CR2

Spinal Manipulation Service Information

Pos: 130

Max: 1

Detail - Optional

Loop: 2000F

Elements: 12

User Option (Usage): Situational

To supply information related to the chiropractic service rendered to a patient

Element Summary:

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	CR201	609	Count Description: Occurrence counter Industry: Treatment Series Number Required if requesting certification for a specific treatment number in a series of treatments.	C	N0	1/9	Situational
	CR202	380	Quantity Description: Numeric value of quantity Industry: Treatment Count Required if CR201 is present.	C	R	1/15	Situational
	CR203	1367	Subluxation Level Code Description: Code identifying the specific level of subluxation Required if the patient’s condition or treatment involves subluxation. All valid standard codes are used.	C	ID	2/3	Situational
	CR204	1367	Subluxation Level Code Description: Code identifying the specific level of subluxation Required if the patient’s condition or treatment involves subluxation to express the ending level of subluxation. All valid standard codes are used.	O	ID	2/3	Situational
	CR205	355	Unit or Basis for Measurement Code Description: Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken Required if requesting authorization for a spinal manipulation treatment series to indicate the proposed treatment time period.	C	ID	2/2	Situational

	Code	Name
	DA	Days
	MO	Months
	WK	Week
	YR	Years

	CR206	380	Quantity Description: Numeric value of quantity Industry: Treatment Period Count Required if requesting authorization for a spinal manipulation treatment series.	C	R	1/15	Situational
	CR207	380	Quantity Description: Numeric value of quantity Industry: Monthly Treatment Count Required if CR205 = “MO” to indicate the proposed number of treatments included in a month of service.	O	R	1/15	Situational
	CR208	1342	Nature of Condition Code Description: Code indicating the nature of a patient's condition Industry: Patient Condition Code Required if UM01 = ‘‘HS’’. All valid standard codes are used.	O	ID	1/1	Situational
	CR209	1073	Yes/No Condition or Response Code Description: Code indicating a Yes or No condition or response Industry: Complication Indicator Required if UM01 = ‘‘HS’’.	O	ID	1/1	Situational

	Code	Name
	N	No
	Y	Yes

	CR210	352	Description Description: A free-form description to clarify the related data elements and their content Industry: Patient Condition Description Use at discretion of requester.	O	AN	1/80	Situational
	CR211	352	Description Description: A free-form description to clarify the related data elements and their content Industry: Patient Condition Description Use at discretion of requester.	O	AN	1/80	Situational
	CR212	1073	Yes/No Condition or Response Code Description: Code indicating a Yes or No condition or response Industry: X-ray Availability Indicator	O	ID	1/1	Required

	Code	Name
	N	No
	Y	Yes

Syntax:

1.	P0102 - If either CR201,CR202 is present, then all are required
2.	C0403 - If CR204 is present, then all of CR203 are required
3.	P0506 - If either CR205,CR206 is present, then all are required

Semantics:

1.	CR201 is the number this treatment is in the series.
2.	CR202 is the total number of treatments in the series.
3.	CR206 is the time period involved in the treatment series.
4.	CR207 is the number of treatments rendered in the month of service.
5.	CR209 is complication indicator. A "Y" value indicates a complicated condition; an "N" value indicates an uncomplicated condition.
6.	CR210 is a description of the patient's condition.
7.	CR211 is an additional description of the patient's condition.
8.	CR212 is X-rays availability indicator. A "Y" value indicates X-rays are maintained and available for carrier review; an "N" value indicates X-rays are not maintained and available for carrier review.

Comments:

1.	When both CR203 and CR204 are present, CR203 is the beginning level of subluxation and CR204 is the ending level of subluxation.

Notes:

1. Required if requesting certification for spinal manipulation services and UM01 = HS (Health Services Review).

Example:

CR2*1*5**********Y~

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