ePayment.04

Reason for Physician Certification Statement

The reason for EMS transport noted on the Physician Certification Statement.

PaymentCodedValue0:MOptional

Validation Rules

No validation rules reference this element

1 state

New Hampshire

Reason for Physician Certification Statement

The reason for EMS transport noted on the Physician Certification Statement

Code	Label
2604001	Bed Confined
2604003	Cardiac/Hemodynamic monitoring required during transport
2604005	Confused, combative, lethargic, comatose
2604007	Contractures
2604009	Danger to self or others-monitoring
2604011	Danger to self or others-seclusion (flight risk)
2604013	DVT requires elevation of lower extremity
2604015	IV medications/fluids required during transport
2604017	Moderate to severe pain on movement
2604019	Morbid Obesity requires additional personnel/equipment to handle
2604021	Non-healing fractures
2604023	Orthopedic device (backboard, halo, use of pins in traction, etc.) requiring special handling in transit
2604025	Restraints (Physical or Chemical) anticipated or used during transport
2604027	Risk of falling off wheelchair or stretcher while in motion (not related to obesity)
2604029	Severe Muscular weakness and de-conditioned state precludes any significant physical activity
2604031	Special handling en route-Isolation
2604033	Third Party assistance/attendant required to apply, administer, or regulate or adjust oxygen en route
2604035	Unable to maintain erect sitting position in a chair for time needed to transport, due to moderate muscular weakness and de-conditioning.
2604037	Unable to sit in chair or wheelchair due to Grade II or greater decubitus ulcers on buttocks.