element -> <ePayment.CertificateGroup>

Group Tag to hold Certification information

Namespace:	http://www.nemsis.org
Type:	anonymous complexType
Content:	complex, 6 elements
Defined:	locally within ePayment complexType in ePayment_v3.xsd; see XML source
Includes:	definitions of 6 elements

Content Model Diagram

XML Representation Summary

<ePayment.CertificateGroup>

Content:

ePayment.02?, ePayment.03?, ePayment.04*, ePayment.05?, ePayment.06?, ePayment.07?

</ePayment.CertificateGroup>

Content model elements (6):

Included in content model of elements (1):

XML Source (w/o annotations (7); see within schema source)

<xs:element id="ePayment.CertificateGroup" minOccurs="0" name="ePayment.CertificateGroup">

<xs:complexType>

<xs:sequence>

<xs:element id="ePayment.PhysicianCertificationStatement" minOccurs="0" name="ePayment.02" type="YesNoUnkValues"/>

<xs:element id="ePayment.DatePhysicianCertificationStatementSigned" minOccurs="0" name="ePayment.03" type="DateTimeType"/>

<xs:element id="ePayment.ReasonforPhysicianCertificationStatement" maxOccurs="unbounded" minOccurs="0" name="ePayment.04">

<xs:complexType>

<xs:simpleContent>

<xs:extension base="Reason">

<xs:attribute name="CorrelationID" type="CorrelationID" use="optional"/>

</xs:extension>

</xs:simpleContent>

</xs:complexType>

</xs:element>

<xs:element id="ePayment.HealthcareProviderTypeSigningPhysicianCertificationStatement" minOccurs="0" name="ePayment.05" type="HealthcareProviderType"/>

<xs:element id="ePayment.LastNameofIndividualSigningPhysicianCertificationStatement" minOccurs="0" name="ePayment.06" type="PersonLastName"/>

<xs:element id="ePayment.FirstNameofIndividualSigningPhysicianCertificationStatement" minOccurs="0" name="ePayment.07" type="PersonFirstName"/>

</xs:sequence>

</xs:complexType>

</xs:element>

Content Element Detail (all declarations; defined in this component only; 6/6)

Type:

YesNoUnkValues, simple content

ePayment.02 Physician Certification Statement No No Indication of whether a physician certification statement (PCS) is available documenting the medical necessity or the EMS encounter. E07_02 Optional Data Element Name changed from Certificate of Medical Necessity to Physician Certification Statement. The PCS statement and documentation of medical necessity is a requirement of the Centers for Medicare & Medicaid Services. The circumstances are defined in 42 CFR 410.40 (d)(2) and (d)(3). http://www.cms.gov/ <br/><br/>A PCS is required for the following non-emergency transport: <br/>1) Non-Emergency Repetitive Scheduled <br/>2) Non Emergency Non-Repetitive-Scheduled <br/>3) Non Emergency Services - Non Scheduled - Under direct care of a physician

enumeration of xs:string

Enumeration:

"9922001"	-	No
"9922003"	-	Unknown
"9922005"	-	Yes

XML Source (w/o annotations (1); see within schema source)

<xs:element id="ePayment.PhysicianCertificationStatement" minOccurs="0" name="ePayment.02" type="YesNoUnkValues"/>

Type:

DateTimeType, simple content

ePayment.03 Date Physician Certification Statement Signed No No The date the Physician Certification Statement was signed Optional Added to assist in billing documentation. Associated with ePayment.02: Physician Certification Statement. <br/><br/>DateTime consists of finite-length characters of the form: yyyy '-' mm '-' dd 'T' hh ':' mm ':' ss ('.' s+)? (zzzzzz) <table cellspacing="2"><tr><td> <table border="1px" cellpadding="3px" cellspacing="0"> <tr><td align="center">yyyy</td><td>a four-digit numeral that represents the year</td></tr> <tr><td align="center">'-'</td><td>separators between parts of the date portion</td></tr> <tr><td align="center">mm</td><td>a two-digit numeral that represents the month</td></tr> <tr><td align="center">dd</td><td>a two-digit numeral that represents the day</td></tr> <tr><td align="center">T</td><td>separator that indicates time-of-day follows</td></tr> <tr><td align="center">hh</td><td>a two-digit numeral that represents the hour</td></tr> <tr><td align="center">':'</td><td>a separator between parts of the time-of-day portion</td></tr> <tr><td align="center">mm</td><td>a two-digit numeral that represents the minute</td></tr> <tr><td align="center">ss</td><td>a two-integer-digit numeral that represents the whole seconds</td></tr> <tr><td align="center">'.' s+</td><td>(not required) represents the fractional seconds</td></tr> <tr><td align="center">zzzzzz</td><td>(required) represents the timezone (as described below)</td></tr> </table> </td></tr></table> <br/>Timezones, required, are durations with (integer-valued) hour and minute properties in the form: ('+' | '-') hh ':' mm <table cellspacing="2"><tr><td> <table border="1px" cellpadding="3px" cellspacing="0"> <tr><td align="center">hh</td><td>a two-digit numeral (with leading zeros as required) that represents the hours</td></tr> <tr><td align="center">mm</td><td>a two-digit numeral that represents the minutes</td></tr> <tr><td align="center">'+'</td><td>a nonnegative duration</td></tr> <tr><td align="center">'-'</td><td>a nonpositive duration</td></tr> </table> </td></tr></table>

maxInclusive:	2050-01-01T00:00:00-00:00
minInclusive:	1950-01-01T00:00:00-00:00
Pattern:	[0-9]{4}-[0-9]{2}-[0-9]{2}T[0-9]{2}:[0-9]{2}:[0-9]{2}(\.\d+)?(\+\|-)[0-9]{2}:[0-9]{2}

XML Source (w/o annotations (1); see within schema source)

<xs:element id="ePayment.DatePhysicianCertificationStatementSigned" minOccurs="0" name="ePayment.03" type="DateTimeType"/>

Type:

anonymous (extension of Reason), simple content

ePayment.04 Reason for Physician Certification Statement No No The reason for EMS transport noted on the Physician Certification Statement Optional Added to assist in billing documentation.

enumeration of xs:string

Enumeration:

"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.

XML Source (w/o annotations (1); see within schema source)

<xs:element id="ePayment.ReasonforPhysicianCertificationStatement" maxOccurs="unbounded" minOccurs="0" name="ePayment.04">

<xs:complexType>

<xs:simpleContent>

<xs:extension base="Reason">

<xs:attribute name="CorrelationID" type="CorrelationID" use="optional"/>

</xs:extension>

</xs:simpleContent>

</xs:complexType>

</xs:element>

Type:

HealthcareProviderType, simple content

ePayment.05 Healthcare Provider Type Signing Physician Certification Statement No No The type of healthcare provider who signed the Physician Certification Statement Optional CMS defines the individual signing the PCS as a person who has personal knowledge of the beneficiary's condition at the time the ambulance transport is ordered or the service is furnished.

enumeration of xs:string

Enumeration:

"2605001"	-	Clinical Nurse Specialist
"2605003"	-	Discharge Planner
"2605005"	-	Physician (MD or DO)
"2605007"	-	Physician Assistant
"2605009"	-	Registered Nurse
"2605011"	-	Registered Nurse Practitioner

XML Source (w/o annotations (1); see within schema source)

<xs:element id="ePayment.HealthcareProviderTypeSigningPhysicianCertificationStatement" minOccurs="0" name="ePayment.05" type="HealthcareProviderType"/>

Type:

PersonLastName, simple content

ePayment.06 Last Name of Individual Signing Physician Certification Statement No No The last name of the healthcare provider who signed the Physician Certification Statement. Optional Added to assist in billing documentation.

maxLength:	50
minLength:	1

XML Source (w/o annotations (1); see within schema source)

<xs:element id="ePayment.LastNameofIndividualSigningPhysicianCertificationStatement" minOccurs="0" name="ePayment.06" type="PersonLastName"/>

Type:

PersonFirstName, simple content

ePayment.07 First Name of Individual Signing Physician Certification Statement No No The first name of the healthcare provider who signed the Physician Certification Statement. Optional Added to assist in billing documentation.

maxLength:	50
minLength:	1

XML Source (w/o annotations (1); see within schema source)

<xs:element id="ePayment.FirstNameofIndividualSigningPhysicianCertificationStatement" minOccurs="0" name="ePayment.07" type="PersonFirstName"/>