United States Health Information Knowledgebase

 

Condition Code

Name:Condition Code
Type:Data Element
Definition:Code(s) used to identify condition(s) relating to this bill or relating to the patient.
Version:005010
Data Element Reference Number:1271
Permissible Values:
Code / Value Meaning Meaning Definition Text
5A Treatment is rendered related to the terminal illness Not Provided
9D Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications Not Provided
9E Sudden Onset of Disorientation Not Provided
9F Sudden Onset of Severe, Incapacitating Pain Not Provided
9H Patient Requires Intensive IV Therapy Not Provided
9J Patient Requires Protective Isolation Not Provided
9K Patient Requires Frequent Monitoring Not Provided
01 Patient was admitted to a hospital Not Provided
02 Patient was bed confined before the ambulance service Not Provided
03 Patient was bed confined after the ambulance service Not Provided
04 Patient was moved by stretcher Not Provided
05 Patient was unconscious or in shock Not Provided
06 Patient was transported in an emergency situation Not Provided
07 Patient had to be physically restrained Not Provided
08 Patient had visible hemorrhaging Not Provided
09 Ambulance service was medically necessary Not Provided
10 Patient is ambulatory Not Provided
11 Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility Not Provided
12 Patient is confined to a bed or chair Not Provided
13 Patient is Confined to a Room or an Area Without Bathroom Facilities Not Provided
14 Ambulation is Impaired and Walking Aid is Used for Mobility Not Provided
15 Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed Not Provided
16 Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons Not Provided
17 Patient's Ability to Breathe is Severely Impaired Not Provided
18 Patient condition requires frequent and/or immediate changes in body positions Not Provided
19 Patient can operate controls Not Provided
20 Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary Not Provided
21 Patient owns equipment Not Provided
22 Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary Not Provided
23 Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair Not Provided
24 Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use Not Provided
25 Item has been prescribed as part of a planned regimen of treatment in patient home Not Provided
26 Patient is highly susceptible to decubitus ulcers Not Provided
27 Patient or a care-giver has been instructed in use of equipment Not Provided
28 Patient has poor diabetic control Not Provided
29 A 6-7 hour nocturnal study documents 30 episodes of apnea each lasting more than 10 seconds Not Provided
30 Without the equipment, the patient would require surgery Not Provided
31 Patient has had a total knee replacement Not Provided
32 Patient has intractable lymphedema of the extremities Not Provided
33 Patient is in a nursing home Not Provided
34 Patient is conscious Not Provided
35 This Feeding is the Only Form of Nutritional Intake for This Patient Not Provided
37 Oxygen delivery equipment is stationary Not Provided
38 Certification signed by the physician is on file at the supplier's office Not Provided
39 Patient Has Mobilizing Respiratory Tract Secretions Not Provided
40 Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision Not Provided
41 Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair Not Provided
42 Patient Requires Leg Elevation for Edema or Body Alignment Not Provided
43 Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair Not Provided
44 Patient Requires Reclining Function of a Wheelchair Not Provided
45 Patient is Unable to Operate a Wheelchair Manually Not Provided
46 Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other Not Provided
58 Durable Medical Equipment (DME) Purchased New Not Provided
59 Durable Medical Equipment (DME) Is Under Warranty Not Provided
60 Transportation Was To the Nearest Facility Not Provided
68 Severe Not Provided
69 Moderate Not Provided
AA Amputation Not Provided
AG Agitated Not Provided
AL Ambulation Limitations Not Provided
BL Bowel Limitations, Bladder Limitations, or both (Incontinence) Not Provided
BPD Beneficiary is Partially Dependent Not Provided
BR Bedrest BRP (Bathroom Privileges) Not Provided
BTD Beneficiary is Totally Dependent Not Provided
CA Cane Required Not Provided
CB Complete Bedrest Not Provided
CM Comatose Not Provided
CNJ Cumulative Injury Not Provided
CO Contracture Not Provided
CR Crutches Required Not Provided
DI Disoriented Not Provided
DP Depressed Not Provided
DY Dyspnea with Minimal Exertion Not Provided
EL Endurance Limitations Not Provided
EP Exercises Prescribed Not Provided
FO Forgetful Not Provided
HL Hearing Limitations Not Provided
HO Hostile Not Provided
IH Independent at Home Not Provided
L1 General Standard of 20 Degree or .5 Diopter Sphere or Cylinder Change Met Not Provided
L2 Replacement Due to Loss or Theft Not Provided
L3 Replacement Due to Breakage or Damage Not Provided
L4 Replacement Due to Patient Preference Not Provided
L5 Replacement Due to Medical Reason Not Provided
LB Legally Blind Not Provided
LE Lethargic Not Provided
MC Other Mental Condition Not Provided
NR No Restrictions Not Provided
OL Other Limitation Not Provided
OT Oriented Not Provided
PA Paralysis Not Provided
PW Partial Weight Bearing Not Provided
SL Speech Limitations Not Provided
TNJ Traumatic Injury Not Provided
TR Transfer to Bed, or Chair, or Both Not Provided
UN Uncooperative Not Provided
UT Up as Tolerated Not Provided
WA Walker Required Not Provided
WR Wheelchair Required Not Provided
Registration Authority:Accredited Standards Committee X12
Source:Accredited Standards Committee X12
Submitting Organization: Washington Publishing Company
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