IRF-PAI Item Summary

Item

XML Tag

Group

Type

Length

Fixed Start-End

Description

ASMT_SYS_CD ASMT_SYS_CD Control Checklist 10 1-10 Assessment System Code
TRANS_TYPE_CD TRANS_TYPE_CD Control Code 1 11-11 Transaction Type Code
FAC_ID FAC_ID Control Text 16 12-27 Facility ID
STATE_CD STATE_CD Control Code 2 28-29 State Code
FAC_ADDR_1 FAC_ADDR_1 Control Text 30 30-59 Facility Address Line 1
FAC_ADDR_2 FAC_ADDR_2 Control Text 30 60-89 Facility Address Line 2
FAC_CITY FAC_CITY Control Text 20 90-109 Facility City
FAC_ZIP FAC_ZIP Control Text 5 110-114 Facility ZIP Code
FAC_CNTCT FAC_CNTCT Control Text 30 115-144 Facility Contact Person Name
FAC_PHONE FAC_PHONE Control Text 10 145-154 Facility Contact Person Phone
FAC_EXTEN FAC_EXTEN Control Text 5 155-159 Facility Contact Person Phone Extension
FAC_DOC_CD FAC_DOC_CD Control Text 8 160-167 Facility Document ID
ITM_SET_VRSN_CD ITM_SET_VRSN_CD Control Code 5 168-172 IRF-PAI item Set Version
SPEC_VRSN_CD SPEC_VRSN_CD Control Code 5 173-177 IRF-PAI Specifications Version
SFTWR_VNDR_ID SFTWR_VNDR_ID Control Text 9 178-186 Software Vendor EIN
SFTWR_VNDR_NAME SFTWR_VNDR_NAME Control Text 30 187-216 Software Vendor Name
SFTWR_VNDR_EMAIL_ADR SFTWR_VNDR_EMAIL_ADR Control Text 50 217-266 Software Vendor Email Address
SFTWR_PROD_NAME SFTWR_PROD_NAME Control Text 50 267-316 Software Product Name
SFTWR_PROD_VRSN_CD SFTWR_PROD_VRSN_CD Control Text 20 317-336 Software Product Version Code
CORRECTION_NUM CORRECTION_NUM Control Number 2 337-338 Correction Number
SBMTD_CMG_TXT SBMTD_CMG_TXT Control Text 10 2128-2137 Submitted CMG Code
SBMTD_CMG_VRSN_TXT SBMTD_CMG_VRSN_TXT Control Text 10 2148-2157 Submitted CMG Version Code
CONTROL_FILLER CNTRL_FLR Control Text 200 339-538 Control items filler
1A R1A Asmt Text 50 539-588 Facility Name
1B R1B Asmt Text 12 589-600 CMS Certification Number (CCN)
2 R2 Asmt Text 12 601-612 Patient Medicare Number
3 R3 Asmt Text 14 613-626 Patient Medicaid Number
4 R4 Asmt Text 12 627-638 Patient First Name
5A R5A Asmt Text 18 639-656 Patient Last Name
6 R6 Asmt Date 8 657-664 Birth Date
7 R7 Asmt Text 9 665-673 Social Security Number (SSN)
8 R8 Asmt Code 1 674-674 Gender
9A R9A Asmt Checklist 1 675-675 Race: American Indian/Alaskan Native
9B R9B Asmt Checklist 1 676-676 Race: Asian
9C R9C Asmt Checklist 1 677-677 Race: Black or African American
9D R9D Asmt Checklist 1 678-678 Ethnicity: Hispanic or Latino
9E R9E Asmt Checklist 1 679-679 Race: Native Hawaiian or other Pacific Islander
9F R9F Asmt Checklist 1 680-680 Race: White
10 R10 Asmt Code 2 681-682 Marital Status
11 R11 Asmt Text 5 683-687 ZIP Code of Patient"s Pre-hospital Residence
12 R12 Asmt Date 8 688-695 Admission Date
13 R13 Asmt Date 8 696-703 Assessment Reference Date
14 R14 Asmt Code 2 704-705 Admission Class
15A R15A Asmt Code 2 1128-1129 Admit From
16A R16A Asmt Code 2 1130-1131 Pre-hospital Living Setting
17 R17 Asmt Code 2 710-711 Pre-Hospital Living With
20A R20A Asmt Code 2 716-717 Primary Payment Source
20B R20B Asmt Code 2 718-719 Secondary Payment Source
21A R21A Asmt Code 9 720-728 Impairment Group: Admission
21D R21D Asmt Code 9 729-737 Impairment Group: Discharge
22A R22A Asmt ICD 8 1426-1433 Etiologic Diagnosis Code A (ICD Code)
22B R22B Asmt ICD 8 1313-1320 Etiologic Diagnosis Code B (ICD Code)
22C R22C Asmt ICD 8 1321-1328 Etiologic Diagnosis Code C (ICD Code)
23 R23 Asmt Date 8 746-753 Date of Onset
24A R24A Asmt ICD 8 754-761 Comorbid Condition 1 (ICD Code)
24B R24B Asmt ICD 8 762-769 Comorbid Condition 2 (ICD Code)
24C R24C Asmt ICD 8 770-777 Comorbid Condition 3 (ICD Code)
24D R24D Asmt ICD 8 778-785 Comorbid Condition 4 (ICD Code)
24E R24E Asmt ICD 8 786-793 Comorbid Condition 5 (ICD Code)
24F R24F Asmt ICD 8 794-801 Comorbid Condition 6 (ICD Code)
24G R24G Asmt ICD 8 802-809 Comorbid Condition 7 (ICD Code)
24H R24H Asmt ICD 8 810-817 Comorbid Condition 8 (ICD Code)
24I R24I Asmt ICD 8 818-825 Comorbid Condition 9 (ICD Code)
24J R24J Asmt ICD 8 826-833 Comorbid Condition 10 (ICD Code)
24K R24K Asmt ICD 8 1132-1139 Comorbid Condition 11 (ICD Code)
24L R24L Asmt ICD 8 1140-1147 Comorbid Condition 12 (ICD Code)
24M R24M Asmt ICD 8 1148-1155 Comorbid Condition 13 (ICD Code)
24N R24N Asmt ICD 8 1156-1163 Comorbid Condition 14 (ICD Code)
24O R24O Asmt ICD 8 1164-1171 Comorbid Condition 15 (ICD Code)
24P R24P Asmt ICD 8 1172-1179 Comorbid Condition 16 (ICD Code)
24Q R24Q Asmt ICD 8 1180-1187 Comorbid Condition 17 (ICD Code)
24R R24R Asmt ICD 8 1188-1195 Comorbid Condition 18 (ICD Code)
24S R24S Asmt ICD 8 1196-1203 Comorbid Condition 19 (ICD Code)
24T R24T Asmt ICD 8 1204-1211 Comorbid Condition 20 (ICD Code)
24U R24U Asmt ICD 8 1212-1219 Comorbid Condition 21 (ICD Code)
24V R24V Asmt ICD 8 1220-1227 Comorbid Condition 22 (ICD Code)
24W R24W Asmt ICD 8 1228-1235 Comorbid Condition 23 (ICD Code)
24X R24X Asmt ICD 8 1236-1243 Comorbid Condition 24 (ICD Code)
24Y R24Y Asmt ICD 8 1244-1251 Comorbid Condition 25 (ICD Code)
24A1 R24A1 Asmt Code 1 1329-1329 Arthritis Conditions Recorded
25A R25A Asmt Number 2 1252-1253 Height
26A R26A Asmt Number 3 1254-1256 Weight
27A R27A Asmt Code 2 836-837 Swallowing Status: Admission
27D R27D Asmt Code 2 838-839 Swallowing Status: Discharge
29A R29A Asmt Code 2 842-843 Bladder Level of Assistance: Admission
29D R29D Asmt Code 2 844-845 Bladder Level of Assistance: Discharge
30A R30A Asmt Code 2 846-847 Bladder Frequency of Accidents: Admission
30D R30D Asmt Code 2 848-849 Bladder Frequency of Accidents: Discharge
31A R31A Asmt Code 2 850-851 Bowel Level of Assistance: Admission
31D R31D Asmt Code 2 852-853 Bowel Level of Assistance: Discharge
32A R32A Asmt Code 2 854-855 Bowel Frequency of Accidents: Admission
32D R32D Asmt Code 2 856-857 Bowel Frequency of Accidents: Discharge
33A R33A Asmt Code 2 858-859 Tub Transfer: Admission
33D R33D Asmt Code 2 860-861 Tub Transfer: Discharge
34A R34A Asmt Code 2 862-863 Shower Transfer: Admission
34D R34D Asmt Code 2 864-865 Shower Transfer: Discharge
35A R35A Asmt Code 2 866-867 Distance Walked: Admission
35D R35D Asmt Code 2 868-869 Distance Walked: Discharge
36A R36A Asmt Code 2 870-871 Distance Traveled in Wheelchair: Admission
36D R36D Asmt Code 2 872-873 Distance Traveled in Wheelchair: Discharge
37A R37A Asmt Code 2 874-875 Walk: Admission
37D R37D Asmt Code 2 876-877 Walk: Discharge
38A R38A Asmt Code 2 878-879 Wheelchair: Admission
38D R38D Asmt Code 2 880-881 Wheelchair: Discharge
39AA R39AA Asmt Code 2 882-883 Self-Care -Eating: Admission
39AD R39AD Asmt Code 2 884-885 Self-Care -Eating: Discharge
39AG R39AG Asmt Code 2 886-887 Self-Care -Eating: Goal
39BA R39BA Asmt Code 2 888-889 Self-Care -Grooming: Admission
39BD R39BD Asmt Code 2 890-891 Self-Care -Grooming: Discharge
39BG R39BG Asmt Code 2 892-893 Self-Care -Grooming: Goal
39CA R39CA Asmt Code 2 894-895 Self-Care -Bathing: Admission
39CD R39CD Asmt Code 2 896-897 Self-Care -Bathing: Discharge
39CG R39CG Asmt Code 2 898-899 Self-Care -Bathing: Goal
39DA R39DA Asmt Code 2 900-901 Self-Care -Dressing - Upper: Admission
39DD R39DD Asmt Code 2 902-903 Self-Care -Dressing - Upper: Discharge
39DG R39DG Asmt Code 2 904-905 Self-Care -Dressing - Upper: Goal
39EA R39EA Asmt Code 2 906-907 Self-Care -Dressing - Lower: Admission
39ED R39ED Asmt Code 2 908-909 Self-Care -Dressing - Lower: Discharge
39EG R39EG Asmt Code 2 910-911 Self-Care -Dressing - Lower: Goal
39FA R39FA Asmt Code 2 912-913 Self-Care -Toileting: Admission
39FD R39FD Asmt Code 2 914-915 Self-Care -Toileting: Discharge
39FG R39FG Asmt Code 2 916-917 Self-Care -Toileting: Goal
39GA R39GA Asmt Code 2 918-919 Sphincter Control -Bladder: Admission
39GD R39GD Asmt Code 2 920-921 Sphincter Control -Bladder: Discharge
39GG R39GG Asmt Code 2 922-923 Sphincter Control -Bladder: Goal
39HA R39HA Asmt Code 2 924-925 Sphincter Control -Bowel: Admission
39HD R39HD Asmt Code 2 926-927 Sphincter Control -Bowel: Discharge
39HG R39HG Asmt Code 2 928-929 Sphincter Control -Bowel: Goal
39IA R39IA Asmt Code 2 930-931 Transfers -Bed, Chair, Wheelchair: Admission
39ID R39ID Asmt Code 2 932-933 Transfers -Bed, Chair, Wheelchair: Discharge
39IG R39IG Asmt Code 2 934-935 Transfers -Bed, Chair, Wheelchair: Goal
39JA R39JA Asmt Code 2 936-937 Transfers -Toilet: Admission
39JD R39JD Asmt Code 2 938-939 Transfers -Toilet: Discharge
39JG R39JG Asmt Code 2 940-941 Transfers -Toilet: Goal
39KA R39KA Asmt Code 2 942-943 Transfers -Tub, Shower: Admission
39KD R39KD Asmt Code 2 944-945 Transfers - Tub, Shower: Discharge
39KG R39KG Asmt Code 2 946-947 Transfers -Tub, Shower: Goal
39LA R39LA Asmt Code 2 948-949 Locomotion -Walk/Wheelchair: Admission
39LAA R39LAA Asmt Code 1 950-950 Locomotion -Walk/Wheelchair/both: Admission
39LD R39LD Asmt Code 2 951-952 Locomotion -Walk/Wheelchair: Discharge
39LDD R39LDD Asmt Code 1 953-953 Locomotion -Walk/Wheelchair/both: Discharge
39LG R39LG Asmt Code 2 954-955 Locomotion -Walk/Wheelchair: Goal
39MA R39MA Asmt Code 2 956-957 Locomotion -Stairs: Admission
39MD R39MD Asmt Code 2 958-959 Locomotion -Stairs: Discharge
39MG R39MG Asmt Code 2 960-961 Locomotion -Stairs: Goal
39NA R39NA Asmt Code 2 962-963 Communication -Comprehension: Admission
39NAA R39NAA Asmt Code 1 964-964 Communication -Comp Auditory/Visual/Both:Admission
39ND R39ND Asmt Code 2 965-966 Communication -Comprehension: Discharge
39NDD R39NDD Asmt Code 1 967-967 Communication -Comp Auditory/Visual/Both:Discharge
39NG R39NG Asmt Code 2 968-969 Communication -Comprehension: Goal
39OA R39OA Asmt Code 2 970-971 Communication -Expression: Admission
39OAA R39OAA Asmt Code 1 972-972 Communication -Expr Vocal/Nonvocal/Both: Admission
39OD R39OD Asmt Code 2 973-974 Communication -Expression: Discharge
39ODD R39ODD Asmt Code 1 975-975 Communication -Expr Vocal/Nonvocal/Both: Discharge
39OG R39OG Asmt Code 2 976-977 Communication -Expression: Goal
39PA R39PA Asmt Code 2 978-979 Social Cognition -Social Interaction: Admission
39PD R39PD Asmt Code 2 980-981 Social Cognition -Social Interaction: Discharge
39PG R39PG Asmt Code 2 982-983 Social Cognition -Social Interaction: Goal
39QA R39QA Asmt Code 2 984-985 Social Cognition -Problem Solving: Admission
39QD R39QD Asmt Code 2 986-987 Social Cognition -Problem Solving: Discharge
39QG R39QG Asmt Code 2 988-989 Social Cognition -Problem Solving: Goal
39RA R39RA Asmt Code 2 990-991 Social Cognition -Memory: Admission
39RD R39RD Asmt Code 2 992-993 Social Cognition -Memory: Discharge
39RG R39RG Asmt Code 2 994-995 Social Cognition -Memory: Goal
40 R40 Asmt Date 8 996-1003 Discharge Date
41 R41 Asmt Code 1 1004-1004 Patient Discharged Against Medical Advice
42 R42 Asmt Code 1 1005-1005 Program Interruption(s) Indicator
43A R43A Asmt Date 8 1006-1013 1st Interruption Date
43B R43B Asmt Date 8 1014-1021 1st Return Date
43C R43C Asmt Date 8 1022-1029 2nd Interruption Date
43D R43D Asmt Date 8 1030-1037 2nd Return Date
43E R43E Asmt Date 8 1038-1045 3rd Interruption Date
43F R43F Asmt Date 8 1046-1053 3rd Return Date
44C R44C Asmt Code 1 1257-1257 Patient Discharged Alive
44D R44D Asmt Code 2 1259-1260 Discharge to Living Setting
45 R45 Asmt Code 2 1057-1058 Discharge to Living With
46 R46 Asmt ICD 8 1059-1066 Diagnosis for Interruption or Death (ICD Code)
47A R47A Asmt ICD 8 1067-1074 Complication during rehab stay 1 (ICD Code)
47B R47B Asmt ICD 8 1075-1082 Complication during rehab stay 2 (ICD Code)
47C R47C Asmt ICD 8 1083-1090 Complication during rehab stay 3 (ICD Code)
47D R47D Asmt ICD 8 1091-1098 Complication during rehab stay 4 (ICD Code)
47E R47E Asmt ICD 8 1099-1106 Complication during rehab stay 5 (ICD Code)
47F R47F Asmt ICD 8 1107-1114 Complication during rehab stay 6 (ICD Code)
O0401AA O0401AA Asmt Number 4 1330-1333 Physical Therapy - Individual Minutes Week 1
O0401AB O0401AB Asmt Number 4 1334-1337 Physical Therapy - Concurrent Minutes Week 1
O0401AC O0401AC Asmt Number 4 1338-1341 Physical Therapy - Group Minutes Week 1
O0401AD O0401AD Asmt Number 4 1342-1345 Physical Therapy - Co-treatment Minutes Week 1
O0401BA O0401BA Asmt Number 4 1346-1349 Occupational Therapy - Individual Minutes Week 1
O0401BB O0401BB Asmt Number 4 1350-1353 Occupational Therapy - Concurrent Minutes Week 1
O0401BC O0401BC Asmt Number 4 1354-1357 Occupational Therapy - Group Minutes Week 1
O0401BD O0401BD Asmt Number 4 1358-1361 Occupational Therapy - Co-treatment Minutes Week 1
O0401CA O0401CA Asmt Number 4 1362-1365 SLP Therapy - Individual Minutes Week 1
O0401CB O0401CB Asmt Number 4 1366-1369 SLP Therapy - Concurrent Minutes Week 1
O0401CC O0401CC Asmt Number 4 1370-1373 SLP Therapy - Group Minutes Week 1
O0401CD O0401CD Asmt Number 4 1374-1377 SLP Therapy - Co-treatment Minutes Week 1
O0402AA O0402AA Asmt Number 4 1378-1381 Physical Therapy - Individual Minutes Week 2
O0402AB O0402AB Asmt Number 4 1382-1385 Physical Therapy - Concurrent Minutes Week 2
O0402AC O0402AC Asmt Number 4 1386-1389 Physical Therapy - Group Minutes Week 2
O0402AD O0402AD Asmt Number 4 1390-1393 Physical Therapy - Co-treatment Minutes Week 2
O0402BA O0402BA Asmt Number 4 1394-1397 Occupational Therapy - Individual Minutes Week 2
O0402BB O0402BB Asmt Number 4 1398-1401 Occupational Therapy - Concurrent Minutes Week 2
O0402BC O0402BC Asmt Number 4 1402-1405 Occupational Therapy - Group Minutes Week 2
O0402BD O0402BD Asmt Number 4 1406-1409 Occupational Therapy - Co-treatment Minutes Week 2
O0402CA O0402CA Asmt Number 4 1410-1413 SLP Therapy - Individual Minutes Week 2
O0402CB O0402CB Asmt Number 4 1414-1417 SLP Therapy - Concurrent Minutes Week 2
O0402CC O0402CC Asmt Number 4 1418-1421 SLP Therapy - Group Minutes Week 2
O0402CD O0402CD Asmt Number 4 1422-1425 SLP Therapy - Co-treatment Minutes Week 2
M0210_1 M0210_1 Asmt Code 1 1261-1261 Pressure Ulcers Present on Admission
M0210_2 M0210_2 Asmt Code 1 1262-1262 Pressure Ulcers Present on Discharge
M0300A1_1 M0300A1_1 Asmt Number 1 1263-1263 Number of Stage 1 pressure ulcers: Admission
M0300A1_2 M0300A1_2 Asmt Number 1 1264-1264 Number of Stage 1 pressure ulcers: Discharge
M0300A2_2 M0300A2_2 Asmt Number 1 1265-1265 Nbr Disch Stg 1 PU were Adm Stg 1 PU
M0300A3_2 M0300A3_2 Asmt Number 1 1266-1266 Nbr Disch Stg 1 PU new
M0300B1_1 M0300B1_1 Asmt Number 1 1267-1267 Number of Stage 2 pressure ulcers: Admission
M0300B1_2 M0300B1_2 Asmt Number 1 1268-1268 Number of Stage 2 pressure ulcers: Discharge
M0300B2_2 M0300B2_2 Asmt Number 1 1269-1269 Nbr Disch Stg 2 PU were Adm Stg 2 PU
M0300B3_2 M0300B3_2 Asmt Number 1 1270-1270 Nbr Disch Stg 2 PU were Adm Unstg PU
M0300B4_2 M0300B4_2 Asmt Number 1 1271-1271 Nbr Disch Stg 2 PU new/worsened
M0300C1_1 M0300C1_1 Asmt Number 1 1272-1272 Number of Stage 3 pressure ulcers: Admission
M0300C1_2 M0300C1_2 Asmt Number 1 1273-1273 Number of Stage 3 pressure ulcers: Discharge
M0300C2_2 M0300C2_2 Asmt Number 1 1274-1274 Nbr Disch Stg 3 PU were Adm Stg 3 PU
M0300C3_2 M0300C3_2 Asmt Number 1 1275-1275 Nbr Disch Stg 3 PU were Adm Unstg PU
M0300C4_2 M0300C4_2 Asmt Number 1 1276-1276 Nbr Disch Stg 3 PU new/worsened
M0300D1_1 M0300D1_1 Asmt Number 1 1277-1277 Number of Stage 4 pressure ulcers: Admission
M0300D1_2 M0300D1_2 Asmt Number 1 1278-1278 Number of Stage 4 pressure ulcers: Discharge
M0300D2_2 M0300D2_2 Asmt Number 1 1279-1279 Nbr Disch Stg 4 PU were Adm Stg 4 PU
M0300D3_2 M0300D3_2 Asmt Number 1 1280-1280 Nbr Disch Stg 4 PU were Adm Unstg PU
M0300D4_2 M0300D4_2 Asmt Number 1 1281-1281 Nbr Disch Stg 4 PU new/worsened
M0300E1_1 M0300E1_1 Asmt Number 1 1282-1282 Nbr Unstg non-remov drsg pressure ulcers: Adm
M0300E1_2 M0300E1_2 Asmt Number 1 1283-1283 Nbr Unstg non-remov drsg pressure ulcers: Dschrg
M0300E2_2 M0300E2_2 Asmt Number 1 1284-1284 Nbr Unstg NRD Disch PU were Adm Unstg NRD PU
M0300E3_2 M0300E3_2 Asmt Number 1 1285-1285 Nbr Unstg NRD Disch PU were Adm Stageable PU
M0300F1_1 M0300F1_1 Asmt Number 1 1286-1286 Nbr Unstg slough/eschar pressure ulcers: Adm
M0300F1_2 M0300F1_2 Asmt Number 1 1287-1287 Nbr Unstg slough/eschar pressure ulcers: Dschrg
M0300F2_2 M0300F2_2 Asmt Number 1 1288-1288 Nbr Unstg S/E Disch PU were Adm Unstg S/E PU
M0300F3_2 M0300F3_2 Asmt Number 1 1289-1289 Nbr Unstg S/E Disch PU were Adm Stageable PU
M0300G1_1 M0300G1_1 Asmt Number 1 1290-1290 Nbr Unstg DTI pressure ulcers: Adm
M0300G1_2 M0300G1_2 Asmt Number 1 1291-1291 Nbr Unstg DTI pressure ulcers: Dschrg
M0300G2_2 M0300G2_2 Asmt Number 1 1292-1292 Nbr Unstg DTI Disch PU were Adm Unstg DTI PU
M0900A M0900A Asmt Number 1 1293-1293 Number of Stage 1 Healed Pressure Ulcers
M0900B M0900B Asmt Number 1 1294-1294 Number of Stage 2 Healed Pressure Ulcers
M0900C M0900C Asmt Number 1 1295-1295 Number of Stage 3 Healed Pressure Ulcers
M0900D M0900D Asmt Number 1 1296-1296 Number of Stage 4 Healed Pressure Ulcers
I0900A I0900A Asmt Code 1 1297-1297 Peripheral Vascular Disease (PVD)
I0900B I0900B Asmt Code 1 1298-1298 Peripheral Arterial Disease ( PAD)
I2900A I2900A Asmt Code 1 1299-1299 Diabetes Mellitus (DM)
I2900B I2900B Asmt Code 1 1300-1300 Diabetic Retinopathy
I2900C I2900C Asmt Code 1 1301-1301 Diabetic Nephropathy
I2900D I2900D Asmt Code 1 1302-1302 Diabetic Neuropathy
O0250A O0250A Asmt Code 1 1303-1303 Was influenza vaccine received
O0250B O0250B Asmt Date 8 1304-1311 Date influenza vaccine received
O0250C O0250C Asmt Code 1 1312-1312 If influenza vaccine not received, state reason
Filler - 15 FILLER_15 Filler Text 2 706-707 Prior v1.10 Admit From
Filler - 16 FILLER_16 Filler Text 2 708-709 Prior v1.10 Pre-Hospital Living Setting
Filler - 18 FILLER_18 Filler Text 2 712-713 Prior v1.10 Pre-Hospital Vocational Category
Filler - 19 FILLER_19 Filler Text 2 714-715 Prior v1.10 Pre-Hospital Vocational Effort
Filler - 22 R22 Filler Text 8 738-745 Prior V1.11 Etiologic Diagnosis Code A (ICD Code)
Filler - 25 FILLER_25 Filler Text 1 834-834 Prior v1.10 Comatose: Admission
Filler - 26 FILLER_26 Filler Text 1 835-835 Prior v1.10 Delirious: Admission
Filler - 28A FILLER_28A Filler Text 1 840-840 Prior v1.10 Clinical Signs of Dehydration: Adm
Filler - 28D FILLER_28D Filler Text 1 841-841 Prior v1.10 Clinical Signs of Dehydration: Disch
Filler - 44A FILLER_44D Filler Text 2 1054-1055 Prior v1.10 Discharge to Living Setting
Filler - 44B FILLER_44B Filler Text 1 1056-1056 Prior v1.10 Patient Dschrgd with HH Services
Filler - 48AA FILLER_48AA Filler Text 1 1115-1115 Filler for deleted item
Filler - 48AD FILLER_48AD Filler Text 1 1116-1116 Filler for deleted item
Filler - 48BA FILLER_48BA Filler Text 1 1117-1117 Filler for deleted item
Filler - 48BD FILLER_48BD Filler Text 1 1118-1118 Filler for deleted item
Filler - 48CA FILLER_48CA Filler Text 1 1119-1119 Filler for deleted item
Filler - 48CD FILLER_48CD Filler Text 1 1120-1120 Filler for deleted item
Filler - 49A FILLER_49A Filler Text 1 1121-1121 Filler for deleted item
Filler - 49B FILLER_49B Filler Text 1 1122-1122 Filler for deleted item
Filler - 49C FILLER_49C Filler Text 1 1123-1123 Filler for deleted item
Filler - 50A FILLER_50A Filler Text 1 1124-1124 Filler for deleted item
Filler - 50B FILLER_50B Filler Text 1 1125-1125 Filler for deleted item
Filler - 50C FILLER_50C Filler Text 1 1126-1126 Filler for deleted item
Filler - 50D FILLER_50d Filler Text 1 1127-1127 Filler for deleted item
FILLER-44C_LNGTH FILLER_44C_LNGTH Filler Text 1 1258-1258 Filler for reduced length
ASMT_FILLER ASMT_FILLER Asmt Text 694 1434-2127 Assessment items filler
RCALC_CMG_TXT RCALC_CMG_TXT Calc Text 10 2138-2147 Recalculated CMG Code
RCALC_CMG_VRSN_TXT RCALC_CMG_VRSN_TXT Calc Text 10 2158-2167 Recalculated CMG Version Code
ASSESSMENT_ID ASSESSMENT_ID Calc Number 15 2168-2182 Assessment ID
ORIGINAL_ASSESSMENT_ID ORIGINAL_ASSESSMENT_ID Calc Number 15 2183-2197 Original Assessment ID
RESIDENT_INTERNAL_ID RESIDENT_INTERNAL_ID Calc Number 10 2198-2207 Resident ID
PROVIDER_INTERNAL_ID PROVIDER_INTERNAL_ID Calc Number 10 2208-2217 Provider Internal Number
SUBMISSION_ID SUBMISSION_ID Calc Number 15 2218-2232 Submission ID
SUBMISSION_DATE SUBMISSION_DATE Calc Date 8 2233-2240 Submission Date
SUBMISSION_COMPLETE_DATE SUBMISSION_COMPLETE_DATE Calc Date 8 2241-2248 Submission Complete Date
SUBMITTING_USER_ID SUBMITTING_USER_ID Calc Text 30 2249-2278 Submitting User ID
BIRTHDATE_SUBMIT_CODE BIRTHDATE_SUBMIT_CODE Calc Code 1 2279-2279 Birthdate Submit Code
RESIDENT_MATCH_CRITERIA RESIDENT_MATCH_CRITERIA Calc Number 2 2280-2281 Resident Matching Criteria
RESIDENT_AGE RESIDENT_AGE Calc Number 3 2282-2284 Resident Age
C_MOTOR_SCRE_TXT C_MOTOR_SCRE_TXT Calc Text 5 2285-2289 Calculated Motor Score
C_CGNTV_SCRE_TXT C_CGNTV_SCRE_TXT Calc Text 5 2290-2294 Calculated Cognitive Score
C_CMG_DLL_VRSN_CD C_CMG_DLL_VRSN_CD Calc Text 10 2295-2304 Calculated CMG dll version
C_CCN_NUM C_CCN_NUM Calc Text 12 2305-2316 CMS Certification Number
CALC_FILLER CALC_FILLER Calc Text 468 2317-2784 Calculated items filler
DATA_END_INDICATOR DATA_END_INDICATOR Calc Text 1 2785-2785 End of Data Terminator Code
CR CR Calc Text 1 2786-2786 Carriage Return
LF LF Calc Text 1 2787-2787 Line Feed

NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 09/09/2015 03:29:57 PM