-1010
Property | Specification |
Data System | IRF-PAI |
Data Specs | V2.00.1 |
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 | [V2.00.0]-The following items were removed from this edit: ITM_SET_VRSN_CD, SPEC_VRSN_CD, I0900A, I0900B, I2900A, I2900B, I2900C, I2900D, M0300A2_2, M0300A3_2, M0300B3_2, M0300B4_2, M0300C3_2, M0300C4_2, M0300D3_2, M0300D4_2, M0300E3_2, M0300F3_2, M0900A. The following items were added for this edit: BB0700, BB0800, C0100, C0200, C0300A, C0300B, C0300C, C0400A, C0400B, C0400C, C0500, C0600, C0900A, C0900B, C0900C, C0900E, C0900Z, GG0100A, GG0100B, GG0100C, GG0100D, GG0110A, GG0110B, GG0110C, GG0110D, GG0110E, GG0110Z, GG0130A1, GG0130A2, GG0130A3, GG0130B1, GG0130B2, GG0130B3, GG0130C1, GG0130C2, GG0130C3, GG0130E1, GG0130E2, GG0130E3, GG0130F1, GG0130F2, GG0130F3, GG0130G1, GG0130G2, GG0130G3, GG0130H1, GG0130H2, GG0130H3, GG0170A1, GG0170A2, GG0170A3, GG0170B1, GG0170B2, GG0170B3, GG0170C1, GG0170C2, GG0170C3, GG0170D1, GG0170D2, GG0170D3, GG0170E1, GG0170E2, GG0170E3, GG0170F1, GG0170F2, GG0170F3, GG0170G1, GG0170G2, GG0170G3, GG0170H1, GG0170H3, GG0170I1, GG0170I2, GG0170I3, GG0170J1, GG0170J2, GG0170J3, GG0170K1, GG0170K2, GG0170K3, GG0170L1, GG0170L2, GG0170L3, GG0170M1, GG0170M2, GG0170M3, GG0170N1, GG0170N2, GG0170N3, GG0170O1, GG0170O2, GG0170O3, GG0170P1, GG0170P2, GG0170P3, GG0170Q1, GG0170Q3, GG0170R1, GG0170R2, GG0170R3, GG0170RR1, GG0170RR3, GG0170S1, GG0170S2, GG0170S3, GG0170SS1, GG0170SS3, H0350, H0400, I0900, I2900, I7900, J1750, J1800, J1900A, J1900B, J1900C, J2000, K0110A, K0110B, K0110C, M0800A, M0800B, M0800C, M0800D, M0800E, M0800F, M0900A1, O0100N. |
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 |
27A | Swallowing Status: Admission |
27D | Swallowing Status: Discharge |
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 | Understanding Verbal 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 Ability - Current Season |
C0900B | Memory/Recall Ability - Location Of Own Room |
C0900C | Memory/Recall Ability - Staff Names and Faces |
C0900E | Memory/Recall Ability - In Hospital unit |
C0900Z | Memory/Recall Ability - None Of The Above |
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 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 |
GG0170H1 | Does the patient walk (Adm) |
GG0170H3 | Does the patient walk (Dschg) |
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 the patient use a wheelchair/scooter (Adm) |
GG0170Q3 | Does the patient use a wheelchair/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 the type of wheelchair/scooter (Adm) |
GG0170RR3 | Indicate the type of wheelchair/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 the type of wheelchair/scooter (Adm) |
GG0170SS3 | Indicate the type of wheelchair/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 Present on Admission |
M0210_2 | Pressure Ulcers Present on Discharge |
M0300A1_1 | Number of Stage 1 pressure ulcers: Admission |
M0300A1_2 | Number of Stage 1 pressure ulcers: 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 pressure ulcers: Adm |
M0300E1_2 | Nbr Unstg non-remov drsg pressure ulcers: Dschrg |
M0300E2_2 | Nbr Unstg NRD Disch PU were Adm Unstg NRD PU |
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 ulcers: Adm |
M0300G1_2 | Nbr Unstg DTI pressure ulcers: Dschrg |
M0300G2_2 | Nbr Unstg DTI Disch PU were Adm Unstg DTI PU |
M0800A | Worsened: Stage 2 pressure ulcers |
M0800B | Worsened: Stage 3 pressure ulcers |
M0800C | Worsened: Stage 4 pressure ulcers |
M0800D | Worsened: Unstageable - Non-removable dressing |
M0800E | Worsened: Unstageable - Slough and/or eschar |
M0800F | Worsened: Unstageable - Deep tissue injury |
M0900A1 | Number of Stage 1 Healed Pressure Ulcers |
M0900B | Number of Stage 2 Healed Pressure Ulcers |
M0900C | Number of Stage 3 Healed Pressure Ulcers |
M0900D | Number of Stage 4 Healed Pressure Ulcers |
O0100N | Total Parenteral Nutrition |
O0250A | Was influenza vaccine received |
O0250C | If influenza vaccine not received, state reason |
NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 08/31/2016 10:31:00 AM