-1009


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Property Specification
Data System LTCH
Data Specs V4.02.0
Edit Type Format
Severity Fatal
Edit Text Only the code values listed in the "Item Values" table of the Detailed Data Specifications Report may be submitted for this item.
Version Notes [V4.02.0]-Removed mappings to deleted items GG0130A2, GG0130B2, GG0130C2, GG0130D2, GG0170A2, GG0170B2, GG0170C2, GG0170D2, GG0170E2, GG0170F2, GG0170G2, GG0170I2, GG0170J2, GG0170K2, GG0170L2, GG0170M2, GG0170N2, GG0170O2, GG0170P2, GG0170R2, GG0170S2, GG0130D1, GG0130D3. Added mapping to new item O0350.

Item List
Item ID Description
ASMT_SYS_CD Assessment system code
ITM_SBST_CD Item subset code
STATE_CD Facility"s state postal code
A0050 Type of record
A0200 Type of provider
A0250 Reason for Assessment
A0800 Gender
A1005A Ethnicity: No, not Hispanic, Latino/a, Spanish
A1005B Ethnicity: Yes, Mex, Mex Amer, Chicano/a
A1005C Ethnicity: Yes, Puerto Rican
A1005D Ethnicity: Yes, Cuban
A1005E Ethnicity: Yes, another Hispanic/Latino/Spanish
A1005X Ethnicity: Patient unable to respond
A1005Y Ethnicity: Patient declines to respond
A1010A Race: White
A1010B Race: Black or African American
A1010C Race: American Indian or Alaska Native
A1010D Race: Asian Indian
A1010E Race: Chinese
A1010F Race: Filipino
A1010G Race: Japanese
A1010H Race: Korean
A1010I Race: Vietnamese
A1010J Race: Other Asian
A1010K Race: Native Hawaiian
A1010L Race: Guamanian or Chamorro
A1010M Race: Samoan
A1010N Race: Other Pacific Islander
A1010X Race: Patient unable to respond
A1010Y Race: Patient declines to respond
A1010Z Race: None of the above
A1110B Does the patient need or want an interpreter
A1200 Marital status
A1250A Transportation: Yes, medical
A1250B Transportation: Yes, non-medical
A1250C Transportation: No
A1250X Transportation: Patient unable to respond
A1250Y Transportation: Patient declines to respond
A1400A Payer: Medicare (FFS)
A1400B Payer: Medicare (managed care/Part C/Mcr Advant.)
A1400C Payer: Medicaid (FFS)
A1400D Payer: Medicaid (managed care)
A1400E Payer: Workers" compensation
A1400F Payer: Title programs
A1400G Payer: Other Government
A1400H Payer: Private insurance/Medigap
A1400I Payer: Private managed care
A1400J Payer: Self-pay
A1400K Payer: No payer source
A1400X Payer: Unknown
A1400Y Payer: Other
A1805 Admitted from
A1990 Discharged against medical advice
A2105 Discharge location
A2121 Current Reconciled Medication List - Provider
A2122A Provider Trans - Electronic Health Record
A2122B Provider Trans - Health Info Exchange
A2122C Provider Trans - Verbal
A2122D Provider Trans - Paper-based
A2122E Provider Trans - Other Methods
A2123 Current Reconciled Medication List - Ptnt/Fam/Care
A2124A Patient Trans - Electronic Health Record
A2124B Patient Trans - Health Info Exchange
A2124C Patient Trans - Verbal
A2124D Patient Trans - Paper-based
A2124E Patient Trans - Other Methods
B0100 Comatose
B0200 Hearing
B1000 Vision
B1300 Health Literacy
BB0700 Expression of Ideas and Wants (3-day asmt period)
BB0800 Understand Verbal/Non-Verbal Content (3-day asmt)
C0100 Brief Interview for Mental Status
C0200 Repetition of three words
C0300A Temporal Orientation: Able to report correct year
C0300B Temporal Orientation: Able to report correct month
C0300C Temporal Orientation: Able to report correct day
C0400A Recall: Able to recall "sock"
C0400B Recall: Able to recall "blue"
C0400C Recall: Able to recall "bed"
C1310A Delirium: Acute Onset Mental Status Change
C1310B Delirium: Inattention
C1310C Delirium: Disorganized thinking
C1310D Delirium: Altered level of consciousness
D0150A1 Mood: Little interest/pleasure doing things: Pres
D0150A2 Mood: Little interest/pleasure doing things: Freq
D0150B1 Mood: Feeling down, depressed, or hopeless: Pres
D0150B2 Mood: Feeling down, depressed, or hopeless: Freq
D0150C1 Mood: Trouble falling or staying asleep: Pres
D0150C2 Mood: Trouble falling or staying asleep: Freq
D0150D1 Mood: Feeling tired or having little energy: Pres
D0150D2 Mood: Feeling tired or having little energy: Freq
D0150E1 Mood: Poor appetite or overeating: Pres
D0150E2 Mood: Poor appetite or overeating: Freq
D0150F1 Mood: Feeling bad about yourself: Pres
D0150F2 Mood: Feeling bad about yourself: Freq
D0150G1 Mood: Trouble concentrating on things: Pres
D0150G2 Mood: Trouble concentrating on things: Freq
D0150H1 Mood: Moving or speaking so slowly: Pres
D0150H2 Mood: Moving or speaking so slowly: Freq
D0150I1 Mood: Thoughts of better off dead: Pres
D0150I2 Mood: Thoughts of better off dead: Freq
D0700 Social Isolation
GG0100B Indoor Mobility (Ambulation)
GG0110A Manual wheelchair
GG0110B Motorized wheelchair and/or scooter
GG0110C Mechanical lift
GG0110Z None of the above
GG0130A1 Self-Care (Adm Perf) - Eating
GG0130A3 Self-Care (Dschg Perf) - Eating
GG0130B1 Self-Care (Adm Perf) - Oral hygiene
GG0130B3 Self-Care (Dschg Perf) - Oral hygiene
GG0130C1 Self-Care (Adm Perf) - Toileting hygiene
GG0130C3 Self-Care (Dschg Perf) - Toileting hygiene
GG0170A1 Func Mobil (Adm Perf) - Roll left and right
GG0170A3 Func Mobil (Dschg Perf) - Roll left and right
GG0170B1 Func Mobil (Adm Perf) - Sit to lying
GG0170B3 Func Mobil (Dschg Perf) - Sit to lying
GG0170C1 Func Mobil (Adm Perf) - Lying to sitting on side
GG0170C3 Func Mobil (Dschg Perf) - Lying to sitting on side
GG0170D1 Func Mobil (Adm Perf) - Sit to stand
GG0170D3 Func Mobil (Dschg Perf) - Sit to stand
GG0170E1 Func Mobil (Adm Perf) - Chair/bed-to-chair trans
GG0170E3 Func Mobil (Dschg Perf) - Chair/bed-to-chair trans
GG0170F1 Func Mobil (Adm Perf) - Toilet transfer
GG0170F3 Func Mobil (Dschg Perf) - Toilet transfer
GG0170G1 Func Mobil (Adm Perf) - Car Transfer
GG0170G3 Func Mobil (Dischrg Perf) - Car Transfer
GG0170I1 Func Mobil (Adm Perf) - Walk 10 feet
GG0170I3 Func Mobil (Dschg Perf) - Walk 10 feet
GG0170J1 Func Mobil (Adm Perf) - Walk 50 feet w/2 turns
GG0170J3 Func Mobil (Dschg Perf) - Walk 50 feet w/2 turns
GG0170K1 Func Mobil (Adm Perf) - Walk 150 feet
GG0170K3 Func Mobil (Dschg Perf) - Walk 150 feet
GG0170L1 Func Mobil (Adm Perf) - Walking 10ft uneven surf
GG0170L3 Func Mobil (Dschg Perf) - Walk 10ft uneven surf
GG0170M1 Func Mobil (Adm Perf) - 1 step (curb)
GG0170M3 Func Mobil (Dschg Perf) - 1 step (curb)
GG0170N1 Func Mobil (Adm Perf) - 4 steps
GG0170N3 Func Mobil (Dschg Perf) - 4 steps
GG0170O1 Func Mobil (Adm Perf) - 12 steps
GG0170O3 Func Mobil (Dschg Perf) - 12 steps
GG0170P1 Func Mobil (Adm Perf) - Picking up an object
GG0170P3 Func Mobil (Dschg Perf) - Picking up an object
GG0170Q1 Does the patient use a wheelchair and/or scooter
GG0170Q3 Does the patient use a wheelchair and/or scooter
GG0170R1 Func Mobil (Adm Perf) - Wheel 50 feet w/2 turns
GG0170R3 Func Mobil (Dschg Perf) - Wheel 50 feet w/2 turns
GG0170RR1 Indicate the type of wheelchair or scooter used
GG0170RR3 Indicate the type of wheelchair or scooter used
GG0170S1 Func Mobil (Adm Perf) - Wheel 150 feet
GG0170S3 Func Mobil (Dschg Perf) - Wheel 150 feet
GG0170SS1 Indicate the type of wheelchair or scooter used
GG0170SS3 Indicate the type of wheelchair or scooter used.
H0350 Bladder continence
H0400 Bowel continence
I0050 Patient primary medical condition
I0103 Metastatic Cancer
I0104 Severe Cancer
I0605 Severe Left Systolic/Ventricular Dysfunction
I0900 Peripheral vascular disease (PVD) or PAD
I1501 Chronic Kidney Disease, Stage 5
I1502 Acute Renal Failure
I2101 Septicemia, Sepsis, Systemic Inflammatory Response
I2600 CNS Infect, Oppor Infect, Bone/Joint/Muscle Infect
I2900 Diabetes mellitus (DM)
I4100 Major Lower Limb Amputation
I4501 Stroke
I4801 Dementia
I4900 Hemiplegia or Hemiparesis
I5000 Paraplegia
I5101 Complete Tetraplegia
I5102 Incomplete Tetraplegia
I5110 Other Spinal Cord Disorder/Injury
I5200 Multiple Sclerosis (MS)
I5250 Huntington"s Disease
I5300 Parkinson"s Disease
I5450 Amyotrophic Lateral Sclerosis
I5455 Other Progressive Neuromuscular Disease
I5460 Locked-In State
I5470 Severe Anoxic Brain Damage, Cerebral Edema
I5480 Other Severe Neurological Injury-Disease-Dysfunc
I5601 Malnutrition
I7100 Lung Transplant
I7101 Heart Transplant
I7102 Liver Transplant
I7103 Kidney Transplant
I7104 Bone Marrow Transplant
I7900 None of the Above
J0510 Pain Effect on Sleep
J0520 Pain Interference with Therapy Activities
J0530 Pain Interference with Day-to-Day Activities
J1800 Any Falls Since Admission
J1900A Num Falls Since Admission - No injury
J1900B Num Falls Since Admission - Injury (except major)
J1900C Num Falls Since Admission - Major injury
K0520A1 Nutritional Approaches (Admission): Parenteral
K0520A4 Nutritional Approaches (7 days): Parenteral
K0520A5 Nutritional Approaches (Discharge): Parenteral
K0520B1 Nutritional Approaches (Admission): Feeding tube
K0520B4 Nutritional Approaches (7 days): Feeding tube
K0520B5 Nutritional Approaches (Discharge): Feeding Tube
K0520C1 Nutritional Approaches (Admission) : Mech Alt Diet
K0520C4 Nutritional Approaches (7 days): Mech Alt Diet
K0520C5 Nutritional Approaches (Discharge): Mech Alt Diet
K0520D1 Nutritional Approaches (Admission) : Therapeutic
K0520D4 Nutritional Approaches (7 day): Therapeutic
K0520D5 Nutritional Approaches (Discharge): Therapeutic
K0520Z1 Nutritional Approaches (Admission) : None
K0520Z4 Nutritional Approaches (7 days): None
K0520Z5 Nutritional Approaches (Discharge): None
M0210 Patient has 1+ unhealed pressure ulcers/injuries
N0415A1 High-Risk Drug (Is Taking): Antipsychotic
N0415A2 High-Risk Drug (Indication) : Antipsychotic
N0415E1 High-Risk Drug (Is taking): Anticoagulant
N0415E2 High-Risk Drug (Indication): Anticoagulant
N0415F1 High-Risk Drug (Is taking): Antibiotic
N0415F2 High-Risk Drug (Indication): Antibiotic
N0415H1 High-Risk Drug (Is taking): Opioid
N0415H2 High-Risk Drug (Indication): Opioid
N0415I1 High-Risk Drug (Is taking): Antiplatelet
N0415I2 High-Risk Drug (Indication): Antiplatelet
N0415J1 High-Risk Drug (Is taking): Hypoglycemic
N0415J2 High-Risk Drug (Indication): Hypoglycemic
N0415Z1 High-Risk Drug (Is taking): None of the above
N2001 Drug Regimen Review
N2003 Medication Follow-up
N2005 Medication Intervention
O0110A1A Treatment: Chemotherapy (Admission)
O0110A1C Treatment: Chemotherapy (Discharge)
O0110A2A Treatment: Chemo - IV (Admission)
O0110A2C Treatment: Chemo - IV (Discharge)
O0110A3A Treatment: Chemo - Oral (Admission)
O0110A3C Treatment: Chemo - Oral (Discharge)
O0110A10A Treatment: Chemo - Other (Admission)
O0110A10C Treatment: Chemo - Other (Discharge)
O0110B1A Treatment: Radiation (Admission)
O0110B1C Treatment: Radiation (Discharge)
O0110C1A Therapies: Oxygen Therapy (Admission)
O0110C1C Therapies: Oxygen Therapy (Discharge)
O0110C2A Therapies: Oxygen - Continuous (Admission)
O0110C2C Therapies: Oxygen - Continuous (Discharge)
O0110C3A Therapies: Oxygen - Intermittent (Admission)
O0110C3C Therapies: Oxygen - Intermittent (Discharge)
O0110C4A Therapies: Oxygen - High-concentration (Admission)
O0110C4C Therapies: Oxygen - High-concentration (Discharge)
O0110D1A Therapies: Suctioning (Admission)
O0110D1C Therapies: Suctioning (Discharge)
O0110D2A Therapies: Suctioning - Scheduled (Admission)
O0110D2C Therapies: Suctioning - Scheduled (Discharge)
O0110D3A Therapies: Suctioning - As Needed (Admission)
O0110D3C Therapies: Suctioning - As Needed (Discharge)
O0110E1A Therapies: Tracheostomy Care (Admission)
O0110E1C Therapies: Tracheostomy Care (Discharge)
O0110F1C Therapies: Invasive Mechanical Ventilator (Disch)
O0110G1A Therapies: Non-Invas Mechanical Ventilator (Admis)
O0110G1C Therapies: Non-Invas Mechanical Ventilator (Disch)
O0110G2A Therapies: BiPAP (Admission)
O0110G2C Therapies: BiPAP (Discharge)
O0110G3A Therapies: CPAP (Admission)
O0110G3C Therapies: CPAP (Discharge)
O0110H1A Other: IV Medications (Admission)
O0110H1C Other: IV Medications (Discharge)
O0110H2A Other: IV - Vasoactive medications (Admission)
O0110H2C Other: IV - Vasoactive medications (Discharge)
O0110H3A Other: IV - Antibiotics (Admission)
O0110H3C Other: IV - Antibiotics (Discharge)
O0110H4A Other: IV - Anticoagulation (Admission)
O0110H4C Other: IV - Anticoagulation (Discharge)
O0110H10A Other: IV - Other (Admission)
O0110H10C Other: IV - Other (Discharge)
O0110I1A Other: Transfusions (Admission)
O0110I1C Other: Transfusions (Discharge)
O0110J1A Other: Dialysis (Admission)
O0110J1C Other: Dialysis (Discharge)
O0110J2A Other: Hemodialysis (Admission)
O0110J2C Other: Hemodialysis (Discharge)
O0110J3A Other: Peritoneal dialysis (Admission)
O0110J3C Other: Peritoneal dialysis (Discharge)
O0110O1A Other: IV Access (Admission)
O0110O1C Other: IV Access (Discharge)
O0110O2A Other: IV Access - Peripheral (Admission)
O0110O2C Other: IV Access - Peripheral (Discharge)
O0110O3A Other: IV Access - Midline (Admission)
O0110O3C Other: IV Access - Midline (Discharge)
O0110O4A Other: IV Access - Central (Admission)
O0110O4C Other: IV Access - Central (Discharge)
O0110Z1A Other: None of the above (Admission)
O0110Z1C Other: None of the above (Discharge)
O0150A SBT: Invasive Mechanical Ventilation Support
O0150A2 SBT: Ventilator Weaning Status
O0150B SBT: Assessed for readiness by day 2
O0150C SBT: Deemed medically ready by day 2
O0150D SBT: Documentation of reason(s) - patient unready
O0150E SBT: Performed by day 2
O0200A Invasive Mechanical Ventilator - Liberation Status
O0350 COVID-19 Vaccination Up To Date

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Generated: 02/14/2024 05:02:35 PM