CR4 Enteral or Parenteral Therapy Certification

Batch

To supply information regarding certification of medical necessity for enteral or parenteral nutrition therapy

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	1073	Yes/No Condition or Response Code	Mandatory	ID	1/1	1
2	1322	Certification Type Code	Opt	ID	1/1	1
3	355	Unit or Basis for Measurement Code	Rel	ID	2/2	1
4	380	Quantity	Rel	Decimal	1/15	1
5	355	Unit or Basis for Measurement Code	Rel	ID	2/2	1
6	380	Quantity	Rel	Decimal	1/15	1
7	1344	Non-Visit Code	Opt	ID	1/1	1
8	355	Unit or Basis for Measurement Code	Rel	ID	2/2	1
9	380	Quantity	Rel	Decimal	1/15	1
10	355	Unit or Basis for Measurement Code	Rel	ID	2/2	1
11	65	Height	Rel	Decimal	1/8	1
12	355	Unit or Basis for Measurement Code	Rel	ID	2/2	1
13	81	Weight	Rel	Decimal	1/10	1
14	380	Quantity	Opt	Decimal	1/15	1
15	352	Description	Opt	Alphanumeric	1/80	1
16	1346	Nutrient Administration Method Code	Opt	ID	1/1	1
17	1347	Nutrient Administration Technique Code	Opt	ID	1/1	1
18	380	Quantity	Opt	Decimal	1/15	1
19	380	Quantity	Opt	Decimal	1/15	1
20	352	Description	Opt	Alphanumeric	1/80	1
21	380	Quantity	Opt	Decimal	1/15	1
22	954	Percent	Opt	Decimal	1/10	1
23	380	Quantity	Opt	Decimal	1/15	1
24	380	Quantity	Opt	Decimal	1/15	1
25	954	Percent	Opt	Decimal	1/10	1
26	380	Quantity	Opt	Decimal	1/15	1
27	954	Percent	Opt	Decimal	1/10	1
28	380	Quantity	Opt	Decimal	1/15	1
29	352	Description	Opt	Alphanumeric	1/80	1

ID1073

NameYes/No Condition or Response Code

LengthMin 1 / Max 1

Position1

RequirementMandatory

Codes