CR5

Home Oxygen Therapy Information

Pos: 140	Max: 1
Detail - Optional
Loop: 2000F	Elements: 10

Ref

Id

Element Name

Req

Type

Min/Max

Usage

CR503

1348

Oxygen Equipment Type Code
Description: Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Either CR503 or CR518 is required.
All valid standard codes are used.

O

ID

1/1

Situational

CR504

1348

Oxygen Equipment Type Code
Description: Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Required if CR503 is present and more than one type of equipment is required to administer the oxygen therapy.
All valid standard codes are used.

O

ID

1/1

Situational

CR505

352

Description
Description: A free-form description to clarify the related data elements and their content
Industry: Equipment Reason Description
Recommended if the UMO is changing the equipment, flow rate, or use count related to the oxygen therapy requested. Otherwise, not used.

O

AN

1/80

Situational

CR506

380

Quantity
Description: Numeric value of quantity
Industry: Oxygen Flow Rate

O

R

1/15

Required

CR507

380

Quantity
Description: Numeric value of quantity
Industry: Daily Oxygen Use Count
Required if relevant to the type of home oxygen therapy authorized.

O

R

1/15

Situational

CR508

380

Quantity
Description: Numeric value of quantity
Industry: Oxygen Use Period Hour Count
Required if relevant to the type of home oxygen therapy authorized.

O

R

1/15

Situational

CR509

352

Description
Description: A free-form description to clarify the related data elements and their content
Industry: Respiratory Therapist Order Text
Use at discretion of UMO.

O

AN

1/80

Situational

CR516

380

Quantity
Description: Numeric value of quantity
Industry: Portable Oxygen System Flow Rate
Required if either CR503, CR505 or CR518 = “D” (Liquid Portable) or “E” (Gaseous Portable).

O

R

1/15

Situational

CR517

1382

Oxygen Delivery System Code
Description: Code to indicate if a particular form of delivery was prescribed
All valid standard codes are used.

O

ID

1/1

Required

CR518

1348

Oxygen Equipment Type Code
Description: Code indicating the specific type of equipment being prescribed for the delivery of oxygen
Either CR503 or CR518 is required.
All valid standard codes are used.

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 the UMO is authorizing specific usage of home oxygen therapy.

Example:

CR5***D***1**********2*A~