-3676
Property | Specification |
Data System | MDS |
Data Specs | V3.01.0 |
Edit Type | Format |
Severity | Fatal |
Edit Text |
Values of Code and Checklist Items: Only the coded values listed in the "Item Values" table of the Detailed Data Specifications Report may be submitted for this item. |
Version Notes |
[V3.01.0]-Mappings to the following deleted items were removed: A0300A, A0300B, A1000A-F, A1100A, A1800, A2100, D0200A1-D0200I2, J0400, J0500A-B, K0510A1-K0510Z2, O0100A1-O0100Z2, Q0100A-C, Q0300A, Q0300B, Q0550B, Q0600, X0570A, X0570B. Added mappings to the following new items: A1005A-Y, A1010A-Z, A1250A-Y, A2122A-E, A2124A-E, GG0120A-Z, K0520A1-A4, K0520B1-B4, K0520C1-C4, K0520D1-D4, K0520Z1-Z4, N0415A1-Z1, O0110A1A-Z1C, Q0110A-Z, A1110B, A1805, A2105, A2121, A2123, B1300, D0150A1-I2, D0700, GG0115A-B, GG0130I1-I5, GG0170FF1-FF5, GG0170Q5, GG0170R5, GG0170RR5, GG0170S5, GG0170SS5, J0410, J0510, J0520, J0530, Q0310A-B, Q0500C, Q0610A, Q0620. |
Item List | |
Item ID | Description |
ASMT_SYS_CD | Assessment system code |
ITM_SBST_CD | Item subset code |
PRODN_TEST_CD | Production/test indicator |
STATE_CD | Facility"s state postal code |
STATE_PDPM_OBRA_CD | State calculation of PDPM for OBRA |
A0050 | Type of transaction (formerly X0100) |
A0200 | Type of provider |
A0310A | Type of assessment: OBRA |
A0310B | Type of assessment: PPS |
A0310E | First assessment since most recent entry |
A0310F | Entry/discharge reporting |
A0310G | Planned/unplanned discharge |
A0310G1 | Interrupted Stay |
A0310H | SNF PPS Part A Discharge (End of Stay) Assessment |
A0410 | Submission requirement |
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: Resident unable to respond |
A1005Y | Ethnicity: Resident 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: Resident unable to respond |
A1010Y | Race: Resident 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: Resident unable to respond |
A1250Y | Transportation: Resident declines to respond |
A1500 | Resident evaluated by PASRR |
A1510A | Level II PASRR conditions: Serious Mental Illness |
A1510B | Level II PASRR conditions: Intellectual Disability |
A1510C | Level II PASRR conditions: Other related condition |
A1550A | ID/DD status: Down syndrome |
A1550B | ID/DD status: Autism |
A1550C | ID/DD status: Epilepsy |
A1550D | ID/DD status: other organic ID/DD condition |
A1550E | ID/DD status: ID/DD with no organic condition |
A1550Z | ID/DD status: none of the above |
A1700 | Type of entry |
A1805 | Admitted from |
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 |
A2400A | Has resident had Medicare-covered stay |
B0100 | Comatose |
B0200 | Hearing |
B0300 | Hearing aid |
B0600 | Speech clarity |
B0700 | Makes self understood |
B0800 | Ability to understand others |
B1000 | Vision |
B1200 | Corrective lenses |
B1300 | Health Literacy |
C0100 | BIMS: should resident interview be conducted |
C0200 | BIMS res interview: repetition of three words |
C0300A | BIMS res interview: able to report correct year |
C0300B | BIMS res interview: able to report correct month |
C0300C | BIMS res interview: can report correct day of week |
C0400A | BIMS res interview: able to recall "sock" |
C0400B | BIMS res interview: able to recall "blue" |
C0400C | BIMS res interview: able to recall "bed" |
C0600 | Staff asmt mental status: conduct asmt |
C0700 | Staff asmt mental status: short-term memory OK |
C0800 | Staff asmt mental status: long-term memory OK |
C0900A | Staff asmt mental status: recall current season |
C0900B | Staff asmt mental status: recall location of room |
C0900C | Staff asmt mental status: recall staff names/faces |
C0900D | Staff asmt mental status: recall in nh/hosp sw bed |
C0900Z | Staff asmt mental status: none of above recalled |
C1000 | Cognitive skills for daily decision making |
C1310A | Acute Onset Mental Status Change |
C1310B | Inattention |
C1310C | Disorganized Thinking |
C1310D | Altered Level of Consciousness |
D0100 | PHQ: should resident mood interview be conducted |
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 |
D0500A1 | PHQ staff: little interest or pleasure - presence |
D0500A2 | PHQ staff: little interest or pleasure - frequency |
D0500B1 | PHQ staff: feeling down, depressed - presence |
D0500B2 | PHQ staff: feeling down, depressed - frequency |
D0500C1 | PHQ staff: trouble with sleep - presence |
D0500C2 | PHQ staff: trouble with sleep - frequency |
D0500D1 | PHQ staff: feeling tired/little energy - presence |
D0500D2 | PHQ staff: feeling tired/little energy - frequency |
D0500E1 | PHQ staff: poor appetite or overeating - presence |
D0500E2 | PHQ staff: poor appetite or overeating - frequency |
D0500F1 | PHQ staff: feeling bad about self - presence |
D0500F2 | PHQ staff: feeling bad about self - frequency |
D0500G1 | PHQ staff: trouble concentrating - presence |
D0500G2 | PHQ staff: trouble concentrating - frequency |
D0500H1 | PHQ staff: slow, fidgety, restless - presence |
D0500H2 | PHQ staff: slow, fidgety, restless - frequency |
D0500I1 | PHQ staff: thoughts better off dead - presence |
D0500I2 | PHQ staff: thoughts better off dead - frequency |
D0500J1 | PHQ staff: short-tempered - presence |
D0500J2 | PHQ staff: short-tempered - frequency |
D0700 | Social Isolation |
E0100A | Psychosis: hallucinations |
E0100B | Psychosis: delusions |
E0100Z | Psychosis: none of the above |
E0200A | Physical behav symptoms directed toward others |
E0200B | Verbal behav symptoms directed toward others |
E0200C | Other behav symptoms not directed toward others |
E0300 | Overall presence of behavioral symptoms |
E0500A | Behav symptoms put res at risk for illness/injury |
E0500B | Behav symptoms interfere with resident care |
E0500C | Behav symptoms interfere with social activities |
E0600A | Behav symptoms put others at risk for injury |
E0600B | Behav symptoms intrude on privacy of others |
E0600C | Behav symptoms disrupt care or living environment |
E0800 | Rejection of care: presence and frequency |
E0900 | Wandering: presence and frequency |
E1000A | Wandering: risk of getting to dangerous place |
E1000B | Wandering: intrude on privacy of others |
E1100 | Change in behavioral or other symptoms |
F0300 | Conduct res interview for daily/activity prefs |
F0400A | Res interview: choose clothes to wear |
F0400B | Res interview: take care of personal belongings |
F0400C | Res interview: choose tub, bath, shower, sponge |
F0400D | Res interview: have snacks between meals |
F0400E | Res interview: choose own bedtime |
F0400F | Res interview: discuss care with family/friend |
F0400G | Res interview: use phone in private |
F0400H | Res interview: lock things to keep them safe |
F0500A | Res interview: have books, newspaper, mags to read |
F0500B | Res interview: listen to music |
F0500C | Res interview: be around animals/pets |
F0500D | Res interview: keep up with news |
F0500E | Res interview: do things with groups of people |
F0500F | Res interview: do favorite activities |
F0500G | Res interview: go outside when good weather |
F0500H | Res interview: participate in religious practices |
F0600 | Primary respondent: daily/activities prefs |
F0700 | Conduct staff assessment for daily/activity prefs |
F0800A | Staff assessment: choosing clothes to wear |
F0800B | Staff assessment: caring for personal belongings |
F0800C | Staff assessment: receiving tub bath |
F0800D | Staff assessment: receiving shower |
F0800E | Staff assessment: receiving bed bath |
F0800F | Staff assessment: receiving sponge bath |
F0800G | Staff assessment: snacks between meals |
F0800H | Staff assessment: staying up past 8PM |
F0800I | Staff assessment: discuss care with family/other |
F0800J | Staff assessment: use phone in private |
F0800K | Staff assessment: place to lock personal things |
F0800L | Staff assessment: reading books, newspapers, mags |
F0800M | Staff assessment: listening to music |
F0800N | Staff assessment: being around animals/pets |
F0800O | Staff assessment: keeping up with news |
F0800P | Staff assessment: doing things with groups |
F0800Q | Staff assessment: participate favorite activities |
F0800R | Staff assessment: spend time away from nursng home |
F0800S | Staff assessment: spend time outdoors |
F0800T | Staff assessment: participate religious activities |
F0800Z | Staff assessment: none of above activities |
GG0100A | Prior Functioning - Self Care |
GG0100B | Prior Functioning - Indoor Mobility (Ambulation) |
GG0100C | Prior Functioning - Stairs |
GG0100D | Prior Functioning - Functional Cognition |
GG0110A | Prior Device Use - Manual wheelchair |
GG0110B | Prior Device Use - Mtrzd wheelchair and/or scooter |
GG0110C | Prior Device Use - Mechanical lift |
GG0110D | Prior Device Use - Walker |
GG0110E | Prior Device Use - Orthotics/Prosthetics |
GG0110Z | Prior Device Use - None of the above |
GG0115A | Functional limits - Upper extremity |
GG0115B | Functional limits - Lower extremity |
GG0120A | Mobility Device - Cane/Crutch |
GG0120B | Mobility Device - Walker |
GG0120C | Mobility Device - Wheelchair (manual or electric) |
GG0120D | Mobility Device - Limb prosthesis |
GG0120Z | Mobility Device - None of the Above |
GG0130A1 | Eating (Start of Stay Perf) |
GG0130A2 | Eating (Dschg Goal) |
GG0130A3 | Eating (Dischg Perf) |
GG0130A5 | Eating (Interim Perf) |
GG0130B1 | Oral hygiene (Start of Stay Perf) |
GG0130B2 | Oral hygiene (Dschg Goal) |
GG0130B3 | Oral hygiene (Dschg Perf) |
GG0130B5 | Oral hygiene (Interim Perf) |
GG0130C1 | Toileting hygiene (Start of Stay Perf) |
GG0130C2 | Toileting hygiene (Dschg Goal) |
GG0130C3 | Toileting hygiene (Dschg Perf) |
GG0130C5 | Toileting hygiene (Interim Perf) |
GG0130E1 | Shower/bathe self (Start of Stay Perf) |
GG0130E2 | Shower/bathe self (Dschg Goal) |
GG0130E3 | Shower/bathe self (Dschg Perf) |
GG0130E5 | Shower/bathe self (Interim Perf) |
GG0130F1 | Upper body dressing (Start of Stay Perf) |
GG0130F2 | Upper body dressing (Dschg Goal) |
GG0130F3 | Upper body dressing (Dschg Perf) |
GG0130F5 | Upper body dressing (Interim Perf) |
GG0130G1 | Lower body dressing (Start of Stay Perf) |
GG0130G2 | Lower body dressing (Dschg Goal) |
GG0130G3 | Lower body dressing (Dschg Perf) |
GG0130G5 | Lower body dressing (Interim Perf) |
GG0130H1 | Put on/take off footwear (Start of Stay Perf) |
GG0130H2 | Put on/take off footwear (Dschg Goal) |
GG0130H3 | Put on/take off footwear (Dschg Perf) |
GG0130H5 | Put on/take off footwear (Interim Perf) |
GG0130I1 | Personal Hygiene (Start of Stay Perf) |
GG0130I3 | Personal Hygiene (Dschg Perf) |
GG0130I5 | Personal Hygiene (Interim Perf) |
GG0170A1 | Roll left and right (Start of Stay Perf) |
GG0170A2 | Roll left and right (Dschg Goal) |
GG0170A3 | Roll left and right (Dschg Perf) |
GG0170A5 | Roll left and right (Interim Perf) |
GG0170B1 | Sit to lying (Start of Stay Perf) |
GG0170B2 | Sit to lying (Dschg Goal) |
GG0170B3 | Sit to lying (Dschg Perf) |
GG0170B5 | Sit to lying (Interim Perf) |
GG0170C1 | Lying to sitting on bed side (Start of Stay Perf) |
GG0170C2 | Lying to sitting on bed side (Dschg Goal) |
GG0170C3 | Lying to sitting on bed side (Dschg Perf) |
GG0170C5 | Lying to sitting on bed side (Interim Perf) |
GG0170D1 | Sit to stand (Start of Stay Perf) |
GG0170D2 | Sit to stand (Dschg Goal) |
GG0170D3 | Sit to stand (Dschg Perf) |
GG0170D5 | Sit to stand (Interim Perf) |
GG0170E1 | Chair/bed-to-chair transfer (Start of Stay Perf) |
GG0170E2 | Chair/bed-to-chair transfer (Dschg Goal) |
GG0170E3 | Chair/bed-to-chair transfer (Dschg Perf) |
GG0170E5 | Chair/bed-to-chair transfer (Interim Perf) |
GG0170F1 | Toilet transfer (Start of Stay Perf) |
GG0170F2 | Toilet transfer (Dschg Goal) |
GG0170F3 | Toilet transfer (Dschg Perf) |
GG0170F5 | Toilet transfer (Interim Perf) |
GG0170FF1 | Tub/Showr Transfer (Start of Stay Perf) |
GG0170FF3 | Tub/Showr Transfer (Dschg Perf) |
GG0170FF5 | Tub/Showr Transfer (Interim Perf) |
GG0170G1 | Car transfer (Start of Stay Perf) |
GG0170G2 | Car transfer (Dschg Goal) |
GG0170G3 | Car transfer (Dschg Perf) |
GG0170I1 | Walk 10 feet (Start of Stay Perf) |
GG0170I2 | Walk 10 feet (Dschg Goal) |
GG0170I3 | Walk 10 feet (Dschg Perf) |
GG0170I5 | Walk 10 feet (Interim Perf) |
GG0170J1 | Walk 50 feet with two turns (Start of Stay Perf) |
GG0170J2 | Walk 50 feet with two turns (Dschg Goal) |
GG0170J3 | Walk 50 feet with two turns (Dschg Perf) |
GG0170J5 | Walk 50 feet with two turns (Interim Perf) |
GG0170K1 | Walk 150 feet (Start of Stay Perf) |
GG0170K2 | Walk 150 feet (Dschg Goal) |
GG0170K3 | Walk 150 feet (Dschg Perf) |
GG0170K5 | Walk 150 feet (Interim Perf) |
GG0170L1 | Walking 10 feet uneven surf (Start of Stay Perf) |
GG0170L2 | Walking 10 feet uneven surf (Dschg Goal) |
GG0170L3 | Walking 10 feet uneven surf (Dschg Perf) |
GG0170M1 | 1 step (curb) (Start of Stay Perf) |
GG0170M2 | 1 step (curb) (Dschg Goal) |
GG0170M3 | 1 step (curb) (Dschg Perf) |
GG0170N1 | 4 steps (Start of Stay Perf) |
GG0170N2 | 4 steps (Dschg Goal) |
GG0170N3 | 4 steps (Dschg Perf) |
GG0170O1 | 12 steps (Start of Stay Perf) |
GG0170O2 | 12 steps (Dschg Goal) |
GG0170O3 | 12 steps (Dschg Perf) |
GG0170P1 | Picking up object (Start of Stay Perf) |
GG0170P2 | Picking up object (Dschg Goal) |
GG0170P3 | Picking up object (Dschg Perf) |
GG0170Q1 | Use wheelchair and/or scooter (Start of Stay Perf) |
GG0170Q3 | Use wheelchair and/or scooter (Dschg Perf) |
GG0170Q5 | Use wheelchair and/or scooter (Interim Perf) |
GG0170R1 | Wheel 50 feet with two turns (Start of Stay Perf) |
GG0170R2 | Wheel 50 feet with two turns (Dschg Goal) |
GG0170R3 | Wheel 50 feet with two turns (Dschg Perf) |
GG0170R5 | Wheel 50 feet with two turns (Interim Perf) |
GG0170RR1 | Type of wheelchair or scooter (Start of Stay Perf) |
GG0170RR3 | Type of wheelchair or scooter (Dschg Perf) |
GG0170RR5 | Type of wheelchair or scooter (Interim Perf) |
GG0170S1 | Wheel 150 feet (Start of Stay Perf) |
GG0170S2 | Wheel 150 feet (Dschg Goal) |
GG0170S3 | Wheel 150 feet (Dschg Perf) |
GG0170S5 | Wheel 150 feet (Interim Perf) |
GG0170SS1 | Type of wheelchair or scooter (Start of Stay Perf) |
GG0170SS3 | Type of wheelchair or scooter (Dschg Perf) |
GG0170SS5 | Type of wheelchair or scooter (Interim Perf) |
H0100A | Appliances: indwelling catheter |
H0100B | Appliances: external catheter |
H0100C | Appliances: ostomy |
H0100D | Appliances: intermittent catheterization |
H0100Z | Appliances: none of the above |
H0200A | Urinary toileting program: has been attempted |
H0200B | Urinary toileting program: response |
H0200C | Urinary toileting program: current program/trial |
H0300 | Urinary continence |
H0400 | Bowel continence |
H0500 | Bowel toileting program being used |
H0600 | Constipation |
I0020 | Primary Medical Condition Category |
I0100 | Cancer (with or without metastasis) |
I0200 | Anemia |
I0300 | Atrial fibrillation and other dysrhythmias |
I0400 | Coronary artery disease (CAD) |
I0500 | Deep venous thrombosis (DVT), PE, or PTE |
I0600 | Heart failure |
I0700 | Hypertension |
I0800 | Orthostatic hypotension |
I0900 | Peripheral vascular disease (PVD) or PAD |
I1100 | Cirrhosis |
I1200 | Gastroesophageal reflux disease (GERD) or ulcer |
I1300 | Ulcerative colitis, Chrohn"s, inflam bowel disease |
I1400 | Benign prostatic hyperplasia (BPH) |
I1500 | Renal insufficiency, renal failure, ESRD |
I1550 | Neurogenic bladder |
I1650 | Obstructive uropathy |
I1700 | Multidrug resistant organism (MDRO) |
I2000 | Pneumonia |
I2100 | Septicemia |
I2200 | Tuberculosis |
I2300 | Urinary tract infection (UTI) (LAST 30 DAYS) |
I2400 | Viral hepatitis (includes type A, B, C, D, and E) |
I2500 | Wound infection (other than foot) |
I2900 | Diabetes mellitus (DM) |
I3100 | Hyponatremia |
I3200 | Hyperkalemia |
I3300 | Hyperlipidemia (e.g., hypercholesterolemia) |
I3400 | Thyroid disorder |
I3700 | Arthritis |
I3800 | Osteoporosis |
I3900 | Hip fracture |
I4000 | Other fracture |
I4200 | Alzheimer"s disease |
I4300 | Aphasia |
I4400 | Cerebral palsy |
I4500 | Cerebrovascular accident (CVA), TIA, or stroke |
I4800 | Non-Alzheimer"s dementia |
I4900 | Hemiplegia or hemiparesis |
I5000 | Paraplegia |
I5100 | Quadriplegia |
I5200 | Multiple sclerosis |
I5250 | Huntington"s disease |
I5300 | Parkinson"s disease |
I5350 | Tourette"s syndrome |
I5400 | Seizure disorder or epilepsy |
I5500 | Traumatic brain injury (TBI) |
I5600 | Malnutrition (protein, calorie), risk of malnutrit |
I5700 | Anxiety disorder |
I5800 | Depression (other than bipolar) |
I5900 | Bipolar disorder |
I5950 | Psychotic disorder (other than schizophrenia) |
I6000 | Schizophrenia |
I6100 | Post-traumatic stress disorder (PTSD) |
I6200 | Asthma (COPD) or chronic lung disease |
I6300 | Respiratory failure |
I6500 | Cataracts, glaucoma, or macular degeneration |
I7900 | None of above active diseases within last 7 days |
J0100A | Pain: received scheduled pain med regimen |
J0100B | Pain: received PRN pain medications |
J0100C | Pain: received non-medication intervention |
J0200 | Should pain assessment interview be conducted |
J0300 | Res pain interview: presence |
J0410 | Pain Frequency |
J0510 | Pain Effect on Sleep |
J0520 | Pain Interference with Therapy Activities |
J0530 | Pain Interference with Day-to-Day Activities |
J0600B | Res pain interview: verbal descriptor scale |
J0700 | Should staff assessment for pain be conducted |
J0800A | Staff pain asmt: non-verbal sounds |
J0800B | Staff pain asmt: vocal complaints of pain |
J0800C | Staff pain asmt: facial expressions |
J0800D | Staff pain asmt: protective movements/postures |
J0800Z | Staff pain asmt: none of these signs observed |
J0850 | Staff pain asmt: frequency of pain |
J1100A | Short breath/trouble breathing: with exertion |
J1100B | Short breath/trouble breathing: sitting at rest |
J1100C | Short breath/trouble breathing: lying flat |
J1100Z | Short breath/trouble breathing: none of above |
J1300 | Current tobacco use |
J1400 | Prognosis: life expectancy of less than 6 months |
J1550A | Problem conditions: fever |
J1550B | Problem conditions: vomiting |
J1550C | Problem conditions: dehydrated |
J1550D | Problem conditions: internal bleeding |
J1550Z | Problem conditions: none of the above |
J1700A | Fall history: fall during month before admission |
J1700B | Fall history: fall 2-6 months before admission |
J1700C | Fall history: fracture from fall 6 month pre admit |
J1800 | Falls since admit/prior asmt: any falls |
J1900A | Falls since admit/prior asmt: no injury |
J1900B | Falls since admit/prior asmt: injury (not major) |
J1900C | Falls since admit/prior asmt: major injury |
J2000 | Prior Surgery (100 days) |
J2100 | Recent Surgery Requiring Active SNF Care |
J2300 | Knee Replacement - partial or total |
J2310 | Hip Replacement - partial or total |
J2320 | Ankle Replacement - partial or total |
J2330 | Shoulder Replacement - partial or total |
J2400 | Spinal Surgery-spinal cord or major spinal nerves |
J2410 | Spinal surgery - fusion of spinal bones |
J2420 | Spinal surgery - lamina, discs, or facets |
J2499 | Spinal surgery - other |
J2500 | Ortho srgry - rpr frctrd shoulder/arm |
J2510 | Ortho srgry - rpr frctrd pelvis/hip/leg/knee/ankle |
J2520 | Ortho srgry - rpr but not replace joints |
J2530 | Ortho srgry - rpr other bones |
J2599 | Ortho srgry - other |
J2600 | Neuro surgery - brain, surrounding tissue |
J2610 | Neuro surgery - nervous system |
J2620 | Neuro surgery - nsrt neural/brain neurostimulators |
J2699 | Neuro surgery - other |
J2700 | Cardiopulmonary surgery - heart/mjr bld vssls |
J2710 | Cardiopulmonary surgery - respiratory system |
J2799 | Cardiopulmonary surgery - other |
J2800 | Genitourinary surgery - male or female organs |
J2810 | Genitourinary surgery - kidneys |
J2899 | Genitourinary surgery - other |
J2900 | Major surgery - tendons, ligament, or muscles |
J2910 | Major surgery - GI tract/abdominal contents |
J2920 | Major surgery - endocrine organs |
J2930 | Major surgery - breast |
J2940 | Major surgery - repair deep ulcers |
J5000 | Major surgery - other not listed above |
K0100A | Swallow disorder: loss liquids/solids from mouth |
K0100B | Swallow disorder: holds food in mouth/cheeks |
K0100C | Swallow disorder: cough/choke with meals/meds |
K0100D | Swallow disorder: difficulty or pain swallowing |
K0100Z | Swallow disorder: none of the above |
K0300 | Weight loss |
K0310 | Weight Gain |
K0520A1 | Nutritional Approaches (Admission): Parenteral |
K0520A2 | Nutritional Approaches (Non-res): Parenteral |
K0520A3 | Nutritional Approaches (7 days): Parenteral |
K0520A4 | Nutritional Approaches (Discharge): Parenteral |
K0520B1 | Nutritional Approaches (Admission): Feeding tube |
K0520B2 | Nutritional Approaches (Non-res): Feeding tube |
K0520B3 | Nutritional Approaches (7 days): Feeding tube |
K0520B4 | Nutritional Approaches (Discharge): Feeding tube |
K0520C1 | Nutritional Approaches (Admission): Mech Alt Diet |
K0520C3 | Nutritional Approaches (7-day): Mech Alt Diet |
K0520C4 | Nutritional Approaches (Discharge): Mech Alt Diet |
K0520D1 | Nutritional Approaches (Admission): Therapeutic |
K0520D3 | Nutritional Approaches (7-day): Therapeutic |
K0520D4 | Nutritional Approaches (Discharge): Therapeutic |
K0520Z1 | Nutritional Approaches (Admission): None |
K0520Z2 | Nutritional Approaches (Non-res): None |
K0520Z3 | Nutritional Approaches (7-day): None |
K0520Z4 | Nutritional Approaches (Discharge): None |
K0710A2 | Prop calories parenteral/tube feed: while resident |
K0710A3 | Prop calories parenteral/tube feed: 7 days |
K0710B2 | Avg fluid intake per day IV/ tube: while resident |
K0710B3 | Avg fluid intake per day IV/tube: 7 days |
L0200A | Dental: broken or loosely fitting denture |
L0200B | Dental: no natural teeth or tooth fragment(s) |
L0200C | Dental: abnormal mouth tissue |
L0200D | Dental: cavity or broken natural teeth |
L0200E | Dental: inflamed/bleeding gums or loose teeth |
L0200F | Dental: pain, discomfort, difficulty chewing |
L0200G | Dental: unable to examine |
L0200Z | Dental: none of the above |
M0100A | Risk determination: has PU/injury, scar, dressing |
M0100B | Risk determination: formal assessment |
M0100C | Risk determination: clinical assessment |
M0100Z | Risk determination: none of the above |
M0150 | Is resident at risk of developing PU/injuries |
M0210 | Resident has 1+ unhealed PU/injuries |
M1040A | Other skin probs: infection of the foot |
M1040B | Other skin probs: diabetic foot ulcer(s) |
M1040C | Other skin probs: other open lesion(s) on the foot |
M1040D | Other skin probs: lesions not ulcers, rashes, cuts |
M1040E | Other skin probs: surgical wound(s) |
M1040F | Other skin probs: burns (second or third degree) |
M1040G | Skin Tear(s) |
M1040H | Moisture Associated Skin Damage (MASD) |
M1040Z | Other skin probs: none of the above |
M1200A | Skin/ulcer/injry treat: prssr rduce dvc for chair |
M1200B | Skin/ulcer/injry treat: prssr reducing dvc for bed |
M1200C | Skin/ulcer/injry treat: turning/repositioning |
M1200D | Skin/ulcer/injry treat: nutrition/hydration |
M1200E | Skin/ulcer/injry treat: prssr ulcer/injry care |
M1200F | Skin/ulcer/injry treat: surgical wound care |
M1200G | Skin/ulcer/injry treat: application of dressings |
M1200H | Skin/ulcer/injry treat: apply ointments/meds |
M1200I | Skin/ulcer/injry treat: apply dressings to feet |
M1200Z | Skin/ulcer/injry treat: none of the above |
N0415A1 | High-Risk Drug (Is Taking): Antipsychotic |
N0415A2 | High-Risk Drug (Indication): Antipsychotic |
N0415B1 | High-Risk Drug (Is Taking): Antianxiety |
N0415B2 | High-Risk Drug (Indication): Antianxiety |
N0415C1 | High-Risk Drug (Is Taking): Antidepressant |
N0415C2 | High-Risk Drug (Indication): Antidepressant |
N0415D1 | High-Risk Drug (Is Taking): Hypnotic |
N0415D2 | High-Risk Drug (Indication): Hypnotic |
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 |
N0415G1 | High-Risk Drug (Is Taking): Diuretic |
N0415G2 | High-Risk Drug (Indication): Diuretic |
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 |
N0450A | Resident received antipsychotic medications |
N0450B | GDR attempted |
N0450D | Physician documented GDR |
N2001 | Drug Regimen Review |
N2003 | Medication Follow-up |
N2005 | Medication Intervention |
O0110A1A | Treatment: Chemotherapy (Admission) |
O0110A1B | Treatment: Chemotherapy (14 days) |
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) |
O0110B1B | Treatment: Radiation (14 days) |
O0110B1C | Treatment: Radiation (Discharge) |
O0110C1A | Therapies: Oxygen Therapy (Admission) |
O0110C1B | Therapies: Oxygen Therapy (14 days) |
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) |
O0110D1B | Therapies: Suctioning (14 days) |
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) |
O0110E1B | Therapies: Tracheostomy Care (14 days) |
O0110E1C | Therapies: Tracheostomy Care (Discharge) |
O0110F1A | Therapies: Invasive Mechanical Ventilator (Admis) |
O0110F1B | Therapies: Invasive Mechanical Ventilator (14day) |
O0110F1C | Therapies: Invasive Mechanical Ventilator (Disch) |
O0110G1A | Therapies: Non-Invas Mechanical Ventilator (Admis) |
O0110G1B | Therapies: Non-Invas Mechanical Ventilator (14day) |
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) |
O0110H1B | Other: IV Medications (14 days) |
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) |
O0110I1B | Other: Transfusions (14 days) |
O0110I1C | Other: Transfusions (Discharge) |
O0110J1A | Other: Dialysis (Admission) |
O0110J1B | Other: Dialysis (14 days) |
O0110J1C | Other: Dialysis (Discharge) |
O0110J2A | Other: Hemodialysis (Admission) |
O0110J2C | Other: Hemodialysis (Discharge) |
O0110J3A | Other: Peritoneal dialysis (Admission) |
O0110J3C | Other: Peritoneal dialysis (Discharge) |
O0110K1B | Other: Hospice care (14 days) |
O0110M1B | Other: Isolation - Infectious Disease (14 days) |
O0110O1A | Other: IV Access (Admission) |
O0110O1B | Other: IV Access (14 days) |
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) |
O0110Z1B | Other: None of the above (14 days) |
O0110Z1C | Other: None of the above (Discharge) |
O0250A | Was influenza vaccine received |
O0250C | If influenza vaccine not received, state reason |
O0300A | Is pneumococcal vaccination up to date |
O0300B | If pneumococcal vacc not received, state reason |
O0450A | Has therapy resumed |
P0100A | Restraints used in bed: bed rail |
P0100B | Restraints used in bed: trunk restraint |
P0100C | Restraints used in bed: limb restraint |
P0100D | Restraints used in bed: other |
P0100E | Restraints in chair/out of bed: trunk restraint |
P0100F | Restraints in chair/out of bed: limb restraint |
P0100G | Restraints in chair/out of bed: chair stops rising |
P0100H | Restraints in chair/out of bed: other |
P0200A | Bed alarm |
P0200B | Chair alarm |
P0200C | Floor mat alarm |
P0200D | Motion sensor alarm |
P0200E | Wander/elopement alarm |
P0200F | Other alarm |
Q0110A | Participants: Resident |
Q0110B | Participants: Family |
Q0110C | Participants: Significant other |
Q0110D | Participants: Legal guardian |
Q0110E | Participants: Other legal representative |
Q0110Z | Participants: None of the Above |
Q0310A | Resident"s Overall Goal |
Q0310B | Q0310A info source |
Q0400A | Active discharge planning for return to community |
Q0490 | Resident"s preference to avoid being asked |
Q0500B | Do you want to talk about returning to community |
Q0500C | Q0500B info source |
Q0550A | Reasking resident preference |
Q0610A | Referral |
Q0620 | Reason referral not made |
V0100A | Prior OBRA reason for assessment |
V0100B | Prior PPS reason for assessment |
V0200A01A | CAA-Delirium: triggered |
V0200A01B | CAA-Delirium: plan |
V0200A02A | CAA-Cognitive loss/dementia: triggered |
V0200A02B | CAA-Cognitive loss/dementia: plan |
V0200A03A | CAA-Visual function: triggered |
V0200A03B | CAA-Visual function: plan |
V0200A04A | CAA-Communication: triggered |
V0200A04B | CAA-Communication: plan |
V0200A05A | CAA-ADL functional/rehab potential: triggered |
V0200A05B | CAA-ADL functional/rehab potential: plan |
V0200A06A | CAA-Urinary incont/indwell catheter: triggered |
V0200A06B | CAA-Urinary incont/indwell catheter: plan |
V0200A07A | CAA-Psychosocial well-being: triggered |
V0200A07B | CAA-Psychosocial well-being: plan |
V0200A08A | CAA-Mood state: triggered |
V0200A08B | CAA-Mood state: plan |
V0200A09A | CAA-Behavioral symptoms: triggered |
V0200A09B | CAA-Behavioral symptoms: plan |
V0200A10A | CAA-Activities: triggered |
V0200A10B | CAA-Activities: plan |
V0200A11A | CAA-Falls: triggered |
V0200A11B | CAA-Falls: plan |
V0200A12A | CAA-Nutritional status: triggered |
V0200A12B | CAA-Nutritional status: plan |
V0200A13A | CAA-Feeding tubes: triggered |
V0200A13B | CAA-Feeding tubes: plan |
V0200A14A | CAA-Dehydration/fluid maintenance: triggered |
V0200A14B | CAA-Dehydration/fluid maintenance: plan |
V0200A15A | CAA-Dental care: triggered |
V0200A15B | CAA-Dental care: plan |
V0200A16A | CAA-Pressure ulcer: triggered |
V0200A16B | CAA-Pressure ulcer: plan |
V0200A17A | CAA-Psychotropic drug use: triggered |
V0200A17B | CAA-Psychotropic drug use: plan |
V0200A18A | CAA-Physical restraints: triggered |
V0200A18B | CAA-Physical restraints: plan |
V0200A19A | CAA-Pain: triggered |
V0200A19B | CAA-Pain: plan |
V0200A20A | CAA-Return to community referral: triggered |
V0200A20B | CAA-Return to community referral: plan |
X0150 | Correction: type of provider |
X0300 | Correction: resident gender |
X0600A | Correction: OBRA reason for assessment |
X0600B | Correction: PPS reason for assessment |
X0600F | Correction: entry/discharge reporting |
X0600H | Correction: SNF PPS Part A Discharge (End of Stay) |
X0900A | Correction: modif reasons - transcription error |
X0900B | Correction: modif reasons - data entry error |
X0900C | Correction: modif reasons - software error |
X0900D | Correction: modif reasons - item coding error |
X0900Z | Correction: modif reasons - other error |
X1050A | Correction: inact reasons - event did not occur |
X1050Z | Correction: inact reasons - other reason |
Z0200C | State case mix: Short Stay Assessment |
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Generated: 02/06/2023 10:33:18 PM