-1009


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Property Specification
Data System LTCH
Data Specs V1.00.3
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 (v1.00.2) Reworded text by removing last sentence. (v1.00.1) Reworded edit text by removing subtitle.

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
A1000A Ethnicity: American Indian or Alaska Native
A1000B Ethnicity: Asian
A1000C Ethnicity: Black or African American
A1000D Ethnicity: Hispanic or Latino
A1000E Ethnicity: Native Hawaiian/Pacific Islander
A1000F Ethnicity: White
A1050 Highest education completed
A1100A Does the patient need or want an interpreter
A1200 Marital status
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 payor source
A1400X Payer: Unknown
A1400Y Payer: Other
A1800 Admitted from
A1810A Last 2 mo: Short-stay acute hospital (IPPS)
A1810B Last 2 mo: Community residential setting
A1810C Last 2 mo: Long-term care facility (LTC)
A1810D Last 2 mo: Skilled nursing facility (SNF)
A1810E Last 2 mo: Hospital emergency department
A1810F Last 2 mo: Long-term care hospital (LTCH)
A1810G Last 2 mo: Inpatient rehabilitation fac/unit(IRF)
A1810H Last 2 mo: Home health agency (HHA)
A1810I Last 2 mo: Hospice
A1810J Last 2 mo: Outpatient services
A1810K Last 2 mo: Psychiatric hospital or unit
A1810L Last 2 mo: ID/DD facility
A1810Z Last 2 mo: None of the above
A1955 Discharge delay
A1960 Reason for discharge delay
A1970 Discharge return status
A2100 Discharge location
B0100 Comatose
GG0160A Functional Mobil: Roll left and right
GG0160B Functional Mobil: Sit to lying
GG0160C Functional Mobil: Lying to sitting on side of bed
H0400 Bowel continence
I0900 Peripheral vascular disease (PVD) or PAD
I2900 Diabetes mellitus (DM)
I5600 Malnutrition (protein, calorie), risk of malnutrit
M0210 Patient has Stage 1 or higher pressure ulcers
M0700 Most severe tissue type for any pressure ulcer

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Generated: 07/12/2012 12:51:39 PM