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Property Specification
Data System IRF-PAI
Data Specs V2.01.1
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 [V2.01.0.]-Removed mappings to deleted items 27A and 27D.

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 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

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Generated: 08/17/2017 04:43:12 PM