used to administer nutrient to a patient
CR418
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR418 is the total number of calories per day of all nutrients prescribed.
CR419
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR419 is the total number of calories per day prescribed for this product.
CR420
Description
String (AN)
Optional
1
80
1
A free-form description to clarify the related data elements and their content
CR420 is the amino acid name.
CR421
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR421 is the number of milliliters of amino acid solution used in the prescription per day.
CR422
Percentage as Decimal
Decimal number (R)
Optional
1
10
1
Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)
CR422 is the percentage of concentration of amino acid used in the prescription.
CR423
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR423 is the number of grams of amino acid used per day.
CR424
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR424 is the number of milliliters of dextrose solution used in the prescription per day.
CR425
Percentage as Decimal
Decimal number (R)
Optional
1
10
1
Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)
CR425 is the percentage of concentration of dextrose used in the prescription.
CR426
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR426 is the number of milliliters of lipids used in the prescription.
CR427
Percentage as Decimal
Decimal number (R)
Optional
1
10
1
Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)
CR427 is the percentage of concentration of lipids used in the prescription.
CR428
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
CR428 is the number of times per week lipids are used in the prescription.
CR429
Description
String (AN)
Optional
1
80
1
A free-form description to clarify the related data elements and their content
CR429 is the special circumstances or medical justification.

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