	Code	Name
	01	Patient was admitted to a hospital
	02	Patient was bed confined before the ambulance service
	03	Patient was bed confined after the ambulance service
	04	Patient was moved by stretcher
	05	Patient was unconscious or in shock
	06	Patient was transported in an emergency situation
	07	Patient had to be physically restrained
	08	Patient had visible hemorrhaging
	09	Ambulance service was medically necessary
	10	Patient is ambulatory
	11	Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility
	12	Patient is confined to a bed or chair
	13	Patient is Confined to a Room or an Area Without Bathroom Facilities
	14	Ambulation is Impaired and Walking Aid is Used for Mobility
	15	Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed
	16	Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons
	17	Patient's Ability to Breathe is Severely Impaired
	18	Patient condition requires frequent and/or immediate changes in body positions
	19	Patient can operate controls
	20	Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary
	21	Patient owns equipment
	22	Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary
	23	Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair
	24	Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use
	25	Item has been prescribed as part of a planned regimen of treatment in patient home
	26	Patient is highly susceptible to decubitus ulcers
	27	Patient or a care-giver has been instructed in use of equipment
	30	Without the equipment, the patient would require surgery
	31	Patient has had a total knee replacement
	35	This Feeding is the Only Form of Nutritional Intake for This Patient
	37	Oxygen delivery equipment is stationary
	39	Patient Has Mobilizing Respiratory Tract Secretions
	40	Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision
	41	Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair
	42	Patient Requires Leg Elevation for Edema or Body Alignment
	43	Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair
	44	Patient Requires Reclining Function of a Wheelchair
	45	Patient is Unable to Operate a Wheelchair Manually
	46	Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other
	60	Transportation Was To the Nearest Facility
	9D	Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications
	9H	Patient Requires Intensive IV Therapy
	9J	Patient Requires Protective Isolation
	9K	Patient Requires Frequent Monitoring
	IH	Independent at Home
	LB	Legally Blind
	SL	Speech Limitations

	Code	Name
	01	Patient was admitted to a hospital
	02	Patient was bed confined before the ambulance service
	03	Patient was bed confined after the ambulance service
	04	Patient was moved by stretcher
	05	Patient was unconscious or in shock
	06	Patient was transported in an emergency situation
	07	Patient had to be physically restrained
	08	Patient had visible hemorrhaging
	09	Ambulance service was medically necessary
	10	Patient is ambulatory
	11	Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility
	12	Patient is confined to a bed or chair
	13	Patient is Confined to a Room or an Area Without Bathroom Facilities
	14	Ambulation is Impaired and Walking Aid is Used for Mobility
	15	Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed
	16	Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons
	17	Patient's Ability to Breathe is Severely Impaired
	18	Patient condition requires frequent and/or immediate changes in body positions
	19	Patient can operate controls
	20	Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary
	21	Patient owns equipment
	22	Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary
	23	Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair
	24	Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use
	25	Item has been prescribed as part of a planned regimen of treatment in patient home
	26	Patient is highly susceptible to decubitus ulcers
	27	Patient or a care-giver has been instructed in use of equipment
	30	Without the equipment, the patient would require surgery
	31	Patient has had a total knee replacement
	35	This Feeding is the Only Form of Nutritional Intake for This Patient
	37	Oxygen delivery equipment is stationary
	39	Patient Has Mobilizing Respiratory Tract Secretions
	40	Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision
	41	Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair
	42	Patient Requires Leg Elevation for Edema or Body Alignment
	43	Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair
	44	Patient Requires Reclining Function of a Wheelchair
	45	Patient is Unable to Operate a Wheelchair Manually
	46	Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other
	60	Transportation Was To the Nearest Facility
	9D	Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications
	9H	Patient Requires Intensive IV Therapy
	9J	Patient Requires Protective Isolation
	9K	Patient Requires Frequent Monitoring
	IH	Independent at Home
	LB	Legally Blind
	SL	Speech Limitations

	Code	Name
	01	Patient was admitted to a hospital
	02	Patient was bed confined before the ambulance service
	03	Patient was bed confined after the ambulance service
	04	Patient was moved by stretcher
	05	Patient was unconscious or in shock
	06	Patient was transported in an emergency situation
	07	Patient had to be physically restrained
	08	Patient had visible hemorrhaging
	09	Ambulance service was medically necessary
	10	Patient is ambulatory
	11	Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility
	12	Patient is confined to a bed or chair
	13	Patient is Confined to a Room or an Area Without Bathroom Facilities
	14	Ambulation is Impaired and Walking Aid is Used for Mobility
	15	Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed
	16	Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons
	17	Patient's Ability to Breathe is Severely Impaired
	18	Patient condition requires frequent and/or immediate changes in body positions
	19	Patient can operate controls
	20	Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary
	21	Patient owns equipment
	22	Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary
	23	Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair
	24	Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use
	25	Item has been prescribed as part of a planned regimen of treatment in patient home
	26	Patient is highly susceptible to decubitus ulcers
	27	Patient or a care-giver has been instructed in use of equipment
	30	Without the equipment, the patient would require surgery
	31	Patient has had a total knee replacement
	35	This Feeding is the Only Form of Nutritional Intake for This Patient
	37	Oxygen delivery equipment is stationary
	39	Patient Has Mobilizing Respiratory Tract Secretions
	40	Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision
	41	Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair
	42	Patient Requires Leg Elevation for Edema or Body Alignment
	43	Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair
	44	Patient Requires Reclining Function of a Wheelchair
	45	Patient is Unable to Operate a Wheelchair Manually
	46	Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other
	60	Transportation Was To the Nearest Facility
	9D	Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications
	9H	Patient Requires Intensive IV Therapy
	9J	Patient Requires Protective Isolation
	9K	Patient Requires Frequent Monitoring
	IH	Independent at Home
	LB	Legally Blind
	SL	Speech Limitations

	Code	Name
	01	Patient was admitted to a hospital
	02	Patient was bed confined before the ambulance service
	03	Patient was bed confined after the ambulance service
	04	Patient was moved by stretcher
	05	Patient was unconscious or in shock
	06	Patient was transported in an emergency situation
	07	Patient had to be physically restrained
	08	Patient had visible hemorrhaging
	09	Ambulance service was medically necessary
	10	Patient is ambulatory
	11	Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility
	12	Patient is confined to a bed or chair
	13	Patient is Confined to a Room or an Area Without Bathroom Facilities
	14	Ambulation is Impaired and Walking Aid is Used for Mobility
	15	Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed
	16	Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons
	17	Patient's Ability to Breathe is Severely Impaired
	18	Patient condition requires frequent and/or immediate changes in body positions
	19	Patient can operate controls
	20	Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary
	21	Patient owns equipment
	22	Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary
	23	Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair
	24	Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use
	25	Item has been prescribed as part of a planned regimen of treatment in patient home
	26	Patient is highly susceptible to decubitus ulcers
	27	Patient or a care-giver has been instructed in use of equipment
	30	Without the equipment, the patient would require surgery
	31	Patient has had a total knee replacement
	35	This Feeding is the Only Form of Nutritional Intake for This Patient
	37	Oxygen delivery equipment is stationary
	39	Patient Has Mobilizing Respiratory Tract Secretions
	40	Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision
	41	Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair
	42	Patient Requires Leg Elevation for Edema or Body Alignment
	43	Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair
	44	Patient Requires Reclining Function of a Wheelchair
	45	Patient is Unable to Operate a Wheelchair Manually
	46	Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other
	60	Transportation Was To the Nearest Facility
	9D	Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications
	9H	Patient Requires Intensive IV Therapy
	9J	Patient Requires Protective Isolation
	9K	Patient Requires Frequent Monitoring
	IH	Independent at Home
	LB	Legally Blind
	SL	Speech Limitations

	Code	Name
	01	Patient was admitted to a hospital
	02	Patient was bed confined before the ambulance service
	03	Patient was bed confined after the ambulance service
	04	Patient was moved by stretcher
	05	Patient was unconscious or in shock
	06	Patient was transported in an emergency situation
	07	Patient had to be physically restrained
	08	Patient had visible hemorrhaging
	09	Ambulance service was medically necessary
	10	Patient is ambulatory
	11	Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility
	12	Patient is confined to a bed or chair
	13	Patient is Confined to a Room or an Area Without Bathroom Facilities
	14	Ambulation is Impaired and Walking Aid is Used for Mobility
	15	Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed
	16	Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons
	17	Patient's Ability to Breathe is Severely Impaired
	18	Patient condition requires frequent and/or immediate changes in body positions
	19	Patient can operate controls
	20	Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary
	21	Patient owns equipment
	22	Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary
	23	Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair
	24	Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use
	25	Item has been prescribed as part of a planned regimen of treatment in patient home
	26	Patient is highly susceptible to decubitus ulcers
	27	Patient or a care-giver has been instructed in use of equipment
	30	Without the equipment, the patient would require surgery
	31	Patient has had a total knee replacement
	35	This Feeding is the Only Form of Nutritional Intake for This Patient
	37	Oxygen delivery equipment is stationary
	39	Patient Has Mobilizing Respiratory Tract Secretions
	40	Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision
	41	Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair
	42	Patient Requires Leg Elevation for Edema or Body Alignment
	43	Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair
	44	Patient Requires Reclining Function of a Wheelchair
	45	Patient is Unable to Operate a Wheelchair Manually
	46	Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other
	60	Transportation Was To the Nearest Facility
	9D	Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications
	9H	Patient Requires Intensive IV Therapy
	9J	Patient Requires Protective Isolation
	9K	Patient Requires Frequent Monitoring
	IH	Independent at Home
	LB	Legally Blind
	SL	Speech Limitations

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	CRC01	1136	Code Category Description: Specifies the situation or category to which the code applies Alias: Condition Code Category	M	ID	2/2	Required

	Code	Name
	07	Ambulance Certification
	08	Chiropractic Certification
	11	Oxygen Therapy Certification
	75	Functional Limitations
	76	Activities Permitted
	77	Mental Status

1.	CRC01 qualifies CRC03 through CRC07.
2.	CRC02 is a Certification Condition Code applies indicator. A "Y" value indicates the condition codes in CRC03 through CRC07 apply; an "N" value indicates the condition codes in CRC03 through CRC07 do not apply.