-3676
| Property | Specification |
| Data System | MDS |
| Data Specs | V3.00.1 |
| Edit Type | Format |
| Severity | Fatal |
| Edit Text |
Values of Code and Checklist Items: Only the coded values listed in the "Item Values" table of the Detailed Data Specifications Report may be submitted for this item. |
| Version Notes |
[V3.00.0]-Mappings to the following items were deleted, since the items were deleted: A0310C, A0310D, D0350, D0650, K0510C1, K0510D1, K0710A1, K0710B1, O0100L2, X0600C, X0600D, X0900E, Z0100C. Mappings to the following new items were added: A0300A, A0300B, A0310G1, GG0130A5, GG0130B5, GG0130C5, GG0170B5, GG0170C5, GG0170D5, GG0170E5, GG0170F5, GG0170I5, GG0170J5, GG0170K5, J2100, J2300, J2310, J2320, J2330, J2400, J2410, J2420, J2499, J2500, J2510, J2520, J2530, J2599, J2600, J2610, J2620, J2699, J2700, J2710, J2799, J2800, J2810, J2899, J2900, J2910, J2920, J2930, J2940, J5000, X0570B, Z0200C. [V3.00.1]-Mapping to new item X0570A was added, per errata issue 04. |
| Item List | |
| Item ID | Description |
| ASMT_SYS_CD | Assessment system code |
| ITM_SBST_CD | Item subset code |
| PRODN_TEST_CD | Production/test indicator |
| STATE_CD | Facility"s state postal code |
| A0050 | Type of transaction (formerly X0100) |
| A0200 | Type of provider |
| A0300A | State Payment Assessment Purpose |
| A0300B | State Payment Assessment Type |
| A0310A | Type of assessment: OBRA |
| A0310B | Type of assessment: PPS |
| A0310E | First assessment since most recent entry |
| A0310F | Entry/discharge reporting |
| A0310G | Planned/unplanned discharge |
| A0310G1 | Interrupted Stay |
| A0310H | SNF PPS Part A Discharge (End of Stay) Assessment |
| A0410 | Submission requirement |
| 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 |
| A1100A | Does the resident need or want an interpreter |
| A1200 | Marital status |
| A1500 | Resident evaluated by PASRR |
| A1510A | Level II PASRR conditions: Serious Mental Illness |
| A1510B | Level II PASRR conditions: Intellectual Disability |
| A1510C | Level II PASRR conditions: Other related condition |
| A1550A | ID/DD status: Down syndrome |
| A1550B | ID/DD status: Autism |
| A1550C | ID/DD status: Epilepsy |
| A1550D | ID/DD status: other organic ID/DD condition |
| A1550E | ID/DD status: ID/DD with no organic condition |
| A1550Z | ID/DD status: none of the above |
| A1700 | Type of entry |
| A1800 | Entered from |
| A2100 | Discharge status |
| A2400A | Has resident had Medicare-covered stay |
| B0100 | Comatose |
| B0200 | Hearing |
| B0300 | Hearing aid |
| B0600 | Speech clarity |
| B0700 | Makes self understood |
| B0800 | Ability to understand others |
| B1000 | Vision |
| B1200 | Corrective lenses |
| C0100 | BIMS: should resident interview be conducted |
| C0200 | BIMS res interview: repetition of three words |
| C0300A | BIMS res interview: able to report correct year |
| C0300B | BIMS res interview: able to report correct month |
| C0300C | BIMS res interview: can report correct day of week |
| C0400A | BIMS res interview: able to recall "sock" |
| C0400B | BIMS res interview: able to recall "blue" |
| C0400C | BIMS res interview: able to recall "bed" |
| C0600 | Staff asmt mental status: conduct asmt |
| C0700 | Staff asmt mental status: short-term memory OK |
| C0800 | Staff asmt mental status: long-term memory OK |
| C0900A | Staff asmt mental status: recall current season |
| C0900B | Staff asmt mental status: recall location of room |
| C0900C | Staff asmt mental status: recall staff names/faces |
| C0900D | Staff asmt mental status: recall in nh/hosp sw bed |
| C0900Z | Staff asmt mental status: none of above recalled |
| C1000 | Cognitive skills for daily decision making |
| C1310A | Acute Onset Mental Status Change |
| C1310B | Inattention |
| C1310C | Disorganized Thinking |
| C1310D | Altered Level of Consciousness |
| D0100 | PHQ: should resident mood interview be conducted |
| D0200A1 | PHQ res: little interest or pleasure - presence |
| D0200A2 | PHQ res: little interest or pleasure - frequency |
| D0200B1 | PHQ res: feeling down, depressed - presence |
| D0200B2 | PHQ res: feeling down, depressed - frequency |
| D0200C1 | PHQ res: trouble with sleep - presence |
| D0200C2 | PHQ res: trouble with sleep - frequency |
| D0200D1 | PHQ res: feeling tired/little energy - presence |
| D0200D2 | PHQ res: feeling tired/little energy - frequency |
| D0200E1 | PHQ res: poor appetite or overeating - presence |
| D0200E2 | PHQ res: poor appetite or overeating - frequency |
| D0200F1 | PHQ res: feeling bad about self - presence |
| D0200F2 | PHQ res: feeling bad about self - frequency |
| D0200G1 | PHQ res: trouble concentrating - presence |
| D0200G2 | PHQ res: trouble concentrating - frequency |
| D0200H1 | PHQ res: slow, fidgety, restless - presence |
| D0200H2 | PHQ res: slow, fidgety, restless - frequency |
| D0200I1 | PHQ res: thoughts better off dead - presence |
| D0200I2 | PHQ res: thoughts better off dead - frequency |
| D0500A1 | PHQ staff: little interest or pleasure - presence |
| D0500A2 | PHQ staff: little interest or pleasure - frequency |
| D0500B1 | PHQ staff: feeling down, depressed - presence |
| D0500B2 | PHQ staff: feeling down, depressed - frequency |
| D0500C1 | PHQ staff: trouble with sleep - presence |
| D0500C2 | PHQ staff: trouble with sleep - frequency |
| D0500D1 | PHQ staff: feeling tired/little energy - presence |
| D0500D2 | PHQ staff: feeling tired/little energy - frequency |
| D0500E1 | PHQ staff: poor appetite or overeating - presence |
| D0500E2 | PHQ staff: poor appetite or overeating - frequency |
| D0500F1 | PHQ staff: feeling bad about self - presence |
| D0500F2 | PHQ staff: feeling bad about self - frequency |
| D0500G1 | PHQ staff: trouble concentrating - presence |
| D0500G2 | PHQ staff: trouble concentrating - frequency |
| D0500H1 | PHQ staff: slow, fidgety, restless - presence |
| D0500H2 | PHQ staff: slow, fidgety, restless - frequency |
| D0500I1 | PHQ staff: thoughts better off dead - presence |
| D0500I2 | PHQ staff: thoughts better off dead - frequency |
| D0500J1 | PHQ staff: short-tempered - presence |
| D0500J2 | PHQ staff: short-tempered - frequency |
| E0100A | Psychosis: hallucinations |
| E0100B | Psychosis: delusions |
| E0100Z | Psychosis: none of the above |
| E0200A | Physical behav symptoms directed toward others |
| E0200B | Verbal behav symptoms directed toward others |
| E0200C | Other behav symptoms not directed toward others |
| E0300 | Overall presence of behavioral symptoms |
| E0500A | Behav symptoms put res at risk for illness/injury |
| E0500B | Behav symptoms interfere with resident care |
| E0500C | Behav symptoms interfere with social activities |
| E0600A | Behav symptoms put others at risk for injury |
| E0600B | Behav symptoms intrude on privacy of others |
| E0600C | Behav symptoms disrupt care or living environment |
| E0800 | Rejection of care: presence and frequency |
| E0900 | Wandering: presence and frequency |
| E1000A | Wandering: risk of getting to dangerous place |
| E1000B | Wandering: intrude on privacy of others |
| E1100 | Change in behavioral or other symptoms |
| F0300 | Conduct res interview for daily/activity prefs |
| F0400A | Res interview: choose clothes to wear |
| F0400B | Res interview: take care of personal belongings |
| F0400C | Res interview: choose tub, bath, shower, sponge |
| F0400D | Res interview: have snacks between meals |
| F0400E | Res interview: choose own bedtime |
| F0400F | Res interview: discuss care with family/friend |
| F0400G | Res interview: use phone in private |
| F0400H | Res interview: lock things to keep them safe |
| F0500A | Res interview: have books, newspaper, mags to read |
| F0500B | Res interview: listen to music |
| F0500C | Res interview: be around animals/pets |
| F0500D | Res interview: keep up with news |
| F0500E | Res interview: do things with groups of people |
| F0500F | Res interview: do favorite activities |
| F0500G | Res interview: go outside when good weather |
| F0500H | Res interview: participate in religious practices |
| F0600 | Primary respondent: daily/activities prefs |
| F0700 | Conduct staff assessment for daily/activity prefs |
| F0800A | Staff assessment: choosing clothes to wear |
| F0800B | Staff assessment: caring for personal belongings |
| F0800C | Staff assessment: receiving tub bath |
| F0800D | Staff assessment: receiving shower |
| F0800E | Staff assessment: receiving bed bath |
| F0800F | Staff assessment: receiving sponge bath |
| F0800G | Staff assessment: snacks between meals |
| F0800H | Staff assessment: staying up past 8PM |
| F0800I | Staff assessment: discuss care with family/other |
| F0800J | Staff assessment: use phone in private |
| F0800K | Staff assessment: place to lock personal things |
| F0800L | Staff assessment: reading books, newspapers, mags |
| F0800M | Staff assessment: listening to music |
| F0800N | Staff assessment: being around animals/pets |
| F0800O | Staff assessment: keeping up with news |
| F0800P | Staff assessment: doing things with groups |
| F0800Q | Staff assessment: participate favorite activities |
| F0800R | Staff assessment: spend time away from nursng home |
| F0800S | Staff assessment: spend time outdoors |
| F0800T | Staff assessment: participate religious activities |
| F0800Z | Staff assessment: none of above activities |
| G0110A1 | Bed mobility: self-performance |
| G0110A2 | Bed mobility: support provided |
| G0110B1 | Transfer: self-performance |
| G0110B2 | Transfer: support provided |
| G0110C1 | Walk in room: self-performance |
| G0110C2 | Walk in room: support provided |
| G0110D1 | Walk in corridor: self-performance |
| G0110D2 | Walk in corridor: support provided |
| G0110E1 | Locomotion on unit: self-performance |
| G0110E2 | Locomotion on unit: support provided |
| G0110F1 | Locomotion off unit: self-performance |
| G0110F2 | Locomotion off unit: support provided |
| G0110G1 | Dressing: self-performance |
| G0110G2 | Dressing: support provided |
| G0110H1 | Eating: self-performance |
| G0110H2 | Eating: support provided |
| G0110I1 | Toilet use: self-performance |
| G0110I2 | Toilet use: support provided |
| G0110J1 | Personal hygiene: self-performance |
| G0110J2 | Personal hygiene: support provided |
| G0120A | Bathing: self-performance |
| G0120B | Bathing: support provided |
| G0300A | Balance: moving from seated to standing position |
| G0300B | Balance: walking (with assistive device if used) |
| G0300C | Balance: turning around while walking |
| G0300D | Balance: moving on and off toilet |
| G0300E | Balance: surface-to-surface transfer |
| G0400A | ROM limitation: upper extremity |
| G0400B | ROM limitation: lower extremity |
| G0600A | Mobility devices: cane/crutch |
| G0600B | Mobility devices: walker |
| G0600C | Mobility devices: wheelchair (manual or electric) |
| G0600D | Mobility devices: limb prosthesis |
| G0600Z | Mobility devices: none of the above |
| G0900A | Resident believes capable of increased independ |
| G0900B | Staff believes res capable of increased independ |
| GG0100A | Prior Functioning - Self Care |
| GG0100B | Prior Functioning - Indoor Mobility (Ambulation) |
| GG0100C | Prior Functioning - Stairs |
| GG0100D | Prior Functioning - Functional Cognition |
| GG0110A | Prior Device Use - Manual wheelchair |
| GG0110B | Prior Device Use - Mtrzd wheelchair and/or scooter |
| GG0110C | Prior Device Use - Mechanical lift |
| GG0110D | Prior Device Use - Walker |
| GG0110E | Prior Device Use - Orthotics/Prosthetics |
| GG0110Z | Prior Device Use - None of the above |
| GG0130A1 | Eating (Start of Stay Perf) |
| GG0130A2 | Eating (Dschg Goal) |
| GG0130A3 | Eating (Dischg Perf) |
| GG0130A5 | Eating (Interim Perf) |
| GG0130B1 | Oral hygiene (Start of Stay Perf) |
| GG0130B2 | Oral hygiene (Dschg Goal) |
| GG0130B3 | Oral hygiene (Dschg Perf) |
| GG0130B5 | Oral hygiene (Interim Perf) |
| GG0130C1 | Toileting hygiene (Start of Stay Perf) |
| GG0130C2 | Toileting hygiene (Dschg Goal) |
| GG0130C3 | Toileting hygiene (Dschg Perf) |
| GG0130C5 | Toileting hygiene (Interim Perf) |
| GG0130E1 | Shower/bathe self (Start of Stay Perf) |
| GG0130E2 | Shower/bathe self (Dschg Goal) |
| GG0130E3 | Shower/bathe self (Dschg Perf) |
| GG0130F1 | Upper body dressing (Start of Stay Perf) |
| GG0130F2 | Upper body dressing (Dschg Goal) |
| GG0130F3 | Upper body dressing (Dschg Perf) |
| GG0130G1 | Lower body dressing (Start of Stay Perf) |
| GG0130G2 | Lower body dressing (Dschg Goal) |
| GG0130G3 | Lower body dressing (Dschg Perf) |
| GG0130H1 | Put on/take off footwear (Start of Stay Perf) |
| GG0130H2 | Put on/take off footwear (Dschg Goal) |
| GG0130H3 | Put on/take off footwear (Dschg Perf) |
| GG0170A1 | Roll left and right (Start of Stay Perf) |
| GG0170A2 | Roll left and right (Dschg Goal) |
| GG0170A3 | Roll left and right (Dschg Perf) |
| GG0170B1 | Sit to lying (Start of Stay Perf) |
| GG0170B2 | Sit to lying (Dschg Goal) |
| GG0170B3 | Sit to lying (Dschg Perf) |
| GG0170B5 | Sit to lying (Interim Perf) |
| GG0170C1 | Lying to sitting on bed side (Start of Stay Perf) |
| GG0170C2 | Lying to sitting on bed side (Dschg Goal) |
| GG0170C3 | Lying to sitting on bed side (Dschg Perf) |
| GG0170C5 | Lying to sitting on bed side (Interim Perf) |
| GG0170D1 | Sit to stand (Start of Stay Perf) |
| GG0170D2 | Sit to stand (Dschg Goal) |
| GG0170D3 | Sit to stand (Dschg Perf) |
| GG0170D5 | Sit to stand (Interim Perf) |
| GG0170E1 | Chair/bed-to-chair transfer (Start of Stay Perf) |
| GG0170E2 | Chair/bed-to-chair transfer (Dschg Goal) |
| GG0170E3 | Chair/bed-to-chair transfer (Dschg Perf) |
| GG0170E5 | Chair/bed-to-chair transfer (Interim Perf) |
| GG0170F1 | Toilet transfer (Start of Stay Perf) |
| GG0170F2 | Toilet transfer (Dschg Goal) |
| GG0170F3 | Toilet transfer (Dschg Perf) |
| GG0170F5 | Toilet transfer (Interim Perf) |
| GG0170G1 | Car transfer (Start of Stay Perf) |
| GG0170G2 | Car transfer (Dschg Goal) |
| GG0170G3 | Car transfer (Dschg Perf) |
| GG0170I1 | Walk 10 feet (Start of Stay Perf) |
| GG0170I2 | Walk 10 feet (Dschg Goal) |
| GG0170I3 | Walk 10 feet (Dschg Perf) |
| GG0170I5 | Walk 10 feet (Interim Perf) |
| GG0170J1 | Walk 50 feet with two turns (Start of Stay Perf) |
| GG0170J2 | Walk 50 feet with two turns (Dschg Goal) |
| GG0170J3 | Walk 50 feet with two turns (Dschg Perf) |
| GG0170J5 | Walk 50 feet with two turns (Interim Perf) |
| GG0170K1 | Walk 150 feet (Start of Stay Perf) |
| GG0170K2 | Walk 150 feet (Dschg Goal) |
| GG0170K3 | Walk 150 feet (Dschg Perf) |
| GG0170K5 | Walk 150 feet (Interim Perf) |
| GG0170L1 | Walking 10 feet uneven surf (Start of Stay Perf) |
| GG0170L2 | Walking 10 feet uneven surf (Dschg Goal) |
| GG0170L3 | Walking 10 feet uneven surf (Dschg Perf) |
| GG0170M1 | 1 step (curb) (Start of Stay Perf) |
| GG0170M2 | 1 step (curb) (Dschg Goal) |
| GG0170M3 | 1 step (curb) (Dschg Perf) |
| GG0170N1 | 4 steps (Start of Stay Perf) |
| GG0170N2 | 4 steps (Dschg Goal) |
| GG0170N3 | 4 steps (Dschg Perf) |
| GG0170O1 | 12 steps (Start of Stay Perf) |
| GG0170O2 | 12 steps (Dschg Goal) |
| GG0170O3 | 12 steps (Dschg Perf) |
| GG0170P1 | Picking up object (Start of Stay Perf) |
| GG0170P2 | Picking up object (Dschg Goal) |
| GG0170P3 | Picking up object (Dschg Perf) |
| GG0170Q1 | Use wheelchair and/or scooter (Start of Stay Perf) |
| GG0170Q3 | Use wheelchair and/or scooter (Dschg Perf) |
| GG0170R1 | Wheel 50 feet with two turns (Start of Stay Perf) |
| GG0170R2 | Wheel 50 feet with two turns (Dschg Goal) |
| GG0170R3 | Wheel 50 feet with two turns (Dschg Perf) |
| GG0170RR1 | Type of wheelchair or scooter (Start of Stay Perf) |
| GG0170RR3 | Type of wheelchair or scooter (Dschg Perf) |
| GG0170S1 | Wheel 150 feet (Start of Stay Perf) |
| GG0170S2 | Wheel 150 feet (Dschg Goal) |
| GG0170S3 | Wheel 150 feet (Dschg Perf) |
| GG0170SS1 | Type of wheelchair or scooter (Start of Stay Perf) |
| GG0170SS3 | Type of wheelchair or scooter (Dschg Perf) |
| H0100A | Appliances: indwelling catheter |
| H0100B | Appliances: external catheter |
| H0100C | Appliances: ostomy |
| H0100D | Appliances: intermittent catheterization |
| H0100Z | Appliances: none of the above |
| H0200A | Urinary toileting program: has been attempted |
| H0200B | Urinary toileting program: response |
| H0200C | Urinary toileting program: current program/trial |
| H0300 | Urinary continence |
| H0400 | Bowel continence |
| H0500 | Bowel toileting program being used |
| H0600 | Constipation |
| I0020 | Primary Medical Condition Category |
| I0100 | Cancer (with or without metastasis) |
| I0200 | Anemia |
| I0300 | Atrial fibrillation and other dysrhythmias |
| I0400 | Coronary artery disease (CAD) |
| I0500 | Deep venous thrombosis (DVT), PE, or PTE |
| I0600 | Heart failure |
| I0700 | Hypertension |
| I0800 | Orthostatic hypotension |
| I0900 | Peripheral vascular disease (PVD) or PAD |
| I1100 | Cirrhosis |
| I1200 | Gastroesophageal reflux disease (GERD) or ulcer |
| I1300 | Ulcerative colitis, Chrohn"s, inflam bowel disease |
| I1400 | Benign prostatic hyperplasia (BPH) |
| I1500 | Renal insufficiency, renal failure, ESRD |
| I1550 | Neurogenic bladder |
| I1650 | Obstructive uropathy |
| I1700 | Multidrug resistant organism (MDRO) |
| I2000 | Pneumonia |
| I2100 | Septicemia |
| I2200 | Tuberculosis |
| I2300 | Urinary tract infection (UTI) (LAST 30 DAYS) |
| I2400 | Viral hepatitis (includes type A, B, C, D, and E) |
| I2500 | Wound infection (other than foot) |
| I2900 | Diabetes mellitus (DM) |
| I3100 | Hyponatremia |
| I3200 | Hyperkalemia |
| I3300 | Hyperlipidemia (e.g., hypercholesterolemia) |
| I3400 | Thyroid disorder |
| I3700 | Arthritis |
| I3800 | Osteoporosis |
| I3900 | Hip fracture |
| I4000 | Other fracture |
| I4200 | Alzheimer"s disease |
| I4300 | Aphasia |
| I4400 | Cerebral palsy |
| I4500 | Cerebrovascular accident (CVA), TIA, or stroke |
| I4800 | Non-Alzheimer"s dementia |
| I4900 | Hemiplegia or hemiparesis |
| I5000 | Paraplegia |
| I5100 | Quadriplegia |
| I5200 | Multiple sclerosis |
| I5250 | Huntington"s disease |
| I5300 | Parkinson"s disease |
| I5350 | Tourette"s syndrome |
| I5400 | Seizure disorder or epilepsy |
| I5500 | Traumatic brain injury (TBI) |
| I5600 | Malnutrition (protein, calorie), risk of malnutrit |
| I5700 | Anxiety disorder |
| I5800 | Depression (other than bipolar) |
| I5900 | Bipolar disorder |
| I5950 | Psychotic disorder (other than schizophrenia) |
| I6000 | Schizophrenia |
| I6100 | Post-traumatic stress disorder (PTSD) |
| I6200 | Asthma (COPD) or chronic lung disease |
| I6300 | Respiratory failure |
| I6500 | Cataracts, glaucoma, or macular degeneration |
| I7900 | None of above active diseases within last 7 days |
| J0100A | Pain: received scheduled pain med regimen |
| J0100B | Pain: received PRN pain medications |
| J0100C | Pain: received non-medication intervention |
| J0200 | Should pain assessment interview be conducted |
| J0300 | Res pain interview: presence |
| J0400 | Res pain interview: frequency |
| J0500A | Res pain interview: made it hard to sleep |
| J0500B | Res pain interview: limited daily activities |
| J0600B | Res pain interview: verbal descriptor scale |
| J0700 | Should staff assessment for pain be conducted |
| J0800A | Staff pain asmt: non-verbal sounds |
| J0800B | Staff pain asmt: vocal complaints of pain |
| J0800C | Staff pain asmt: facial expressions |
| J0800D | Staff pain asmt: protective movements/postures |
| J0800Z | Staff pain asmt: none of these signs observed |
| J0850 | Staff pain asmt: frequency of pain |
| J1100A | Short breath/trouble breathing: with exertion |
| J1100B | Short breath/trouble breathing: sitting at rest |
| J1100C | Short breath/trouble breathing: lying flat |
| J1100Z | Short breath/trouble breathing: none of above |
| J1300 | Current tobacco use |
| J1400 | Prognosis: life expectancy of less than 6 months |
| J1550A | Problem conditions: fever |
| J1550B | Problem conditions: vomiting |
| J1550C | Problem conditions: dehydrated |
| J1550D | Problem conditions: internal bleeding |
| J1550Z | Problem conditions: none of the above |
| J1700A | Fall history: fall during month before admission |
| J1700B | Fall history: fall 2-6 months before admission |
| J1700C | Fall history: fracture from fall 6 month pre admit |
| J1800 | Falls since admit/prior asmt: any falls |
| J1900A | Falls since admit/prior asmt: no injury |
| J1900B | Falls since admit/prior asmt: injury (not major) |
| J1900C | Falls since admit/prior asmt: major injury |
| J2000 | Prior Surgery (100 days) |
| J2100 | Recent Surgery Requiring Active SNF Care |
| J2300 | Knee Replacement - partial or total |
| J2310 | Hip Replacement - partial or total |
| J2320 | Ankle Replacement - partial or total |
| J2330 | Shoulder Replacement - partial or total |
| J2400 | Spinal Surgery-spinal cord or major spinal nerves |
| J2410 | Spinal surgery - fusion of spinal bones |
| J2420 | Spinal surgery - lamina, discs, or facets |
| J2499 | Spinal surgery - other |
| J2500 | Ortho srgry - rpr frctrd shoulder/arm |
| J2510 | Ortho srgry - rpr frctrd pelvis/hip/leg/knee/ankle |
| J2520 | Ortho srgry - rpr but not replace joints |
| J2530 | Ortho srgry - rpr other bones |
| J2599 | Ortho srgry - other |
| J2600 | Neuro surgery - brain, surrounding tissue |
| J2610 | Neuro surgery - nervous system |
| J2620 | Neuro surgery - nsrt neural/brain neurostimulators |
| J2699 | Neuro surgery - other |
| J2700 | Cardiopulmonary surgery - heart/mjr bld vssls |
| J2710 | Cardiopulmonary surgery - respiratory system |
| J2799 | Cardiopulmonary surgery - other |
| J2800 | Genitourinary surgery - male or female organs |
| J2810 | Genitourinary surgery - kidneys |
| J2899 | Genitourinary surgery - other |
| J2900 | Major surgery - tendons, ligament, or muscles |
| J2910 | Major surgery - GI tract/abdominal contents |
| J2920 | Major surgery - endocrine organs |
| J2930 | Major surgery - breast |
| J2940 | Major surgery - repair deep ulcers |
| J5000 | Major surgery - other not listed above |
| K0100A | Swallow disorder: loss liquids/solids from mouth |
| K0100B | Swallow disorder: holds food in mouth/cheeks |
| K0100C | Swallow disorder: cough/choke with meals/meds |
| K0100D | Swallow disorder: difficulty or pain swallowing |
| K0100Z | Swallow disorder: none of the above |
| K0300 | Weight loss |
| K0310 | Weight Gain |
| K0510A1 | Nutrition approach: Not Res: parenteral/IV feeding |
| K0510A2 | Nutrition approach: Res: parenteral /IV feeding |
| K0510B1 | Nutrition approach: Not Res: feeding tube |
| K0510B2 | Nutrition approach: Res: feeding tube |
| K0510C2 | Nutrition approach: Res: mechanic altered diet |
| K0510D2 | Nutrition approach: Res: therapeutic diet |
| K0510Z1 | Nutrition approach: Not Res: none of the above |
| K0510Z2 | Nutrition approach: Res: none of the above |
| K0710A2 | Prop calories parenteral/tube feed: while resident |
| K0710A3 | Prop calories parenteral/tube feed: 7 days |
| K0710B2 | Avg fluid intake per day IV/ tube: while resident |
| K0710B3 | Avg fluid intake per day IV/tube: 7 days |
| L0200A | Dental: broken or loosely fitting denture |
| L0200B | Dental: no natural teeth or tooth fragment(s) |
| L0200C | Dental: abnormal mouth tissue |
| L0200D | Dental: cavity or broken natural teeth |
| L0200E | Dental: inflamed/bleeding gums or loose teeth |
| L0200F | Dental: pain, discomfort, difficulty chewing |
| L0200G | Dental: unable to examine |
| L0200Z | Dental: none of the above |
| M0100A | Risk determination: has PU/injury, scar, dressing |
| M0100B | Risk determination: formal assessment |
| M0100C | Risk determination: clinical assessment |
| M0100Z | Risk determination: none of the above |
| M0150 | Is resident at risk of developing PU/injuries |
| M0210 | Resident has 1+ unhealed PU/injuries |
| M1040A | Other skin probs: infection of the foot |
| M1040B | Other skin probs: diabetic foot ulcer(s) |
| M1040C | Other skin probs: other open lesion(s) on the foot |
| M1040D | Other skin probs: lesions not ulcers, rashes, cuts |
| M1040E | Other skin probs: surgical wound(s) |
| M1040F | Other skin probs: burns (second or third degree) |
| M1040G | Skin Tear(s) |
| M1040H | Moisture Associated Skin Damage (MASD) |
| M1040Z | Other skin probs: none of the above |
| M1200A | Skin/ulcer/injry treat: prssr rduce dvc for chair |
| M1200B | Skin/ulcer/injry treat: prssr reducing dvc for bed |
| M1200C | Skin/ulcer/injry treat: turning/repositioning |
| M1200D | Skin/ulcer/injry treat: nutrition/hydration |
| M1200E | Skin/ulcer/injry treat: prssr ulcer/injry care |
| M1200F | Skin/ulcer/injry treat: surgical wound care |
| M1200G | Skin/ulcer/injry treat: application of dressings |
| M1200H | Skin/ulcer/injry treat: apply ointments/meds |
| M1200I | Skin/ulcer/injry treat: apply dressings to feet |
| M1200Z | Skin/ulcer/injry treat: none of the above |
| N0450A | Resident received antipsychotic medications |
| N0450B | GDR attempted |
| N0450D | Physician documented GDR |
| N2001 | Drug Regimen Review |
| N2003 | Medication Follow-up |
| N2005 | Medication Intervention |
| O0100A1 | Treatment: chemotherapy - while not resident |
| O0100A2 | Treatment: chemotherapy - while resident |
| O0100B1 | Treatment: radiation - while not resident |
| O0100B2 | Treatment: radiation - while resident |
| O0100C1 | Treatment: oxygen therapy - while not resident |
| O0100C2 | Treatment: oxygen therapy - while resident |
| O0100D1 | Treatment: suctioning - while not resident |
| O0100D2 | Treatment: suctioning - while resident |
| O0100E1 | Treatment: tracheostomy care - while not resident |
| O0100E2 | Treatment: tracheostomy care - while resident |
| O0100F1 | Treat: Invsv Mech Vent - while not resident |
| O0100F2 | Treat: Invsv Mech Vent - while resident |
| O0100G1 | Treat: Non-invsv Mech Vent - while not resident |
| O0100G2 | Treat: Non-invsv Mech Vent - while resident |
| O0100H1 | Treatment: IV medications - while not resident |
| O0100H2 | Treatment: IV medications - while resident |
| O0100I1 | Treatment: transfusions - while not resident |
| O0100I2 | Treatment: transfusions - while resident |
| O0100J1 | Treatment: dialysis - while not resident |
| O0100J2 | Treatment: dialysis - while resident |
| O0100K1 | Treatment: hospice care - while not resident |
| O0100K2 | Treatment: hospice care - while resident |
| O0100M1 | Treatment: isolate/quarantine - while not resident |
| O0100M2 | Treatment: isolate/quarantine - while resident |
| O0100Z1 | Treatment: none of above - while not resident |
| O0100Z2 | Treatment: none of above - while resident |
| O0250A | Was influenza vaccine received |
| O0250C | If influenza vaccine not received, state reason |
| O0300A | Is pneumococcal vaccination up to date |
| O0300B | If pneumococcal vacc not received, state reason |
| O0450A | Has therapy resumed |
| P0100A | Restraints used in bed: bed rail |
| P0100B | Restraints used in bed: trunk restraint |
| P0100C | Restraints used in bed: limb restraint |
| P0100D | Restraints used in bed: other |
| P0100E | Restraints in chair/out of bed: trunk restraint |
| P0100F | Restraints in chair/out of bed: limb restraint |
| P0100G | Restraints in chair/out of bed: chair stops rising |
| P0100H | Restraints in chair/out of bed: other |
| P0200A | Bed alarm |
| P0200B | Chair alarm |
| P0200C | Floor mat alarm |
| P0200D | Motion sensor alarm |
| P0200E | Wander/elopement alarm |
| P0200F | Other alarm |
| Q0100A | Resident participated in assessment |
| Q0100B | Family/signif other participated in assessment |
| Q0100C | Guardian/legal rep participated in assessment |
| Q0300A | Resident"s overall goal |
| Q0300B | Information source for resident"s goal |
| Q0400A | Active discharge planning for return to community |
| Q0490 | Resident"s preference to avoid being asked |
| Q0500B | Do you want to talk about returning to community |
| Q0550A | Reasking resident preference |
| Q0550B | Reasking resident preference source |
| Q0600 | Referral been made to Local Contact Agency |
| V0100A | Prior OBRA reason for assessment |
| V0100B | Prior PPS reason for assessment |
| V0200A01A | CAA-Delirium: triggered |
| V0200A01B | CAA-Delirium: plan |
| V0200A02A | CAA-Cognitive loss/dementia: triggered |
| V0200A02B | CAA-Cognitive loss/dementia: plan |
| V0200A03A | CAA-Visual function: triggered |
| V0200A03B | CAA-Visual function: plan |
| V0200A04A | CAA-Communication: triggered |
| V0200A04B | CAA-Communication: plan |
| V0200A05A | CAA-ADL functional/rehab potential: triggered |
| V0200A05B | CAA-ADL functional/rehab potential: plan |
| V0200A06A | CAA-Urinary incont/indwell catheter: triggered |
| V0200A06B | CAA-Urinary incont/indwell catheter: plan |
| V0200A07A | CAA-Psychosocial well-being: triggered |
| V0200A07B | CAA-Psychosocial well-being: plan |
| V0200A08A | CAA-Mood state: triggered |
| V0200A08B | CAA-Mood state: plan |
| V0200A09A | CAA-Behavioral symptoms: triggered |
| V0200A09B | CAA-Behavioral symptoms: plan |
| V0200A10A | CAA-Activities: triggered |
| V0200A10B | CAA-Activities: plan |
| V0200A11A | CAA-Falls: triggered |
| V0200A11B | CAA-Falls: plan |
| V0200A12A | CAA-Nutritional status: triggered |
| V0200A12B | CAA-Nutritional status: plan |
| V0200A13A | CAA-Feeding tubes: triggered |
| V0200A13B | CAA-Feeding tubes: plan |
| V0200A14A | CAA-Dehydration/fluid maintenance: triggered |
| V0200A14B | CAA-Dehydration/fluid maintenance: plan |
| V0200A15A | CAA-Dental care: triggered |
| V0200A15B | CAA-Dental care: plan |
| V0200A16A | CAA-Pressure ulcer: triggered |
| V0200A16B | CAA-Pressure ulcer: plan |
| V0200A17A | CAA-Psychotropic drug use: triggered |
| V0200A17B | CAA-Psychotropic drug use: plan |
| V0200A18A | CAA-Physical restraints: triggered |
| V0200A18B | CAA-Physical restraints: plan |
| V0200A19A | CAA-Pain: triggered |
| V0200A19B | CAA-Pain: plan |
| V0200A20A | CAA-Return to community referral: triggered |
| V0200A20B | CAA-Return to community referral: plan |
| X0150 | Correction: type of provider |
| X0300 | Correction: resident gender |
| X0570A | Correction: Optional State Assessment Purpose |
| X0570B | Correction: Optional State Assessment Type |
| X0600A | Correction: OBRA reason for assessment |
| X0600B | Correction: PPS reason for assessment |
| X0600F | Correction: entry/discharge reporting |
| X0600H | Correction: SNF PPS Part A Discharge (End of Stay) |
| X0900A | Correction: modif reasons - transcription error |
| X0900B | Correction: modif reasons - data entry error |
| X0900C | Correction: modif reasons - software error |
| X0900D | Correction: modif reasons - item coding error |
| X0900Z | Correction: modif reasons - other error |
| X1050A | Correction: inact reasons - event did not occur |
| X1050Z | Correction: inact reasons - other reason |
| Z0200C | State case mix: Short Stay Assessment |
NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 08/20/2019 08:20:02 AM