CR1

Ambulance Transport Information

Pos: 120	Max: 1
Detail - Optional
Loop: 2000F	Elements: 5

Ref

Id

Element Name

Req

Type

Min/Max

Usage

CR103

1316

Ambulance Transport Code
Description: Code indicating the type of ambulance transport
All valid standard codes are used.

O

ID

1/1

Required

CR105

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 CR106 is present.

C

ID

2/2

Situational

Code

Name

DH

Miles

DK

Kilometers

CR106

380

Quantity
Description: Numeric value of quantity
Industry: Transport Distance
Required if known.

C

R

1/15

Situational

CR107

166

Address Information
Description: Address information
Industry: Ambulance Trip Origin Address
Required if valued on the request.

O

AN

1/55

Situational

CR108

166

Address Information
Description: Address information
Industry: Ambulance Trip Destination Address
Required if valued on the request.

O

AN

1/55

Situational

1.

P0102 - If either CR101,CR102 is present, then all are required

2.

P0506 - If either CR105,CR106 is present, then all are required

1.

CR102 is the weight of the patient at time of transport.

2.

CR106 is the distance traveled during transport.

3.

CR107 is the address of origin.

4.

CR108 is the address of destination.

5.

CR109 is the purpose for the round trip ambulance service.

6.

CR110 is the purpose for the usage of a stretcher during ambulance service.

Notes:

1. Use this segment for certifications involving ambulance transport of the patient.
2. Required if the UMO is authorizing specific ambulance transport criteria.

Example:

CR1***T**DH*28~