CR5 |
Home Oxygen Therapy Information |
|
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|
Ref |
Id |
Element Name |
Req |
Type |
Min/Max |
Usage |
|
CR503 |
1348 |
Oxygen Equipment Type Code
|
O |
ID |
1/1 |
Situational |
|
CR504 |
1348 |
Oxygen Equipment Type Code
|
O |
ID |
1/1 |
Situational |
|
CR505 |
352 |
Description
|
O |
AN |
1/80 |
Situational |
|
CR506 |
380 |
Quantity
|
O |
R |
1/15 |
Required |
|
CR507 |
380 |
Quantity
|
O |
R |
1/15 |
Situational |
|
CR508 |
380 |
Quantity
|
O |
R |
1/15 |
Situational |
|
CR509 |
352 |
Description
|
O |
AN |
1/80 |
Situational |
|
CR510 |
380 |
Quantity
|
O |
R |
1/15 |
Situational |
|
CR511 |
380 |
Quantity
|
O |
R |
1/15 |
Situational |
|
CR512 |
1349 |
Oxygen Test Condition Code
|
O |
ID |
1/1 |
Required |
|
CR513 |
1350 |
Oxygen Test Findings Code
|
O |
ID |
1/1 |
Situational |
|
CR514 |
1350 |
Oxygen Test Findings Code
|
O |
ID |
1/1 |
Situational |
|
CR515 |
1350 |
Oxygen Test Findings Code
|
O |
ID |
1/1 |
Situational |
|
CR516 |
380 |
Quantity
|
O |
R |
1/15 |
Situational |
|
CR517 |
1382 |
Oxygen Delivery System Code
|
O |
ID |
1/1 |
Required |
|
CR518 |
1348 |
Oxygen Equipment Type Code
|
O |
ID |
1/1 |
Situational |
1. |
CR502 is the number of months covered by this certification. |
2. |
CR505 is the reason for equipment. |
3. |
CR506 is the oxygen flow rate in liters per minute. |
4. |
CR507 is the number of times per day the patient must use oxygen. |
5. |
CR508 is the number of hours per period of oxygen use. |
6. |
CR509 is the special orders for the respiratory therapist. |
7. |
CR510 is the arterial blood gas. |
8. |
CR511 is the oxygen saturation. |
9. |
CR516 is the oxygen flow rate for a portable oxygen system in liters per minute. |
Notes: |
1. Required if requesting initial, extended, or revised certification of home oxygen therapy.
|
Example: |
CR5***D***1*****87*N*****A~ |