-1010


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Property Specification
Data System IRF-PAI
Data Specs V4.00.0 DRAFT
Edit Type Format
Severity Fatal
Edit Text Invalid Data Value: The submitted value for this item is not in the valid range of acceptable values.
Version Notes [V4.00.0]-The following mappings were deleted, since the items were deleted: 29A, 29D, 30A, 30D, 31A, 31D, 32A, 32D, 33A, 33D, 34A, 34D, 35A, 35D, 36A, 36D, 37A, 37D, 38A, 38D, 39AA, 39AD, 39AG, 39BA, 39BD, 39BG, 39CA, 39CD, 39CG, 39DA, 39DD, 39DG, 39EA, 39ED, 39EG, 39FA, 39FD, 39FG, 39GA, 39GD, 39GG, 39HA, 39HD, 39HG, 39IA, 39ID, 39IG, 39JA, 39JD, 39JG, 39KA, 39KD, 39KG, 39LA, 39LAA, 39LD, 39LDD, 39LG, 39MA, 39MD, 39MG, 39NA, 39NAA, 39ND, 39NDD, 39NG, 39OA, 39OAA, 39OD, 39ODD, 39OG, 39PA, 39PD, 39PG, 39QA, 39QD, 39QG, 39RA, 39RD, 39RG, O0250A, O0250C.

Item List
Item ID Description
ASMT_SYS_CD Assessment System Code
STATE_CD State Code
CORRECTION_NUM Correction Number
8 Gender
9A Race: American Indian/Alaskan Native
9B Race: Asian
9C Race: Black or African American
9D Ethnicity: Hispanic or Latino
9E Race: Native Hawaiian or other Pacific Islander
9F Race: White
10 Marital Status
14 Admission Class
15A Admit From
16A Pre-hospital Living Setting
17 Pre-Hospital Living With
20A Primary Payment Source
20B Secondary Payment Source
21A Impairment Group: Admission
21D Impairment Group: Discharge
24A1 Arthritis Conditions Recorded
25A Height
26A Weight
41 Patient Discharged Against Medical Advice
42 Program Interruption(s) Indicator
44C Patient Discharged Alive
44D Discharge to Living Setting
45 Discharge to Living With
O0401AA Physical Therapy - Individual Minutes Week 1
O0401AB Physical Therapy - Concurrent Minutes Week 1
O0401AC Physical Therapy - Group Minutes Week 1
O0401AD Physical Therapy - Co-treatment Minutes Week 1
O0401BA Occupational Therapy - Individual Minutes Week 1
O0401BB Occupational Therapy - Concurrent Minutes Week 1
O0401BC Occupational Therapy - Group Minutes Week 1
O0401BD Occupational Therapy - Co-treatment Minutes Week 1
O0401CA SLP Therapy - Individual Minutes Week 1
O0401CB SLP Therapy - Concurrent Minutes Week 1
O0401CC SLP Therapy - Group Minutes Week 1
O0401CD SLP Therapy - Co-treatment Minutes Week 1
O0402AA Physical Therapy - Individual Minutes Week 2
O0402AB Physical Therapy - Concurrent Minutes Week 2
O0402AC Physical Therapy - Group Minutes Week 2
O0402AD Physical Therapy - Co-treatment Minutes Week 2
O0402BA Occupational Therapy - Individual Minutes Week 2
O0402BB Occupational Therapy - Concurrent Minutes Week 2
O0402BC Occupational Therapy - Group Minutes Week 2
O0402BD Occupational Therapy - Co-treatment Minutes Week 2
O0402CA SLP Therapy - Individual Minutes Week 2
O0402CB SLP Therapy - Concurrent Minutes Week 2
O0402CC SLP Therapy - Group Minutes Week 2
O0402CD SLP Therapy - Co-treatment Minutes Week 2
BB0700 Expression of Ideas and Wants (3-day asmt period)
BB0800 Undrstnd Vrbl/Non-Vrbl 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
C0400A BIMS - Recalls Sock
C0400B BIMS - Recalls Blue
C0400C BIMS - Recalls Bed
C0500 BIMS - Summary Score
C0600 Conduct Staff Assessment - Mental Status
C0900A Memory/Recall - Current Season (3-day Asmt Prd)
C0900B Memory/Recall - Loc Of Own Room (3-day Asmt Prd)
C0900C Memory/Recall - Staff Names/Faces (3-day Asmt Prd)
C0900E Memory/Recall - In Hospital Unit (3-day Asmt Prd)
C0900Z Memory/Recall - None Of The Above (3-day Asmt Prd)
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 and/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
GG0130A2 Self-Care (Dschg Goal) - Eating
GG0130A3 Self-Care (Dschg Perf) - Eating
GG0130B1 Self-Care (Adm Perf) - Oral hygiene
GG0130B2 Self-Care (Dschg Goal) - Oral hygiene
GG0130B3 Self-Care (Dschg Perf) - Oral hygiene
GG0130C1 Self-Care (Adm Perf) - Toileting hygiene
GG0130C2 Self-Care (Dschg Goal) - Toileting hygiene
GG0130C3 Self-Care (Dschg Perf) - Toileting hygiene
GG0130E1 Self-Care (Adm Perf) - Shower/bathe self
GG0130E2 Self-Care (Dschg Goal) - Shower/bathe self
GG0130E3 Self-Care (Dschg Perf) - Shower/bathe self
GG0130F1 Self-Care (Adm Perf) - Upper Body Dressing
GG0130F2 Self-Care (Dschg Goal) - Upper Body Dressing
GG0130F3 Self-Care (Dschg Perf) - Upper Body Dressing
GG0130G1 Self-Care (Adm Perf) - Lower Body Dressing
GG0130G2 Self-Care (Dschg Goal) - Lower Body Dressing
GG0130G3 Self-Care (Dschg Perf) - Lower Body Dressing
GG0130H1 Self-Care (Adm Perf) - On/Off Footwear
GG0130H2 Self-Care (Dschg Goal) - On/Off Footwear
GG0130H3 Self-Care (Dschg Perf) - On/Off Footwear
GG0170A1 Func Mobil (Adm Perf) - Roll left and right
GG0170A2 Func Mobil (Dschg Goal) - Roll left and right
GG0170A3 Func Mobil (Dschg Perf) - Roll left and right
GG0170B1 Func Mobil (Adm Perf) - Sit to lying
GG0170B2 Func Mobil (Dschg Goal) - Sit to lying
GG0170B3 Func Mobil (Dschg Perf) - Sit to lying
GG0170C1 Func Mobil (Adm Perf) - Lying to sit on side
GG0170C2 Func Mobil (Dschg Goal) - Lying to sitting on side
GG0170C3 Func Mobil (Dschg Perf) - Lying to sitting on side
GG0170D1 Func Mobil (Adm Perf) - Sit to stand
GG0170D2 Func Mobil (Dschg Goal) - Sit to stand
GG0170D3 Func Mobil (Dschg Perf) - Sit to stand
GG0170E1 Func Mobil (Adm Perf) - Chair/bed-to-chair trans
GG0170E2 Func Mobil (Dschg Goal) - Chair/bed-to-chair trans
GG0170E3 Func Mobil (Dschg Perf) - Chair/bed-to-chair trans
GG0170F1 Func Mobil (Adm Perf) - Toilet transfer
GG0170F2 Func Mobil (Dschg Goal) - Toilet transfer
GG0170F3 Func Mobil (Dschg Perf) - Toilet transfer
GG0170G1 Func Mobil (Adm Perf) - Car Transfer
GG0170G2 Func Mobil (Dschg Goal) - Car Transfer
GG0170G3 Func Mobil (Dschg Perf) - Car Transfer
GG0170I1 Func Mobil (Adm Perf) - Walk 10 feet
GG0170I2 Func Mobil (Dschg Goal) - Walk 10 feet
GG0170I3 Func Mobil (Dschg Perf) - Walk 10 feet
GG0170J1 Func Mobil (Adm Perf) - Walk 50 feet w/2 turns
GG0170J2 Func Mobil (Dschg Goal) - 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
GG0170K2 Func Mobil (Dschg Goal) - Walk 150 feet
GG0170K3 Func Mobil (Dschg Perf) - Walk 150 feet
GG0170L1 Func Mobil (Adm Perf) - Walk 10 Ft Uneven Surf
GG0170L2 Func Mobil (Dschg Goal) - Walk 10 Ft Uneven Surf
GG0170L3 Func Mobil (Dschg Perf) - Walk 10 Ft Uneven Surf
GG0170M1 Func Mobil (Adm Perf) - 1 Step (Curb)
GG0170M2 Func Mobil (Dschg Goal) - 1 Step (Curb)
GG0170M3 Func Mobil (Dschg Perf) - 1 Step (Curb)
GG0170N1 Func Mobil (Adm Perf) - 4 Steps
GG0170N2 Func Mobil (Dschg Goal) - 4 Steps
GG0170N3 Func Mobil (Dschg Perf) - 4 Steps
GG0170O1 Func Mobil (Adm Perf) - 12 Steps
GG0170O2 Func Mobil (Dschg Goal) - 12 Steps
GG0170O3 Func Mobil (Dschg Perf) - 12 Steps
GG0170P1 Func Mobil (Adm Perf) - Picking Up Object
GG0170P2 Func Mobil (Dschg Goal) - Picking Up Object
GG0170P3 Func Mobil (Dschg Perf) - Picking Up Object
GG0170Q1 Does patient use wheelchair and/or scooter (Adm)
GG0170Q3 Does patient use wheelchair and/or scooter (Dschg)
GG0170R1 Func Mobil (Adm Perf) - Wheel 50 feet w/2 turns
GG0170R2 Func Mobil (Dschg Goal) - Wheel 50 feet w/2 turns
GG0170R3 Func Mobil (Dschg Perf) - Wheel 50 feet w/2 turns
GG0170RR1 Indicate type of wheelchair or scooter (Adm)
GG0170RR3 Indicate type of wheelchair or scooter (Dschg)
GG0170S1 Func Mobil (Adm Perf) - Wheel 150 feet
GG0170S2 Func Mobil (Dschg Goal) - Wheel 150 feet
GG0170S3 Func Mobil (Dschg Perf) - Wheel 150 feet
GG0170SS1 Indicate type of wheelchair or scooter (Adm)
GG0170SS3 Indicate type of wheelchair or 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/Injuries Present on Admission
M0210_2 Pressure Ulcers/Injuries Present on Discharge
M0300A1_1 Number of Stage 1 pressure injuries: Admission
M0300A1_2 Number of Stage 1 pressure injuries: Discharge
M0300B1_1 Number of Stage 2 pressure ulcers: Admission
M0300B1_2 Number of Stage 2 pressure ulcers: Discharge
M0300B2_2 Nbr Disch Stg 2 PU were Adm Stg 2 PU
M0300C1_1 Number of Stage 3 pressure ulcers: Admission
M0300C1_2 Number of Stage 3 pressure ulcers: Discharge
M0300C2_2 Nbr Disch Stg 3 PU were Adm Stg 3 PU
M0300D1_1 Number of Stage 4 pressure ulcers: Admission
M0300D1_2 Number of Stage 4 pressure ulcers: Discharge
M0300D2_2 Nbr Disch Stg 4 PU were Adm Stg 4 PU
M0300E1_1 Nbr Unstg non-remov drsg prss ulcers/injrs: Adm
M0300E1_2 Nbr Unstg non-remov drsg prss ulcers/injrs: Dschrg
M0300E2_2 Nbr Unstg NRD Disch PU/Injrs present at Adm
M0300F1_1 Nbr Unstg slough/eschar pressure ulcers: Adm
M0300F1_2 Nbr Unstg slough/eschar pressure ulcers: Dschrg
M0300F2_2 Nbr Unstg S/E Disch PU were Adm Unstg S/E PU
M0300G1_1 Nbr Unstg DTI pressure injrs: Adm
M0300G1_2 Nbr Unstg DTI pressure injrs: Dschrg
M0300G2_2 Nbr Unstg DTI Disch PU/Injrs present at Adm
N2001 Drug Regimen Review
N2003 Medication Follow-up
N2005 Medication Intervention
O0100N Total Parenteral Nutrition

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Generated: 01/23/2019 09:42:17 AM