-3900


Edit Summary

Previous edit

Next edit


Property Specification
Data System LTCH
Data Specs V4.00.0 DRAFT
Edit Type Consistency
Severity Warning
Edit Text A dash (-) submitted in this item may result in a payment reduction for your facility of two percentage points for the affected payment determination.
Version Notes [V4.00.0] - Removing references to C1610A, C1610, C1610C, C1610D, C1610E1, C1610E2 as they were deleted. Updating wording. Unmapping I5101, I5200, I5250, I5300, I5450, I5460 and I5470. Adding A1110A, B0200, B1000, C0100, C0200, C0300A, C0300B, C0300C, C0400A, C0400B, C0400C, C0500, C1310A, C1310B, C1310C, C1310D, D0150A1, D0150A2, D0150B1, D0150B2, D0150C1, D0150C2, D0150D1, D0150D2, D0150E1, D0150E2, D0150F1, D0150F2, D0150G1, D0150G2, D0150H1, D0150H2, D0150I1, D0150I2, D0160, GG0170G1, GG0170G3, GG0170L1, GG0170L3, GG0170M1, GG0170M3, GG0170N1, GG0170N3, GG0170O1, GG0170O3, GG0170P1, GG0170P3, K0520A1, K0520A4, K0520A5, K0520B1, K0520B4, K0520B5, K0520C1, K0520C4, K0520C5, K0520D1, K0520D4, K0520D5, K0520Z1, K0520Z4, K0520Z5, M0300B1, M0300C1, M0300D1, M0300E1, M0300F1, M0300G1, N0415A1, N0415A2, N0415E1, N0415E2, N0415F1, N0415F2, N0415H1, N0415H2, N0415I1, N0415I2, N0415J1, N0415J2, O0110A1a, O0110A1c, O0110A2a, O0110A2c, O0110A3a, O0110A3c, O0110A10a, O0110A10c, O0110B1a, O0110B1c, O0110C1a, O0110C1c, O0110C2a, O0110C2c, O0110C3a, O0110C3c, O0110C4a, O0110C4c, O0110D1a, O0110D1c, O0110D2a, O0110D2c, O0110D3a, O0110D3c, O0110E1a, O0110E1c, O0110F1a, O0110F1c, O0110G1a, O0110G1c, O0110G2a, I0110G2c, O0110G3a, O0110G3c, O0110H1a, O0110H1c, O0110H2a, O0110H2c, O0110H3a, O0110H3c, O0110H4a, O0110H4c, O0110H10a, O0110H10c, O0110I1a, O0110I1c, O0110J1a, O0110J1c, O0110J2a, O0110J2c, O0110J3a, O0110J3c, O0110O1a, O0110O1c, O0110O2a, O0110O2c, O0110O3a, O0110O3c, O0110O4a, O0110O4c, O0110Z1a, O0110Z1c, O0150A2,

Item List
Item ID Description
A1110A Preferred language
B0100 Comatose
B0200 Hearing
B1000 Vision
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 Able to report correct year
C0300B Able to report correct month
C0300C Able to report correct day of the week
C0400A Able to recall "sock"
C0400B Able to recall "blue"
C0400C Able to recall "bed"
C0500 BIMS Summary Score
C1310A Acute Onset Mental Status Change
C1310B Inattention
C1310C Disorganized thinking
C1310D Altered level of consciousness
D0150A1 Little interest or pleasure in doing things: Pres
D0150A2 Little interest or pleasure in doing things: Freq
D0150B1 Feeling down, depressed, or hopeless: Pres
D0150B2 Feeling down, depressed, or hopeless: Freq
D0150C1 Trouble falling or staying asleep: Pres
D0150C2 Trouble falling or staying asleep: Freq
D0150D1 Feeling tired or having little energy: Pres
D0150D2 Feeling tired or having little energy: Freq
D0150E1 Poor appetite or overeating: Pres
D0150E2 Poor appetite or overeating: Freq
D0150F1 Feeling bad about yourself: Pres
D0150F2 Feeling bad about yourself: Freq
D0150G1 Trouble concentrating on things: Pres
D0150G2 Trouble concentrating on things: Freq
D0150H1 Moving or speaking so slowly: Pres
D0150H2 Moving or speaking so slowly: Freq
D0150I1 Thoughts that you would be better off dead: Pres
D0150I2 Thoughts that you would be better off dead: Freq
D0160 Total severity score
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
GG0130D1 Self-Care (Adm Perf) - Wash upper body
GG0130D3 Self-Care (Dschg Perf) - Wash upper body
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 Mobil Perf (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
I0900 Peripheral vascular disease (PVD) or PAD
I2900 Diabetes mellitus (DM)
J1900C Num Falls Since Admission - Major injury
K0200A Height (in inches)
K0200B Weight (in pounds)
K0520A1 Nutritional approach (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) : Mechanically
K0520C4 Nutritional approaches (7 days): mech altered diet
K0520C5 Nutritional approaches (discharge): mech altered
K0520D1 Nutritional approaches (admission) : Therapeutic
K0520D4 Nutritional approaches (7 day): Therapeutic diet
K0520D5 Nutritional approaches (discharge): Therapeutic
K0520Z1 Nutritional approaches (admission) : None
K0520Z4 Nutritional approaches (7 days): None
K0520Z5 Nutritional approaches (discharge): None
M0300B1 Stage 2 pressure ulcers: number present
M0300B2 Stage 2 pressure ulcers: number at admit
M0300C1 Stage 3 pressure ulcers: number present
M0300C2 Stage 3 pressure ulcers: number at admit
M0300D1 Stage 4 pressure ulcers: number present
M0300D2 Stage 4 pressure ulcers: number at admit
M0300E1 Unstageable due to dressing/device: number present
M0300E2 Unstageable due to dressing/device: number at adm
M0300F1 Unstageable slough/eschar: number present
M0300F2 Unstageable slough/eschar: number at admit
M0300G1 Unstageable as deep tissue: num present
M0300G2 Unstageable as deep tissue: num at adm
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-Drug Risk (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
N2001 Drug Regimen Review
N2003 Medication Follow-up
N2005 Medication Intervention
O0110A1a Treatment: Chemotherapy (Admission)
O0110A2a Treatment: IV (Admission)
O0110A3a Treatment: Oral (Admission)
O0110A10a Treatment: Other (Admission)
O0110B1a Treatment: Radiation (Admission)
O0110C1a Therapies: Oxygen Therapy (Admission)
O0110C2a Therapies: Continuous (Admission)
O0110C3a Therapies: Intermittent (Admission)
O0110C4a Therapies: High-concentration (Admission)
O0110D1a Therapies: Suctioning (Admission)
O0110D2a Therapies: Scheduled
O0110D3a Therapies: As Needed (Admission)
O0110E1a Therapies: Tracheostomy Care (Admission)
O0110G1a Therapies: Non-Invas Mechanical Ventilator (Admis)
O0110G2a Therapies: BiPAP (Admission)
O0110G3a Therapies: CPAP (Admission)
O0110H1a Other: IV Medications (Admission)
O0110H2a Other: Vasoactive medications (Admission)
O0110H3a Other: Antibiotics (Admission)
O0110H4a Other: Anticoagulation (Admission)
O0110H10a Other: Other (Admission)
O0110I1a Other: Transfusions (Admission)
O0110J1a Other: Dialysis (Admission)
O0110J2a Other: Hemodialysis (Admission)
O0110J3a Other: Peritoneal dialysis (Admission)
O0110O1a Other: IV Access (Admission)
O0110O2a Other: Peripheral (Admission)
O0110O3a Other: Midline (Admission)
O0110O4a Other: Central (Admission)
O0110Z1a Other: None of the above (Admission)
O0110A1c Treatment: Chemotherapy (Discharge)
O0110A2c Treatment: IV (Discharge)
O0110A3c Treatment: Oral (Discharge)
O0110A10c Treatment: Other (Discharge)
O0110B1c Treatment: Radiation (Discharge)
O0110C1c Therapies: Oxygen Therapy (Discharge)
O0110C2c Therapies: Continuous (Discharge)
O0110C3c Therapies: Intermittent (Discharge)
O0110C4c Therapies: High-concentration (Discharge)
O0110D1c Therapies: Suctioning (Discharge)
O0110D2c Therapies: Scheduled (Discharge)
O0110D3c Therapies: As Needed (Discharge)
O0110E1c Therapies: Tracheostomy Care (Discharge)
O0110G1c Therapies: Non-Invas Mechanical Ventilator (Disch)
O0110G2c Therapies: BiPAP (Discharge)
O0110G3c Therapies: CPAP (Discharge)
O0110H1c Other: IV Medications (Discharge)
O0110H2c Other: Vasoactive medications (Discharge)
O0110H3c Other: Antibiotics (Discharge)
O0110H4c Other: Anticoagulation (Discharge)
O0110H10c Other: Other (Discharge)
O0110I1c Other: Transfusions (Discharge)
O0110J1c Other: Dialysis (Discharge)
O0110J2c Other: Hemodialysis (Discharge)
O0110J3c Other: Peritoneal dialysis (Discharge)
O0110O1c Other: IV Access (Discharge)
O0110O2c Other: Peripheral (Discharge)
O0110O3c Other: Midline (Discharge)
O0110O4c Other: Central (Discharge)
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

Edit Summary

Previous edit

Next edit



NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 02/29/2020 10:39:12 PM