CRC

Homebound Indicator

Pos: 220

Max: 1

Detail - Optional

Loop: 2300

Elements: 3

User Option (Usage): Situational

To supply information on conditions

Element Summary:

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	CRC01	1136	Code Category Description: Specifies the situation or category to which the code applies	M	ID	2/2	Required

	Code	Name
	75	Functional Limitations

CRC02

1073

Yes/No Condition or Response Code
Description: Code indicating a Yes or No condition or response

1/1

Required

	Code	Name
	Y	Yes

CRC03

1321

Condition Indicator
Description: Code indicating a condition
Industry: Homebound Indicator

2/2

Required

Code

Name

Independent at Home

NSF Reference:

EA0-50.0

Semantics:

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. Required for Medicare claims/encounters when an independent laboratory renders an EKG tracing or obtains a specimen from a homebound or institutionalized patient.

Example:

CRC*75*Y*IH~

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