-5004
Property | Specification |
Data System | IRF-PAI |
Data Specs | V5.02.1 |
Edit Type | Consistency |
Severity | Warning |
Edit Text | A dash (-) submitted in this item may result in a payment reduction for your facility of two percentage points for the applicable FY annual increase factor. |
Version Notes | [V5.02.0]-Added mapping to new item O0350. Added mappings to the M0300 admission items. Removed mappings to D0160_1 and D0160_2. |
Item List | |
Item ID | Description |
25A | Height |
26A | Weight |
A1110A | Preferred language |
B0200 | Hearing |
B1000 | Vision |
C0100 | Brief Interview - Mental Status (BIMS) (Adm) |
C0100_2 | Brief Interview - Mental Status (BIMS) (Dsch) |
C0200 | BIMS - Repetition of Three Words (Adm) |
C0200_2 | BIMS - Repetition of Three Words (Dsch) |
C0300A | BIMS - Temporal Orientation - Year (Adm) |
C0300A_2 | BIMS - Temporal Orientation - Year (Dsch) |
C0300B | BIMS - Temporal Orientation - Month (Adm) |
C0300B_2 | BIMS - Temporal Orientation - Month (Dsch) |
C0300C | BIMS - Temporal Orientation - Day (Adm) |
C0300C_2 | BIMS - Temporal Orientation - Day (Dsch) |
C0500 | BIMS - Summary Score (Adm) |
C0500_2 | BIMS - Summary Score (Dsch) |
C1310A_1 | Delirium: Acute Onset Mental Status Change (Adm) |
C1310A_2 | Delirium: Acute Onset Mental Status Change (Dsch) |
C1310B_1 | Delirium: Inattention (Adm) |
C1310B_2 | Delirium: Inattention (Dsch) |
C1310C_1 | Delirium: Disorganized thinking (Adm) |
C1310C_2 | Delirium: Disorganized thinking (Dsch) |
C1310D_1 | Delirium: Altered level of consciousness (Adm) |
C1310D_2 | Delirium: Altered level of consciousness (Dsch) |
D0150A1_1 | Mood: Little interest/pleasure doing things: P (A) |
D0150A1_2 | Mood: Little interest/pleasure doing things: P (D) |
D0150B1_1 | Mood: Feeling down, depressed, or hopeless: P (A) |
D0150B1_2 | Mood: Feeling down, depressed, or hopeless: P (D) |
D0150C1_1 | Mood: Trouble falling or staying asleep: P (A) |
D0150C1_2 | Mood: Trouble falling or staying asleep: P (D) |
D0150D1_1 | Mood: Feeling tired or having little energy: P (A) |
D0150D1_2 | Mood: Feeling tired or having little energy: P (D) |
D0150E1_1 | Mood: Poor appetite or overeating: P (A) |
D0150E1_2 | Mood: Poor appetite or overeating: P (D) |
D0150F1_1 | Mood: Feeling bad about yourself: P (A) |
D0150F1_2 | Mood: Feeling bad about yourself: P (D) |
D0150G1_1 | Mood: Trouble concentrating on things: P (A) |
D0150G1_2 | Mood: Trouble concentrating on things: P (D) |
D0150H1_1 | Mood: Moving or speaking so slowly: P (A) |
D0150H1_2 | Mood: Moving or speaking so slowly: P (D) |
D0150I1_1 | Mood: Thoughts of better off dead: P (A) |
D0150I1_2 | Mood: Thoughts of better off dead: P (D) |
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 |
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 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 |
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 |
GG0170S3 | Func Mobil (Dschg Perf) - Wheel 150 feet |
GG0170SS1 | Indicate type of wheelchair or scooter (Adm) |
GG0170SS3 | Indicate type of wheelchair or scooter (Dschg) |
H0400 | Bowel Continence |
I0900 | Diagnoses: Peripheral vascular disease (PVD)/PAD |
I2900 | Diagnoses: Diabetes mellitus (DM) |
J1900C | Num Falls Since Admission - Major injury |
K0520A1 | Nutritional Approaches (Admission): Parenteral |
K0520A4 | Nutritional Approaches (7 days): Parenteral |
K0520A5 | Nutritional Approaches (Discharge): Parenteral |
K0520B1 | Nutritional Approaches (Admission): Feeding tube |
K0520B4 | Nutritional Approaches (7 days): Feeding tube |
K0520B5 | Nutritional Approaches (Discharge): Feeding Tube |
K0520C1 | Nutritional Approaches (Admission) : Mech Alt Diet |
K0520C4 | Nutritional Approaches (7 days): Mech Alt Diet |
K0520C5 | Nutritional Approaches (Discharge): Mech Alt Diet |
K0520D1 | Nutritional Approaches (Admission) : Therapeutic |
K0520D4 | Nutritional Approaches (7 day): Therapeutic |
K0520D5 | Nutritional Approaches (Discharge): Therapeutic |
K0520Z1 | Nutritional Approaches (Admission) : None |
K0520Z4 | Nutritional Approaches (7 days): None |
K0520Z5 | Nutritional Approaches (Discharge): None |
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 |
N0415A1_1 | High-Risk Drug (Is Taking): Antipsychotic (Adm) |
N0415A1_2 | High-Risk Drug (Is Taking): Antipsychotic (Dsch) |
N0415A2_1 | High-Risk Drug (Indication) : Antipsychotic (Adm) |
N0415A2_2 | High-Risk Drug (Indication) : Antipsychotic (Dsch) |
N0415E1_1 | High-Risk Drug (Is taking): Anticoagulant (Adm) |
N0415E1_2 | High-Risk Drug (Is taking): Anticoagulant (Dsch) |
N0415E2_1 | High-Risk Drug (Indication): Anticoagulant (Adm) |
N0415E2_2 | High-Risk Drug (Indication): Anticoagulant (Dsch) |
N0415F1_1 | High-Risk Drug (Is taking): Antibiotic (Adm) |
N0415F1_2 | High-Risk Drug (Is taking): Antibiotic (Dsch) |
N0415F2_1 | High-Risk Drug (Indication): Antibiotic (Adm) |
N0415F2_2 | High-Risk Drug (Indication): Antibiotic (Dsch) |
N0415H1_1 | High-Risk Drug (Is taking): Opioid (Adm) |
N0415H1_2 | High-Risk Drug (Is taking): Opioid (Dsch) |
N0415H2_1 | High-Drug Risk (Indication): Opioid (Adm) |
N0415H2_2 | High-Drug Risk (Indication): Opioid (Dsch) |
N0415I1_1 | High-Risk Drug (Is taking): Antiplatelet (Adm) |
N0415I1_2 | High-Risk Drug (Is taking): Antiplatelet (Dsch) |
N0415I2_1 | High-Risk Drug (Indication): Antiplatelet (Adm) |
N0415I2_2 | High-Risk Drug (Indication): Antiplatelet (Dsch) |
N0415J1_1 | High-Risk Drug (Is taking): Hypoglycemic (Adm) |
N0415J1_2 | High-Risk Drug (Is taking): Hypoglycemic (Dsch) |
N0415J2_1 | High-Risk Drug (Indication): Hypoglycemic (Adm) |
N0415J2_2 | High-Risk Drug (Indication): Hypoglycemic (Dsch) |
N0415Z1_1 | High-Risk Drug (Is taking): None of above (Adm) |
N0415Z1_2 | High-Risk Drug (Is taking): None of above (Dsch) |
N2001 | Drug Regimen Review |
N2003 | Medication Follow-up |
N2005 | Medication Intervention |
O0110A1A | Treatment: Chemotherapy (Admission) |
O0110A1C | Treatment: Chemotherapy (Discharge) |
O0110A2A | Treatment: Chemo - IV (Admission) |
O0110A2C | Treatment: Chemo - IV (Discharge) |
O0110A3A | Treatment: Chemo - Oral (Admission) |
O0110A3C | Treatment: Chemo - Oral (Discharge) |
O0110A10A | Treatment: Chemo - Other (Admission) |
O0110A10C | Treatment: Chemo - Other (Discharge) |
O0110B1A | Treatment: Radiation (Admission) |
O0110B1C | Treatment: Radiation (Discharge) |
O0110C1A | Therapies: Oxygen Therapy (Admission) |
O0110C1C | Therapies: Oxygen Therapy (Discharge) |
O0110C2A | Therapies: Oxygen - Continuous (Admission) |
O0110C2C | Therapies: Oxygen - Continuous (Discharge) |
O0110C3A | Therapies: Oxygen - Intermittent (Admission) |
O0110C3C | Therapies: Oxygen - Intermittent (Discharge) |
O0110C4A | Therapies: Oxygen - High-concentration (Admission) |
O0110C4C | Therapies: Oxygen - High-concentration (Discharge) |
O0110D1A | Therapies: Suctioning (Admission) |
O0110D1C | Therapies: Suctioning (Discharge) |
O0110D2A | Therapies: Suctioning - Scheduled (Admission) |
O0110D2C | Therapies: Suctioning - Scheduled (Discharge) |
O0110D3A | Therapies: Suctioning - As Needed (Admission) |
O0110D3C | Therapies: Suctioning - As Needed (Discharge) |
O0110E1A | Therapies: Tracheostomy Care (Admission) |
O0110E1C | Therapies: Tracheostomy Care (Discharge) |
O0110F1A | Therapies: Invasive Mechanical Ventilator (Admis) |
O0110F1C | Therapies: Invasive Mechanical Ventilator (Disch) |
O0110G1A | Therapies: Non-Invas Mechanical Ventilator (Admis) |
O0110G1C | Therapies: Non-Invas Mechanical Ventilator (Disch) |
O0110G2A | Therapies: BiPAP (Admission) |
O0110G2C | Therapies: BiPAP (Discharge) |
O0110G3A | Therapies: CPAP (Admission) |
O0110G3C | Therapies: CPAP (Discharge) |
O0110H1A | Other: IV Medications (Admission) |
O0110H1C | Other: IV Medications (Discharge) |
O0110H2A | Other: IV - Vasoactive medications (Admission) |
O0110H2C | Other: IV - Vasoactive medications (Discharge) |
O0110H3A | Other: IV - Antibiotics (Admission) |
O0110H3C | Other: IV - Antibiotics (Discharge) |
O0110H4A | Other: IV - Anticoagulation (Admission) |
O0110H4C | Other: IV - Anticoagulation (Discharge) |
O0110H10A | Other: IV - Other (Admission) |
O0110H10C | Other: IV - Other (Discharge) |
O0110I1A | Other: Transfusions (Admission) |
O0110I1C | Other: Transfusions (Discharge) |
O0110J1A | Other: Dialysis (Admission) |
O0110J1C | Other: Dialysis (Discharge) |
O0110J2A | Other: Hemodialysis (Admission) |
O0110J2C | Other: Hemodialysis (Discharge) |
O0110J3A | Other: Peritoneal dialysis (Admission) |
O0110J3C | Other: Peritoneal dialysis (Discharge) |
O0110O1A | Other: IV Access (Admission) |
O0110O1C | Other: IV Access (Discharge) |
O0110O2A | Other: IV Access - Peripheral (Admission) |
O0110O2C | Other: IV Access - Peripheral (Discharge) |
O0110O3A | Other: IV Access - Midline (Admission) |
O0110O3C | Other: IV Access - Midline (Discharge) |
O0110O4A | Other: IV Access - Central (Admission) |
O0110O4C | Other: IV Access - Central (Discharge) |
O0110Z1A | Other: None of the above (Admission) |
O0110Z1C | Other: None of the above (Discharge) |
O0350 | COVID-19 Vaccination Up To Date |
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Generated: 06/05/2024 02:10:29 PM