-1010
| Property | Specification |
| Data System | IRF-PAI |
| Data Specs | V3.00.1 |
| 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 | [V3.00.0]-The mappings to the following items were removed, since these items were deleted: GG0170H1, GG0170H3, M0800A-F, M0900A1, M0900B-D. Added mappings to the following new items: N2001, N2003, N2005 |
| 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 |
| 29A | Bladder Level of Assistance: Admission |
| 29D | Bladder Level of Assistance: Discharge |
| 30A | Bladder Frequency of Accidents: Admission |
| 30D | Bladder Frequency of Accidents: Discharge |
| 31A | Bowel Level of Assistance: Admission |
| 31D | Bowel Level of Assistance: Discharge |
| 32A | Bowel Frequency of Accidents: Admission |
| 32D | Bowel Frequency of Accidents: Discharge |
| 33A | Tub Transfer: Admission |
| 33D | Tub Transfer: Discharge |
| 34A | Shower Transfer: Admission |
| 34D | Shower Transfer: Discharge |
| 35A | Distance Walked: Admission |
| 35D | Distance Walked: Discharge |
| 36A | Distance Traveled in Wheelchair: Admission |
| 36D | Distance Traveled in Wheelchair: Discharge |
| 37A | Walk: Admission |
| 37D | Walk: Discharge |
| 38A | Wheelchair: Admission |
| 38D | Wheelchair: Discharge |
| 39AA | Self-Care -Eating: Admission |
| 39AD | Self-Care -Eating: Discharge |
| 39AG | Self-Care -Eating: Goal |
| 39BA | Self-Care -Grooming: Admission |
| 39BD | Self-Care -Grooming: Discharge |
| 39BG | Self-Care -Grooming: Goal |
| 39CA | Self-Care -Bathing: Admission |
| 39CD | Self-Care -Bathing: Discharge |
| 39CG | Self-Care -Bathing: Goal |
| 39DA | Self-Care -Dressing - Upper: Admission |
| 39DD | Self-Care -Dressing - Upper: Discharge |
| 39DG | Self-Care -Dressing - Upper: Goal |
| 39EA | Self-Care -Dressing - Lower: Admission |
| 39ED | Self-Care -Dressing - Lower: Discharge |
| 39EG | Self-Care -Dressing - Lower: Goal |
| 39FA | Self-Care -Toileting: Admission |
| 39FD | Self-Care -Toileting: Discharge |
| 39FG | Self-Care -Toileting: Goal |
| 39GA | Sphincter Control -Bladder: Admission |
| 39GD | Sphincter Control -Bladder: Discharge |
| 39GG | Sphincter Control -Bladder: Goal |
| 39HA | Sphincter Control -Bowel: Admission |
| 39HD | Sphincter Control -Bowel: Discharge |
| 39HG | Sphincter Control -Bowel: Goal |
| 39IA | Transfers -Bed, Chair, Wheelchair: Admission |
| 39ID | Transfers -Bed, Chair, Wheelchair: Discharge |
| 39IG | Transfers -Bed, Chair, Wheelchair: Goal |
| 39JA | Transfers -Toilet: Admission |
| 39JD | Transfers -Toilet: Discharge |
| 39JG | Transfers -Toilet: Goal |
| 39KA | Transfers -Tub, Shower: Admission |
| 39KD | Transfers - Tub, Shower: Discharge |
| 39KG | Transfers -Tub, Shower: Goal |
| 39LA | Locomotion -Walk/Wheelchair: Admission |
| 39LAA | Locomotion -Walk/Wheelchair/both: Admission |
| 39LD | Locomotion -Walk/Wheelchair: Discharge |
| 39LDD | Locomotion -Walk/Wheelchair/both: Discharge |
| 39LG | Locomotion -Walk/Wheelchair: Goal |
| 39MA | Locomotion -Stairs: Admission |
| 39MD | Locomotion -Stairs: Discharge |
| 39MG | Locomotion -Stairs: Goal |
| 39NA | Communication -Comprehension: Admission |
| 39NAA | Communication -Comp Auditory/Visual/Both:Admission |
| 39ND | Communication -Comprehension: Discharge |
| 39NDD | Communication -Comp Auditory/Visual/Both:Discharge |
| 39NG | Communication -Comprehension: Goal |
| 39OA | Communication -Expression: Admission |
| 39OAA | Communication -Expr Vocal/Nonvocal/Both: Admission |
| 39OD | Communication -Expression: Discharge |
| 39ODD | Communication -Expr Vocal/Nonvocal/Both: Discharge |
| 39OG | Communication -Expression: Goal |
| 39PA | Social Cognition -Social Interaction: Admission |
| 39PD | Social Cognition -Social Interaction: Discharge |
| 39PG | Social Cognition -Social Interaction: Goal |
| 39QA | Social Cognition -Problem Solving: Admission |
| 39QD | Social Cognition -Problem Solving: Discharge |
| 39QG | Social Cognition -Problem Solving: Goal |
| 39RA | Social Cognition -Memory: Admission |
| 39RD | Social Cognition -Memory: Discharge |
| 39RG | Social Cognition -Memory: Goal |
| 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 |
| O0250A | Was influenza vaccine received |
| O0250C | If influenza vaccine not received, state reason |
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Generated: 08/29/2018 04:52:58 PM