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Property Specification
Data System IRF-PAI
Data Specs V2.00.1
Edit Type Consistency
Severity Warning
Edit Text Entering a dash as a response to any Quality Measure item may result in a payment reduction of two percentage points for the applicable FY annual increase factor.
Version Notes [V2.00.0]-Added mappings to all Quality Measure items, with the exceptions of O0250A through O0250C. Removed mappings to the following deleted items: I0900A, I0900B, I2900A, M0300B4_2, M0300C4_2, and M0300D4_2.
[V2.00.1]-Per issue 07 of the errata for V2.00.0, removed mappings to the following items: GG0130A2, GG0130B2, GG0130C2, GG0130E2, GG0130F2, GG0130G2, GG0130H2, GG0170A2, GG0170B2, GG0170C2, GG0170D2, GG0170E2, GG0170F2, GG0170G2, GG0170I2, GG0170J2, GG0170K2, GG0170L2, GG0170M2, GG0170N2, GG0170O2, GG0170P2, GG0170R2, GG0170S2. Per issue 09 of the errata for V2.00.0, removed mappings to the following items: C0400A, C0400B, C0400C.

Item List
Item ID Description
25A Height
26A Weight
BB0700 Expression of Ideas and Wants (3-day asmt period)
BB0800 Understanding Verbal Content (3-day asmt period)
C0100 Brief Interview - Mental Status (BIMS)
C0200 BIMS - Repetition of Three Words
C0300A BIMS - Temporal Orientation - Year
C0300B BIMS - Temporal Orientation - Month
C0300C BIMS - Temporal Orientation - Day
C0500 BIMS - Summary Score
C0600 Conduct Staff Assessment - Mental Status
C0900A Memory/Recall Ability - Current Season
C0900B Memory/Recall Ability - Location Of Own Room
C0900C Memory/Recall Ability - Staff Names and Faces
C0900E Memory/Recall Ability - In Hospital unit
C0900Z Memory/Recall Ability - None Of The Above
GG0100A Prior Function - Self Care
GG0100B Prior Function - Indoor Mobility (Ambulation)
GG0100C Prior Function - Stairs
GG0100D Prior Function - Functional Cognition
GG0110A Prior Device - Manual wheelchair
GG0110B Prior Device - Motorized wheelchair or scooter
GG0110C Prior Device - Mechanical lift
GG0110D Prior Device - Walker
GG0110E Prior Device - Orthotics/Prosthetics
GG0110Z Prior Device - 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
GG0130E1 Self-Care (Adm Perf) - Shower/bathe self
GG0130E3 Self-Care (Dschg Perf) - Shower/bathe self
GG0130F1 Self-Care (Adm Perf) - Upper Body Dressing
GG0130F3 Self-Care (Dschg Perf) - Upper Body Dressing
GG0130G1 Self-Care (Adm Perf) - Lower Body Dressing
GG0130G3 Self-Care (Dschg Perf) - Lower Body Dressing
GG0130H1 Self-Care (Adm Perf) - On/Off Footwear
GG0130H3 Self-Care (Dschg Perf) - On/Off Footwear
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 sit 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 (Dschg Perf) - Car Transfer
GG0170H1 Does the patient walk (Adm)
GG0170H3 Does the patient walk (Dschg)
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) - Walk 10 Ft Uneven Surf
GG0170L3 Func Mobil (Dschg Perf) - Walk 10 Ft 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 Object
GG0170P3 Func Mobil (Dschg Perf) - Picking Up Object
GG0170Q1 Does the patient use a wheelchair/scooter (Adm)
GG0170Q3 Does the patient use a wheelchair/scooter (Dschg)
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/scooter (Adm)
GG0170RR3 Indicate the type of wheelchair/scooter (Dschg)
GG0170S1 Func Mobil (Adm Perf) - Wheel 150 feet
GG0170S3 Func Mobil (Dschg Perf) - Wheel 150 feet
GG0170SS1 Indicate the type of wheelchair/scooter (Adm)
GG0170SS3 Indicate the type of wheelchair/scooter (Dschg)
H0350 Bladder continence
H0400 Bowel continence
I0900 Diagnoses: Peripheral vascular disease (PVD)/PAD
I2900 Diagnoses: Diabetes mellitus (DM)
I7900 Diagnoses: None of the Above
J1750 History Of Falls
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
J2000 Prior Surgery
K0110A Swallow/Nutrit - Regular Food
K0110B Swallow/Nutrit - Modified Food
K0110C Swallow/Nutrit - Tube/Parenteral Feeding
M0210_1 Pressure Ulcers Present on Admission
M0210_2 Pressure Ulcers Present on Discharge
M0300A1_1 Number of Stage 1 pressure ulcers: Admission
M0300A1_2 Number of Stage 1 pressure ulcers: Discharge
M0300B1_1 Number of Stage 2 pressure ulcers: Admission
M0300B1_2 Number of Stage 2 pressure ulcers: Discharge
M0300C1_1 Number of Stage 3 pressure ulcers: Admission
M0300C1_2 Number of Stage 3 pressure ulcers: Discharge
M0300D1_1 Number of Stage 4 pressure ulcers: Admission
M0300D1_2 Number of Stage 4 pressure ulcers: Discharge
M0300E1_1 Nbr Unstg non-remov drsg pressure ulcers: Adm
M0300E1_2 Nbr Unstg non-remov drsg pressure ulcers: Dschrg
M0300F1_1 Nbr Unstg slough/eschar pressure ulcers: Adm
M0300F1_2 Nbr Unstg slough/eschar pressure ulcers: Dschrg
M0300G1_1 Nbr Unstg DTI pressure ulcers: Adm
M0300G1_2 Nbr Unstg DTI pressure ulcers: Dschrg
M0800A Worsened: Stage 2 pressure ulcers
M0800B Worsened: Stage 3 pressure ulcers
M0800C Worsened: Stage 4 pressure ulcers
M0800D Worsened: Unstageable - Non-removable dressing
M0800E Worsened: Unstageable - Slough and/or eschar
M0800F Worsened: Unstageable - Deep tissue injury
M0900A1 Number of Stage 1 Healed Pressure Ulcers
M0900B Number of Stage 2 Healed Pressure Ulcers
M0900C Number of Stage 3 Healed Pressure Ulcers
M0900D Number of Stage 4 Healed Pressure Ulcers
O0100N Total Parenteral Nutrition

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Generated: 08/31/2016 10:31:00 AM