CRC |
Ambulance Certification |
|
||||||
|
Ref |
Id |
Element Name |
Req |
Type |
Min/Max |
Usage |
|
CRC01 |
1136 |
Code Category
|
M |
ID |
2/2 |
Required |
|
Code |
Name |
|
07 |
Ambulance Certification |
|
CRC02 |
1073 |
Yes/No Condition or Response Code
|
M |
ID |
1/1 |
Required |
|
Code |
Name |
|
N |
No |
|
Y |
Yes |
|
CRC03 |
1321 |
Condition Indicator
|
M |
ID |
2/2 |
Required |
|
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
|
||
|
60 |
Transportation Was To the Nearest Facility
|
|
CRC04 |
1321 |
Condition Indicator
|
O |
ID |
2/2 |
Situational |
|
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
|
||
|
60 |
Transportation Was To the Nearest Facility
|
|
CRC05 |
1321 |
Condition Indicator
|
O |
ID |
2/2 |
Situational |
|
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
|
||
|
60 |
Transportation Was To the Nearest Facility
|
|
CRC06 |
1321 |
Condition Indicator
|
O |
ID |
2/2 |
Situational |
|
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
|
||
|
60 |
Transportation Was To the Nearest Facility
|
|
CRC07 |
1321 |
Condition Indicator
|
O |
ID |
2/2 |
Situational |
|
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
|
||
|
60 |
Transportation Was To the Nearest Facility
|
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. |
Notes: |
1. The CRC segment in Loop ID-2300 applies to the entire claim unless overridden by a CRC segment at the service line level in Loop ID-2400 with the same value in CRC01.
|
Example: |
CRC*07*Y*01~ |