Record Layout Report

Fri Nov 17 02:00:08 EST 2017 QIES Workbench
Record Layout Report
For Job: DUA # 16702 Q4 2010 ( 166497.1 )
Report Name: DUA # 16702

Data Type Offset Length DP Field Name

CHAR 1 2 0 State Code

NUM 3 10 0 Facility/Provider Internal ID

NUM 13 10 0 Resident Internal ID

NUM 23 15 0 Assessment ID

CHAR 38 4 0 Item Subset Code (ISC)

DATE 42 8 0 Target Date

DATE 50 8 0 Submission Date

NUM 58 22 0 Submission ID

CHAR 80 1 0 Submission Required Code (SUB_REQ)

CHAR 81 1 0 Birth Date Submit Code

NUM 82 2 0 Correction Number

CHAR 84 1 0 Correction Status Code

CHAR 85 10 0 Data Submission Specification Version Code

CHAR 95 20 0 Facility Document Identifier

CHAR 115 10 0 Item Set Version Code

NUM 125 22 0 Original Assessment ID

DATE 147 8 0 Processed Timestamp

NUM 155 8 0 Resident Age

NUM 163 2 0 Resident Match Criteria ID

CHAR 165 50 0 Software Product Name

CHAR 215 20 0 Software Product Version

CHAR 235 1 0 CBSA Urban/Rural Code

CHAR 236 7 0 Recalculated Z0100A

CHAR 243 10 0 Recalculated Z0100B

CHAR 253 1 0 Recalculated Z0100C

CHAR 254 3 0 CMI Set for Recalculated Z0100A

CHAR 257 7 0 CMI Value for Recalculated Z0100A

CHAR 264 7 0 Recalculated Z0150A

CHAR 271 10 0 Recalculated Z0150B

CHAR 281 3 0 CMI Set for Recalculated Z0150A

CHAR 284 7 0 CMI Value for Recalculated Z0150A

CHAR 291 10 0 Recalculated Z0200A

CHAR 301 10 0 Recalculated Z0200B

CHAR 311 3 0 CMI Set for Recalculated Z0200A

CHAR 314 7 0 CMI Value for Recalculated Z0200A

CHAR 321 10 0 Recalculated Z0250A

CHAR 331 10 0 Recalculated Z0250B

CHAR 341 3 0 CMI Set for Recalculated Z0250A

CHAR 344 7 0 CMI Value for Recalculated Z0250A

CHAR 351 10 0 Medicare RUG III Index Maximized Group

CHAR 361 10 0 Medicare RUG III Index Maximized Version

CHAR 371 3 0 Medicare RUG III Index Maximized CMI Set

CHAR 374 7 0 Medicare RUG III Index Maximized CMI Value

CHAR 381 10 0 Medicare RUG III Hierarchical Group

CHAR 391 10 0 Medicare RUG III Hierarchical Version

CHAR 401 10 0 Medicare RUG IV Hierarchical Group

CHAR 411 10 0 Medicare RUG IV Hierarchical Version

CHAR 421 12 0 Calculated CCN

CHAR 433 1 0 A0050 Type of Record Code

CHAR 434 10 0 A0100A Facility National Provider Identifier (NPI)

CHAR 444 12 0 A0100B Facility CMS Certification Number (CCN)

CHAR 456 15 0 A0100C State Provider Number

CHAR 471 1 0 A0200 Type of Provider

CHAR 472 2 0 A0310A Federal OBRA Reason for Assessment Code

CHAR 474 2 0 A0310B PPS Assessment Code

CHAR 476 1 0 A0310C PPS Other Medicare Required Assessment (OMRA) Code

CHAR 477 1 0 A0310D Swing Bed Clinical Change Code

CHAR 478 1 0 A0310E First Assessment Since Most Recent Admission Code

CHAR 479 2 0 A0310F Entry/Discharge Code

CHAR 481 1 0 A0310G Planned Discharge Code

CHAR 482 1 0 A0310H SNF PPS Part A Discharge Assessment

CHAR 483 1 0 A0410 Submission Required Code

CHAR 484 1 0 A0800 Gender

DATE 485 8 0 A0900 Birth Date

CHAR 493 1 0 A1000A Race/Ethnicity: American Indian or Alaskan Native Code

CHAR 494 1 0 A1000B Race/Ethnicity: Asian Code

CHAR 495 1 0 A1000C Race/Ethnicity: African American Code

CHAR 496 1 0 A1000D Race/Ethnicity: Hispanic Code

CHAR 497 1 0 A1000E Race/Ethnicity: Native Hawaiian/Pacific Islander Code

CHAR 498 1 0 A1000F Race/Ethnicity: White Code

CHAR 499 1 0 A1100A Resident Need Interpreter Code

CHAR 500 15 0 A1100B Preferred Language

CHAR 515 1 0 A1200 Marital Status Code

CHAR 516 12 0 A1300A Medical Record Number

CHAR 528 10 0 A1300B Room Number

CHAR 538 23 0 A1300C Preferred Name

CHAR 561 23 0 A1300D Lifetime Occupation(s) Text

CHAR 584 1 0 A1500 Preadmission Screening and Resident Review (PASRR) Code

CHAR 585 1 0 A1510A Serious Mental Illness Code

CHAR 586 1 0 A1510B Intellectual Disability Code

CHAR 587 1 0 A1510C Other Related Conditions Code

CHAR 588 1 0 A1550A ID/DD Status: Down Syndrome Code

CHAR 589 1 0 A1550B ID/DD Status: Autism Code

CHAR 590 1 0 A1550C ID/DD Status: Epilepsy Code

CHAR 591 1 0 A1550D ID/DD Status: Other Organic ID/DD Condition Code

CHAR 592 1 0 A1550E ID/DD Status: ID/DD With No Organic Condition Code

CHAR 593 1 0 A1550Z ID/DD Status: None of the Above

DATE 594 8 0 A1600 Entry Date

CHAR 602 1 0 A1700 Type of Entry Code

CHAR 603 2 0 A1800 Entered From Code

DATE 605 8 0 A1900 Admission Date

CHAR 613 8 0 A2000 Discharge Date

CHAR 621 2 0 A2100 Discharge Status Code

CHAR 623 8 0 A2200 Previous Assessment Reference Date For Significant Correction

DATE 631 8 0 A2300 Assessment Reference Date

CHAR 639 1 0 A2400A Has Resident Had a Medicare Stay Code Since Most Recent Admission

CHAR 640 8 0 A2400B Start Date of Most Recent Medicare Stay

CHAR 648 8 0 A2400C End Date of Most Recent Medicare Stay

CHAR 656 1 0 B0100 Comatose Code

CHAR 657 1 0 B0200 Hearing Code

CHAR 658 1 0 B0300 Hearing Aide Code

CHAR 659 1 0 B0600 Speech Clarity Code

CHAR 660 1 0 B0700 Makes Self Understood Code

CHAR 661 1 0 B0800 Ability to Understand Others Code

CHAR 662 1 0 B1000 Vision Code

CHAR 663 1 0 B1200 Corrective Lenses Code

CHAR 664 1 0 C0100 Brief Interview for Mental Status Be Conducted Code

CHAR 665 1 0 C0200 BIMS: Number of Words Repeated After First Attempt

CHAR 666 1 0 C0300A BIMS: Temporal Orientation - Able to Report Correct Year

CHAR 667 1 0 C0300B BIMS: Temporal Orientation - Able to Report Correct Month

CHAR 668 1 0 C0300C BIMS: Temporal Orientation - Able to Report Correct Day of Week

CHAR 669 1 0 C0400A BIMS: Recall - Able to Recall Sock

CHAR 670 1 0 C0400B BIMS: Recall - Able to Recall Blue

CHAR 671 1 0 C0400C BIMS: Recall - Able to Recall Bed

CHAR 672 2 0 C0500 Brief Interview for Mental Status (BIMS) Score Number

CHAR 674 1 0 C0600 Staff to Conduct Brief Interview for Mental Status

CHAR 675 1 0 C0700 Staff Assessment of Mental Status - Short Term Memory Code

CHAR 676 1 0 C0800 Staff Assessment of Mental Status - Long Term Memory Code

CHAR 677 1 0 Staff Assessment of Mental Status - Recalls Current Season Code

CHAR 678 1 0 Staff Assessment of Mental Status - Recalls Location of Room Code

CHAR 679 1 0 Staff Assessment of Mental Status - Recalls Staff Name Code

CHAR 680 1 0 Staff Assessment of Mental Status - Recalls Nursing Home Code

CHAR 681 1 0 C0900Z Staff Assessment of Mental Status - Recalls None of Above Code

CHAR 682 1 0 C1000 Cognitive Skills for Decision Making Code

CHAR 683 1 0 C1300A Signs and Symptoms of Delirium - Inattention

CHAR 684 1 0 C1300B Signs and Symptoms of Delirium - Disorganized Thinking

CHAR 685 1 0 C1300C Signs and Symptoms of Delirium - Altered Level of Consciousness

CHAR 686 1 0 C1300D Signs and Symptoms of Delirium - Psychomotor Retardation

CHAR 687 1 0 C1310A Acute Mental Status Change

CHAR 688 1 0 C1310B Signs and Symptoms of Delirium: Inattention

CHAR 689 1 0 C1310C Signs and Symptoms of Delirium: Disorganized Thinking

CHAR 690 1 0 C1310D Signs and Symptoms of Delirium: Altered Level of Consciousness

CHAR 691 1 0 C1600 Acute Onset Mental Status Change

CHAR 692 1 0 D0100 Resident Mood Interview Be Conducted Code

CHAR 693 1 0 D0200A1 Resident Mood Interview - Interest Loss Code

CHAR 694 1 0 D0200A2 Resident Mood Interview - Interest Loss Frequency Code

CHAR 695 1 0 D0200B1 Resident Mood Interview - Feel Down Code

CHAR 696 1 0 D0200B2 Resident Mood Interview - Feel Down Frequency Code

CHAR 697 1 0 D0200C1 Resident Mood Interview - Trouble Sleep Code

CHAR 698 1 0 D0200C2 Resident Mood Interview - Trouble Sleep Frequency Code

CHAR 699 1 0 D0200D1 Resident Mood Interview - Little Energy Code

CHAR 700 1 0 D0200D2 Resident Mood Interview - Little Energy Frequency Code

CHAR 701 1 0 D0200E1 Resident Mood Interview - Poor Appetite Code

CHAR 702 1 0 D0200E2 Resident Mood Interview - Poor Appetite Frequency Code

CHAR 703 1 0 D0200F1 Resident Mood Interview - Self Depreciation Code

CHAR 704 1 0 D0200F2 Resident Mood Interview - Self Depreciation Frequency Code

CHAR 705 1 0 D0200G1 Resident Mood Interview - Lack of Concentration Code

CHAR 706 1 0 D0200G2 Resident Mood Interview - Lack of Concentration Frequency Code

CHAR 707 1 0 D0200H1 Resident Mood Interview - Movement Different Code

CHAR 708 1 0 D0200H2 Resident Mood Interview - Movement Different Frequency Code

CHAR 709 1 0 D0200I1 Resident Mood Interview - Negative Statement Code

CHAR 710 1 0 D0200I2 Resident Mood Interview - Negative Statement Frequency Code

CHAR 711 2 0 D0300 Resident Mood Interview - Total Severity Mood Score Code

CHAR 713 1 0 D0350 Resident Mood Interview - Negative Statements Notify Staff Code

CHAR 714 1 0 D0500A1 Staff Assessment of Resident Mood - Interest Loss Code

CHAR 715 1 0 D0500A2 Staff Assessment of Resident Mood - Interest Loss Frequency Code

CHAR 716 1 0 D0500B1 Staff Assessment of Resident Mood - Feel Down Code

CHAR 717 1 0 D0500B2 Staff Assessment of Resident Mood - Feel Down Frequency Code

CHAR 718 1 0 D0500C1 Staff Assessment of Resident Mood - Trouble Sleep Code

CHAR 719 1 0 D0500C2 Staff Assessment of Resident Mood - Trouble Sleep Frequency Code

CHAR 720 1 0 D0500D1 Staff Assessment of Resident Mood - Little Energy Code

CHAR 721 1 0 D0500D2 Staff Assessment of Resident Mood - Little Energy Frequency Code

CHAR 722 1 0 D0500E1 Staff Assessment of Resident Mood - Poor Appetite Code

CHAR 723 1 0 D0500E2 Staff Assessment of Resident Mood - Poor Appetite Frequency Code

CHAR 724 1 0 D0500F1 Staff Assessment of Resident Mood - Self Depreciation Code

CHAR 725 1 0 D0500F2 Staff Assessment of Resident Mood - Self Depreciation Frequency Code

CHAR 726 1 0 D0500G1 Staff Assessment of Resident Mood - Concentration Code

CHAR 727 1 0 D0500G2 Staff Assessment of Resident Mood - Concentration Frequency Code

CHAR 728 1 0 D0500H1 Staff Assessment of Resident Mood - Movement Different Code

CHAR 729 1 0 D0500H2 Staff Assessment of Resident Mood - Movement Different Frequency Code

CHAR 730 1 0 D0500I1 Staff Assessment of Resident Mood - Negative Statement Code

CHAR 731 1 0 D0500I2 Staff Assessment of Resident Mood - Negative Statement Frequency Code

CHAR 732 1 0 D0500J1 Staff Assessment of Resident Mood - Short Temper Code

CHAR 733 1 0 D0500J2 Staff Assessment of Resident Mood - Short Temper Frequency Code

CHAR 734 2 0 D0600 Staff Assessment Total Severity Mood Score

CHAR 736 1 0 D0650 Staff Assessment of Resident Mood - Negative Statement Notify Code

CHAR 737 1 0 E0100A Behavior: Hallucinations Code

CHAR 738 1 0 E0100B Behavior: Delusion Code

CHAR 739 1 0 E0100Z Behavior: No Psychosis Code

CHAR 740 1 0 E0200A Behavior: Physical Behavioral Code

CHAR 741 1 0 E0200B Behavior: Verbal Behavioral Code

CHAR 742 1 0 E0200C Behavior: Other Behavioral Code

CHAR 743 1 0 E0300 Overall Presence of Behavioral Symptoms

CHAR 744 1 0 E0500A Behavior Impact on Resident: Risk to Injure Self

CHAR 745 1 0 E0500B Behavior Impact on Resident: Interferes With Care

CHAR 746 1 0 E0500C Behavior Impact on Resident: Interferes With Participation

CHAR 747 1 0 E0600A Behavior Impact on Others: Risk to Injure Others

CHAR 748 1 0 E0600B Behavior Impact on Others: Intrude On Privacy of Others

CHAR 749 1 0 E0600C Behavior Impact on Others: Disrupt Care or Living Environment

CHAR 750 1 0 E0800 Rejection of Care: Presence and Frequency

CHAR 751 1 0 E0900 Wandering: Presence and Frequency

CHAR 752 1 0 E1000A Wander Risk Impact

CHAR 753 1 0 E1000B Wandering Intrudes on Privacy of Others

CHAR 754 1 0 E1100 Change in Behavior or Other Symptoms

CHAR 755 1 0 F0300 Should Daily and Activity Preference Interview Be Conducted

CHAR 756 1 0 F0400A Interview for Daily Preferences: Chooses Clothes Code

CHAR 757 1 0 F0400B Interview for Daily Preferences: Care Personal Items Code

CHAR 758 1 0 F0400C Interview for Daily Preferences: Bathing Option Code

CHAR 759 1 0 F0400D Interview for Daily Preferences: Snack Between Meals Code

CHAR 760 1 0 F0400E Interview for Daily Preferences: Choose Bed Time Code

CHAR 761 1 0 F0400F Interview for Daily Preferences: Family Involvement Code

CHAR 762 1 0 F0400G Interview for Daily Preferences: Private Phone Time Code

CHAR 763 1 0 F0400H Interview for Daily Preferences: Lock Item Code

CHAR 764 1 0 F0500A Interview for Activity Preferences: Reading Materials Available Code

CHAR 765 1 0 F0500B Interview for Activity Preferences: Music Code

CHAR 766 1 0 F0500C Interview for Activity Preferences: Animal Presence Code

CHAR 767 1 0 F0500D Interview for Activity Preferences: News Code

CHAR 768 1 0 F0500E Interview for Activity Preferences: Group Activity Code

CHAR 769 1 0 F0500F Interview for Activity Preferences: Favorite Activity Code

CHAR 770 1 0 F0500G Interview for Activity Preferences: Time Outdoors Code

CHAR 771 1 0 F0500H Interview for Activity Preferences: Religion Code

CHAR 772 1 0 F0600 Daily and Activity Preferences Primary Respondent Code

CHAR 773 1 0 F0700 Conduct Staff Assessment of Daily and Activity Preferences Code

CHAR 774 1 0 F0800A Staff Assessment: Chooses Clothes Code

CHAR 775 1 0 F0800B Staff Assessment: Care Personal Item Code

CHAR 776 1 0 F0800C Staff Assessment: Tub Bath Code

CHAR 777 1 0 F0800D Staff Assessment: Shower Code

CHAR 778 1 0 F0800E Staff Assessment: Bed Bath Code

CHAR 779 1 0 F0800F Staff Assessment: Sponge Bath Code

CHAR 780 1 0 F0800G Staff Assessment: Snacks Between Code

CHAR 781 1 0 F0800H Staff Assessment: Bed Time Code

CHAR 782 1 0 F0800I Staff Assessment: Family Involvement Code

CHAR 783 1 0 F0800J Staff Assessment: Private Phone Code

CHAR 784 1 0 F0800K Staff Assessment: Lock Item Code

CHAR 785 1 0 F0800L Staff Assessment: Reading Materials Available Code

CHAR 786 1 0 F0800M Staff Assessment: Music Code

CHAR 787 1 0 F0800N Staff Assessment: Animal Presence Code

CHAR 788 1 0 F0800O Staff Assessment: News Code

CHAR 789 1 0 F0800P Staff Assessment: Group Activity Code

CHAR 790 1 0 F0800Q Staff Assessment: Favorite Activity Code

CHAR 791 1 0 F0800R Staff Assessment: Time Away Nursing Home Code

CHAR 792 1 0 F0800S Staff Assessment: Time Outdoors Code

CHAR 793 1 0 F0800T Staff Assessment: Participating in Religious Activities Code

CHAR 794 1 0 F0800Z Staff Assessment: None of Above Activity Code

CHAR 795 1 0 G0110A1 ADL Assistance: Bed Mobility Self Performance Code

CHAR 796 1 0 G0110A2 ADL Assistance: Bed Mobility Support Provided Code

CHAR 797 1 0 G0110B1 ADL Assistance: Transfer Self Performance Code

CHAR 798 1 0 G0110B2 ADL Assistance: Transfer Self Support Provided Code

CHAR 799 1 0 G0110C1 ADL Assistance: Walk In Room Self Performance Code

CHAR 800 1 0 G0110C2 ADL Assistance: Walk In Room Support Provided Code

CHAR 801 1 0 G0110D1 ADL Assistance: Walk In Corridor Self Performance Code

CHAR 802 1 0 G0110D2 ADL Assistance: Walk In Corridor Self Support Provided Code

CHAR 803 1 0 G0110E1 ADL Assistance: Locomotion On Self Performance Code

CHAR 804 1 0 G0110E2 ADL Assistance: Locomotion On Support Provided Code

CHAR 805 1 0 G0110F1 ADL Assistance: Locomotion Off Self Performance Code

CHAR 806 1 0 G0110F2 ADL Assistance: Locomotion Off Support Provided Code

CHAR 807 1 0 G0110G1 ADL Assistance: Dress Self Performance Code

CHAR 808 1 0 G0110G2 ADL Assistance: Dress Support Provided Code

CHAR 809 1 0 G0110H1 ADL Assistance: Eating Self Performance Code

CHAR 810 1 0 G0110H2 ADL Assistance: Eating Support Provided Code

CHAR 811 1 0 G0110I1 ADL Assistance: Toileting Self Performance Code

CHAR 812 1 0 G0110I2 ADL Assistance: Toileting Support Provided Code

CHAR 813 1 0 G0110J1 ADL Assistance: Personal Hygiene Self Performance Code

CHAR 814 1 0 G0110J2 ADL Assistance: Personal Hygiene Support Provided Code

CHAR 815 1 0 G0120A ADL Assistance: Bathing Self Performance Code

CHAR 816 1 0 G0120B ADL Assistance: Bathing Support Provided Code

CHAR 817 1 0 G0300A Balance During Seated to Standing Position Code

CHAR 818 1 0 G0300B Balance During Walking Code

CHAR 819 1 0 G0300C Balance When Turning Around Code

CHAR 820 1 0 G0300D Balance Moving On and Off Toilet Code

CHAR 821 1 0 G0300E Balance With Surface to Surface Transfer Code

CHAR 822 1 0 G0400A Functional Limitation in ROM: Upper Extremity Motion Code

CHAR 823 1 0 G0400B Functional Limitation in ROM: Lower Extremity Motion Code

CHAR 824 1 0 G0600A Mobility Devices: Cane Code

CHAR 825 1 0 G0600B Mobility Devices: Walker Code

CHAR 826 1 0 G0600C Mobility Devices: Wheelchair Code

CHAR 827 1 0 G0600D Mobility Devices: Limb Prosthesis Code

CHAR 828 1 0 G0600Z Mobility Devices: None of Above Code

CHAR 829 1 0 G0900A Functional Rehabilitation Potential: Resident Increased Independence Code

CHAR 830 1 0 G0900B Functional Rehabilitation Potential: Staff Increased Independence Code

CHAR 831 2 0 GG0130A1 Self Care: Eating Ability at Start of SNF PPS Part A Stay

CHAR 833 2 0 GG0130A2 Self Care: Eating Goal by End of SNF PPS Part A Stay

CHAR 835 2 0 GG0130A3 Self Care: Eating Ability at End of SNF PPS Part A Stay

CHAR 837 2 0 GG0130B1 Self Care: Oral Hygiene Ability at Start of SNF PPS Part A Stay

CHAR 839 2 0 GG0130B2 Self Care: Oral Hygiene Goal by End of SNF PPS Part A Stay

CHAR 841 2 0 GG0130B3 Self Care: Oral Hygiene Ability at End of SNF PPS Part A Stay

CHAR 843 2 0 GG0130C1 Self Care: Toileting Hygiene Ability at Start of SNF PPS Part A Stay

CHAR 845 2 0 GG0130C2 Self Care: Toileting Hygiene Goal by End of SNF PPS Part A Stay

CHAR 847 2 0 GG0130C3 Self Care: Toileting Hygiene Ability at End of SNF PPS Part A Stay

CHAR 849 2 0 GG0170B1 Mobility: Sit to Lying Ability at Start of SNF PPS Part A Stay

CHAR 851 2 0 GG0170B2 Mobility: Sit to Lying Goal by End of SNF PPS Part A Stay

CHAR 853 2 0 GG0170B3 Mobility: Sit to Lying Ability at End of SNF PPS Part A Stay

CHAR 855 2 0 GG0170C1 Mobility: Lying to Sitting at Side of Bed Ability at Start of SNF PPS Part A Stay

CHAR 857 2 0 GG0170C2 Mobility: Lying to Sitting at Side of Bed Goal by End of SNF PPS Part A Stay

CHAR 859 2 0 GG0170C3 Mobility: Lying to Sitting at Side of Bed Ability at End of SNF PPS Part A Stay

CHAR 861 2 0 GG0170D1 Mobility: Sitting to Standing Ability at Start of SNF PPS Part A Stay

CHAR 863 2 0 GG0170D2 Mobility: Sitting to Standing Goal by End of SNF PPS Part A Stay

CHAR 865 2 0 GG0170D3 Mobility: Sitting to Standing Ability at End of SNF PPS Part A Stay

CHAR 867 2 0 GG0170E1 Mobility: Chair/Bed to Chair Transfer Ability at Start of SNF PPS Part A Stay

CHAR 869 2 0 GG0170E2 Mobility: Chair/Bed to Chair Transfer Goal by End of SNF PPS Part A Stay

CHAR 871 2 0 GG0170E3 Mobility: Chair/Bed to Chair Transfer Ability at End of SNF PPS Part A Stay

CHAR 873 2 0 GG0170F1 Mobility: Toilet Transfer at Start of SNF PPS Part A Stay

CHAR 875 2 0 GG0170F2 Mobility: Toilet Transfer Goal by End of SNF PPS Part A Stay

CHAR 877 2 0 GG0170F3 Mobility: Toilet Transfer at End of SNF PPS Part A Stay

CHAR 879 1 0 GG0170H3 Mobility: Does Resident Walk at End of SNF PPS Part A Stay

CHAR 880 2 0 GG0170J1 Mobility: Ability to Walk 50 Feet With Two Turns at Start of SNF PPS Part A Stay

CHAR 882 2 0 GG0170J2 Mobility: Goal to Walk 50 Feet With Two Turns by End of SNF PPS Part A Stay

CHAR 884 2 0 GG0170J3 Mobility: Ability to Walk 50 Feet With Two Turns at End of SNF PPS Part A Stay

CHAR 886 2 0 GG0170K1 Mobility: Ability to Walk 150 Feet at Start of SNF PPS Part A Stay

CHAR 888 2 0 GG0170K2 Mobility: Goal to Walk 150 Feet by End of SNF PPS Part A Stay

CHAR 890 2 0 GG0170K3 Mobility: Ability to Walk 150 Feet at End of SNF PPS Part A Stay

CHAR 892 1 0 GG0170Q1 Mobility: Uses Wheelchair/Scooter at Start of SNF PPS Part A Stay

CHAR 893 1 0 GG0170Q3 Mobility: Uses Wheelchair/Scooter at End of SNF PPS Part A Stay

CHAR 894 2 0 GG0170R1 Mobility: Ability to Wheel 50 Feet With Two Turns at Start of SNF PPS Part A Stay

CHAR 896 2 0 GG0170R2 Mobility: Goal to Wheel 50 Feet With Two Turns by End of SNF PPS Part A Stay

CHAR 898 2 0 GG0170R3 Mobility: Ability to Wheel 50 Feet With Two Turns at End of SNF PPS Part A Stay

CHAR 900 1 0 GG0170RR1 Type of Wheelchair Used to Propel 50 Feet at SNF PPS Part A Admission

CHAR 901 1 0 GG0170RR3 Type of Wheelchair Used to Propel 50 Feet at End of SNF PPS Part A Stay

CHAR 902 2 0 GG0170S1 Mobility: Ability to Wheel at Least 150 Feet in Corridor at Start of SNF PPS Part A Stay

CHAR 904 2 0 GG0170S2 Mobility: Goal to Wheel at Least 150 Feet by End of SNF PPS Part A Stay

CHAR 906 2 0 GG0170S3 Mobility: Ability to Wheel at Least 150 Feet in Corridor at End of SNF PPS Part A Stay

CHAR 908 1 0 GG0170SS1 Mobility: Type of Wheelchair Used to Propel 150 Feet at Start of SNF PPS Part A Stay

CHAR 909 1 0 GG0170SS3 Mobility: Type of Wheelchair Used to Propel 150 Feet at End of SNF PPS Part A Stay

CHAR 910 1 0 H0100A Bladder and Bowel Appliances: Indwelling Catheter Code

CHAR 911 1 0 H0100B Bladder and Bowel Appliances: External Catheter Code

CHAR 912 1 0 H0100C Bladder and Bowel Appliances: Ostomy Code

CHAR 913 1 0 H0100D Bladder and Bowel Appliances: Intermittent Catheter Code

CHAR 914 1 0 H0100Z Bladder and Bowel Appliances: No Urinary Appliance Code

CHAR 915 1 0 H0200A Urinary Toileting Program: Trial Toileting Program Code

CHAR 916 1 0 H0200B Urinary Toileting Program: Response To Toileting Program Code

CHAR 917 1 0 H0200C Urinary Toileting Program: Current Toileting Program Code

CHAR 918 1 0 H0300 Urinary Continence Code

CHAR 919 1 0 H0400 Bowel Continence Code

CHAR 920 1 0 H0500 Bowel Toileting Program Code

CHAR 921 1 0 H0600 Constipation Code

CHAR 922 1 0 I0100 Active Diagnoses: Cancer Code

CHAR 923 1 0 I0200 Active Diagnoses: Anemia Code

CHAR 924 1 0 I0300 Active Diagnoses: Dysrhythmia Code

CHAR 925 1 0 I0400 Active Diagnoses: Coronary Artery Disease (CAD) Code

CHAR 926 1 0 I0500 Active Diagnoses: Deep Vein Thrombosis (DVT) Code

CHAR 927 1 0 I0600 Active Diagnoses: Heart Failure (CHF) Code

CHAR 928 1 0 I0700 Active Diagnoses: Hypertension Code

CHAR 929 1 0 I0800 Active Diagnoses: Hypotension Code

CHAR 930 1 0 I0900 Active Diagnoses: Peripheral Vascular Disease (PVD) Code

CHAR 931 1 0 I1100 Active Diagnoses: Cirrhosis Code

CHAR 932 1 0 Diagnoses: Gastroesophageal Reflux Disease (GERD) Code

CHAR 933 1 0 I1300 Active Diagnoses: Ulcerative Colitis Code

CHAR 934 1 0 I1400 Active Diagnoses: Benign Prostatic Hyperplasia (BPH) Code

CHAR 935 1 0 I1500 Active Diagnoses: End Stage Renal Disease (ESRD) Code

CHAR 936 1 0 I1550 Active Diagnoses: Neurogenic Bladder Code

CHAR 937 1 0 I1650 Active Diagnoses: Obstructive Uropathy Code

CHAR 938 1 0 I1700 Active Diagnoses: Multi-drug Resistant Drug Organism (MDRO) Code

CHAR 939 1 0 I2000 Active Diagnoses: Pneumonia Code

CHAR 940 1 0 I2100 Active Diagnoses: Septicemia Code

CHAR 941 1 0 I2200 Active Diagnoses: Tuberculosis Code

CHAR 942 1 0 I2300 Active Diagnoses: Urinary Tract Infection (UTI) Code

CHAR 943 1 0 I2400 Active Diagnoses: Viral Hepatitis Code

CHAR 944 1 0 I2500 Wound Infection Code

CHAR 945 1 0 I2900 Active Diagnoses: Diabetes Mellitus (DM) Code

CHAR 946 1 0 I3100 Active Diagnoses: Hyponatremia Code

CHAR 947 1 0 I3200 Active Diagnoses: Hyperkalemia Code

CHAR 948 1 0 I3300 Active Diagnoses: Hyperlipidemia Code

CHAR 949 1 0 I3400 Active Diagnoses: Thyroid Code

CHAR 950 1 0 I3700 Active Diagnoses: Arthritis Code

CHAR 951 1 0 I3800 Active Diagnoses: Osteoporosis Code

CHAR 952 1 0 I3900 Active Diagnoses: Hip Fracture Code

CHAR 953 1 0 I4000 Active Diagnoses: Other Fracture Code

CHAR 954 1 0 I4200 Active Diagnoses: Alzheimers Disease Code

CHAR 955 1 0 I4300 Active Diagnoses: Aphasia Code

CHAR 956 1 0 I4400 Active Diagnoses: Cerebral Palsy Code

CHAR 957 1 0 I4500 Active Diagnoses: Stroke (CVA or TIA or Stroke) Code

CHAR 958 1 0 I4800 Active Diagnoses: Dementia Code

CHAR 959 1 0 I4900 Active Diagnoses: Hemiplegia Code

CHAR 960 1 0 I5000 Active Diagnoses: Paraplegia Code

CHAR 961 1 0 Diagnoses: Quadriplegia Code

CHAR 962 1 0 I5200 Active Diagnoses: Multiple Sclerosis Code

CHAR 963 1 0 I5250 Active Diagnoses: Huntingtons Code

CHAR 964 1 0 I5300 Active Diagnoses: Parkinsons Code

CHAR 965 1 0 I5350 Tourettes Code

CHAR 966 1 0 I5400 Active Diagnoses: Seizure Code

CHAR 967 1 0 I5500 Active Diagnoses: Traumatic Brain Injury (TBI) Code

CHAR 968 1 0 I5600 Active Diagnoses: Malnutrition Code

CHAR 969 1 0 I5700 Active Diagnoses: Anxiety Disorder Code

CHAR 970 1 0 I5800 Active Diagnoses: Depression Code

CHAR 971 1 0 I5900 Active Diagnoses: Manic Depression Code

CHAR 972 1 0 I5950 Active Diagnoses: Psychotic Code

CHAR 973 1 0 Diagnoses: Schizophrenia Code

CHAR 974 1 0 I6100 Active Diagnoses: Post-traumatic Stress Disorder (PTSD) Code

CHAR 975 1 0 Diagnoses: Asthma, COPD, Chronic Lung Disease Code

CHAR 976 1 0 I6300 Active Diagnoses: Respiratory Failure Code

CHAR 977 1 0 I6500 Active Diagnoses: Cataracts, Glaucoma or Macular Degeneration Code

CHAR 978 1 0 I7900 Active Diagnoses: No Active Disease Code

CHAR 979 8 0 I8000A Additional Active Diagnoses: ICD 1 Code

CHAR 987 8 0 I8000B Additional Active Diagnoses: ICD 2 Code

CHAR 995 8 0 I8000C Additional Active Diagnoses: ICD 3 Code

CHAR 1003 8 0 I8000D Additional Active Diagnoses: ICD 4 Code

CHAR 1011 8 0 I8000E Additional Active Diagnoses: ICD 5 Code

CHAR 1019 8 0 I8000F Additional Active Diagnoses: ICD 6 Code

CHAR 1027 8 0 I8000G Additional Active Diagnoses: ICD 7 Code

CHAR 1035 8 0 I8000H Additional Active Diagnoses: ICD 8 Code

CHAR 1043 8 0 I8000I Additional Active Diagnoses: ICD 9 Code

CHAR 1051 8 0 I8000J Additional Active Diagnoses: ICD 10 Code

CHAR 1059 1 0 J0100A Pain management: Scheduled Pain Medication Code

CHAR 1060 1 0 J0100B Pain management: PRN Pain Medication Code

CHAR 1061 1 0 J0100C Pain management: Other Pain Intervention Code

CHAR 1062 1 0 J0200 Should Pain Assessment be Conducted Code

CHAR 1063 1 0 J0300 Pain Assessment Interview: Pain Presence Code

CHAR 1064 1 0 J0400 Pain Assessment Interview: Pain Frequency Code

CHAR 1065 1 0 J0500A Pain Assessment Interview: Pain Effect Sleep Code

CHAR 1066 1 0 J0500B Pain Assessment Interview: Pain Effect Activity Code

CHAR 1067 2 0 J0600A Pain Intensity Numeric Rating Scale Number

CHAR 1069 1 0 J0600B Pain Intensity Verbal Descriptor Scale Number

CHAR 1070 1 0 J0700 Staff Conduct Pain Assessment Code

CHAR 1071 1 0 J0800A Staff Assessment for Pain: Nonverbal Sound Code

CHAR 1072 1 0 J0800B Staff Assessment for Pain: Vocal Complaint Code

CHAR 1073 1 0 J0800C Staff Assessment for Pain: Facial Expression Code

CHAR 1074 1 0 J0800D Staff Assessment for Pain: Protective Movement Code

CHAR 1075 1 0 J0800Z Staff Assessment for Pain: None of Above Signs of Pain Code

CHAR 1076 1 0 J0850 Staff Frequency of Indicator of Pain or Possible Pain Frequency Code

CHAR 1077 1 0 J1100A Shortness of Breath With Exertion Code

CHAR 1078 1 0 J1100B Shortness of Breath When Sitting Code

CHAR 1079 1 0 J1100C Shortness of Breath When Lying Flat Code

CHAR 1080 1 0 J1100Z None of Above Shortness of Breath Code

CHAR 1081 1 0 J1300 Tobacco Use Code

CHAR 1082 1 0 J1400 Life Prognosis Less Than Six Months Code

CHAR 1083 1 0 J1550A Problem Conditions: Fever Code

CHAR 1084 1 0 J1550B Problem Conditions: Vomiting Code

CHAR 1085 1 0 J1550C Problem Conditions: Dehydration Code

CHAR 1086 1 0 J1550D Problem Conditions: Internal Bleeding Code

CHAR 1087 1 0 J1550Z Problem Conditions: None of Above Code

CHAR 1088 1 0 J1700A Fall History on Admission: Fall 30 Day Code

CHAR 1089 1 0 J1700B Fall History on Admission: Fall 31-180 Day Code

CHAR 1090 1 0 J1700C Fall History on Admission: Fall Six Month Code

CHAR 1091 1 0 J1800 Falls Since Admission or Prior Assessment Code

CHAR 1092 1 0 J1900A Number of Falls Since Admission or Prior Assessment With No Injury Code

CHAR 1093 1 0 J1900B Number of Falls Since Admission or Prior Assessment With Injury Except Major Code

CHAR 1094 1 0 J1900C Number of Falls Since Admission or Prior Assessment With Major Injury Code

CHAR 1095 1 0 K0100A Swallowing Disorder: Loss Mouth Eating Code

CHAR 1096 1 0 K0100B Swallowing Disorder: Hold Food Mouth Code

CHAR 1097 1 0 K0100C Swallowing Disorder: Choke Drinking Meal Code

CHAR 1098 1 0 K0100D Swallowing Disorder: Complaint Swallowing Code

CHAR 1099 1 0 K0100Z Swallowing Disorder: None of Above Code

CHAR 1100 2 0 K0200A Height Number

CHAR 1102 3 0 K0200B Weight Number

CHAR 1105 1 0 K0300 Weight Loss Code

CHAR 1106 1 0 K0310 Weight Gain Code

CHAR 1107 1 0 K0500A Nutritional Approaches: Parenteral/IV Feeding Code

CHAR 1108 1 0 K0500B Nutritional Approaches: Feeding Tube Code

CHAR 1109 1 0 K0500C Nutritional Approaches: Mechanically Altered Diet Code

CHAR 1110 1 0 K0500D Nutritional Approaches: Therapeutic Diet Code

CHAR 1111 1 0 K0500Z Nutritional Approaches: None of Above Code

CHAR 1112 1 0 K0510A1 Nutritional Approaches: Prior Parenteral/IV Feeding Code

CHAR 1113 1 0 K0510A2 Nutritional Approaches: Post Parenteral/IV Feeding Code

CHAR 1114 1 0 K0510B1 Nutritional Approaches: Prior Feeding Tube Code

CHAR 1115 1 0 K0510B2 Nutritional Approaches: Post Feeding Tube Code

CHAR 1116 1 0 K0510C1 Nutritional Approaches: Prior Mechanically Altered Diet Code

CHAR 1117 1 0 K0510C2 Nutritional Approaches: Post Mechanically Altered Diet Code

CHAR 1118 1 0 K0510D1 Nutritional Approaches: Prior Therapeutic Diet Code

CHAR 1119 1 0 K0510D2 Nutritional Approaches: Post Therapeutic Diet Code

CHAR 1120 1 0 K0510Z1 Nutritional Approaches: Prior None of Above Code

CHAR 1121 1 0 K0510Z2 Nutritional Approaches: Post None of Above Code

CHAR 1122 1 0 K0700A Percent Caloric Intake Through Parenteral/Tube Feeding Code

CHAR 1123 1 0 K0700B Average Fluid Intake by IV Or Tube Feeding Code

CHAR 1124 1 0 K0710A1 Percent Caloric Intake Through Parenteral/Tube Feeding While Not Resident

CHAR 1125 1 0 K0710A2 Percent Caloric Intake Through Parenteral/Tube Feeding While A Resident

CHAR 1126 1 0 K0710A3 Percent Caloric Intake Through Parenteral/Tube Feeding During Entire 7 Days

CHAR 1127 1 0 K0710B1 Average Fluid Intake by IV Or Tube Feeding While Not Resident

CHAR 1128 1 0 K0710B2 Average Fluid Intake by IV Or Tube Feeding While A Resident

CHAR 1129 1 0 K0710B3 Average Fluid Intake by IV Or Tube Feeding During Entire 7 Days

CHAR 1130 1 0 L0200A Dental Status: Broken Denture Code

CHAR 1131 1 0 L0200B Dental Status: No Teeth Code

CHAR 1132 1 0 L0200C Dental Status: Abnormal Mouth Tissue Code

CHAR 1133 1 0 L0200D Dental Status: Cavity Code

CHAR 1134 1 0 L0200E Dental Status: Inflamed Gum Code

CHAR 1135 1 0 L0200F Dental Status: Mouth or Facial Pain Code

CHAR 1136 1 0 L0200G Dental Status: Unable to Examine Code

CHAR 1137 1 0 L0200Z Dental Status: None of Above Code

CHAR 1138 1 0 M0100A Determination of Pressure Ulcer Risk: Ulcer Visible Code

CHAR 1139 1 0 M0100B Determination of Pressure Ulcer Risk: Formal Assessment/Instrument Code

CHAR 1140 1 0 M0100C Determination of Pressure Ulcer Risk: Clinical Assessment Code

CHAR 1141 1 0 M0100Z Determination of Pressure Ulcer Risk: None of Above

CHAR 1142 1 0 M0150 Pressure Ulcer Risk Code

CHAR 1143 1 0 M0210 One or More Stage 1 or Higher Unhealed Pressure Ulcer Code

CHAR 1144 1 0 M0300A Stage 1 Pressure Ulcer Number

CHAR 1145 1 0 M0300B1 Stage 2 Pressure Ulcer Number

CHAR 1146 1 0 M0300B2 Stage 2 Pressure Ulcer Present on Admission Number

CHAR 1147 8 0 M0300B3 Date of Oldest Stage 2 Pressure Ulcer

CHAR 1155 1 0 M0300C1 Stage 3 Pressure Ulcer Number

CHAR 1156 1 0 M0300C2 Stage 3 Pressure Ulcer Present on Admission Number

CHAR 1157 1 0 M0300D1 Stage 4 Pressure Ulcer Number

CHAR 1158 1 0 M0300D2 Stage 4 Pressure Ulcer Present on Admission Number

CHAR 1159 1 0 M0300E1 Unstageable Pressure Ulcer Due To Dressing Number

CHAR 1160 1 0 M0300E2 Unstageable Pressure Ulcer Due To Dressing on Admission Number

CHAR 1161 1 0 M0300F1 Unstageable Pressure Ulcer With Slough or Eschar Number

CHAR 1162 1 0 M0300F2 Unstageable Pressure Ulcer With Slough or Eschar on Admission Number

CHAR 1163 1 0 M0300G1 Unstageable Pressure Ulcer With Deep Tissue Injury Number

CHAR 1164 1 0 M0300G2 Unstageable Pressure Ulcer With Deep Tissue Injury on Admission Number

CHAR 1165 4 0 M0610A Unhealed Stage 3-4 Pressure Ulcer Length Number

CHAR 1169 4 0 M0610B Unhealed Stage 3-4 Pressure Ulcer Width Number

CHAR 1173 4 0 M0610C Unhealed Stage 3-4 Pressure Ulcer Depth Number

CHAR 1177 1 0 M0700 Most Severe Pressure Ulcer Tissue Type Code

CHAR 1178 1 0 M0800A Worsening Stage 2 Pressure Ulcer Since Prior Assessment Number

CHAR 1179 1 0 M0800B Worsening Stage 3 Pressure Ulcer Since Prior Assessment Number

CHAR 1180 1 0 M0800C Worsening Stage 4 Pressure Ulcer Since Prior Assessment Number

CHAR 1181 1 0 M0900A Healed Pressure Ulcer Present on Prior Assessment Code

CHAR 1182 1 0 M0900B Healed Stage 2 Pressure Ulcer Number

CHAR 1183 1 0 M0900C Healed Stage 3 Pressure Ulcer Number

CHAR 1184 1 0 M0900D Healed Stage 4 Pressure Ulcer Number

CHAR 1185 1 0 M1030 Venous and Arterial Ulcer Number

CHAR 1186 1 0 M1040A Other Foot Skin Problems: Foot Infection Code

CHAR 1187 1 0 M1040B Other Foot Skin Problems: Diabetic Foot Ulcer Code

CHAR 1188 1 0 M1040C Other Foot Skin Problems: Other Open Lesion on Foot Code

CHAR 1189 1 0 M1040D Other Skin Problems: Open Lesions Other Than Ulcers, Rashes, Cuts Code

CHAR 1190 1 0 M1040E Other Skin Problems: Surgical Wound(s) Code

CHAR 1191 1 0 M1040F Other Skin Problems: Burn(s) Code

CHAR 1192 1 0 M1040G Other Skin Problems: Skin Tear(s)

CHAR 1193 1 0 M1040H Other Skin Problems: Moisture Associated Skin Damage

CHAR 1194 1 0 M1040Z Other Skin Problems: None of Above Code

CHAR 1195 1 0 M1200A Skin and Ulcer Treatments: Pressure Reducing Device in Chair Code

CHAR 1196 1 0 M1200B Skin and Ulcer Treatments: Pressure Reducing Device in Bed Code

CHAR 1197 1 0 M1200C Skin and Ulcer Treatments: Turning/Repositioning Program Code

CHAR 1198 1 0 M1200D Skin and Ulcer Treatments: Nutrition/Hydration Code

CHAR 1199 1 0 M1200E Skin and Ulcer Treatments: Ulcer Care Code

CHAR 1200 1 0 M1200F Skin and Ulcer Treatments: Surgical Wound Care Code

CHAR 1201 1 0 M1200G Skin and Ulcer Treatments: Application Nonsurgical Dressing Code

CHAR 1202 1 0 M1200H Skin and Ulcer Treatments: Application Ointments/Medications Code

CHAR 1203 1 0 M1200I Skin and Ulcer Treatments: Application Dressings to Foot Code

CHAR 1204 1 0 M1200Z Skin and Ulcer Treatments: None of Above Code

CHAR 1205 1 0 N0300 Number of Days Injections of Any Type

CHAR 1206 1 0 N0350A Number of Days Insulin Injections

CHAR 1207 1 0 N0350B Number of Days Insulin Orders Changed

CHAR 1208 1 0 N0400A Medications Received: Antipsychotic Code

CHAR 1209 1 0 N0400B Medications Received: Antianxiety Code

CHAR 1210 1 0 N0400C Medications Received: Antidepressant Code

CHAR 1211 1 0 N0400D Medications Received: Hypnotic Code

CHAR 1212 1 0 N0400E Medications Received: Anticoagulant Code

CHAR 1213 1 0 N0400F Medications Received: Antibiotic Code

CHAR 1214 1 0 Medications Received: Diuretic Code

CHAR 1215 1 0 N0400Z Medications Received: None of Above

CHAR 1216 1 0 N0410A Medications Received: Antipsychotic Number Days

CHAR 1217 1 0 N0410B Medications Received: Antianxiety Number Days

CHAR 1218 1 0 N0410C Medications Received: Antidepressant Number Days

CHAR 1219 1 0 N0410D Medications Received: Hypnotic Number Days

CHAR 1220 1 0 N0410E Medications Received: Anticoagulant Number Days

CHAR 1221 1 0 N0410F Medications Received: Antibiotic Number Days

CHAR 1222 1 0 N0410G Medications Received: Diuretic Number Days

CHAR 1223 1 0 N0410H Medications Received: Opioid Number Days

CHAR 1224 1 0 O0100A1 Special Treatments/Programs: Chemotherapy Pre-admit Code

CHAR 1225 1 0 O0100A2 Special Treatments/Programs: Chemotherapy Post-admit Code

CHAR 1226 1 0 O0100B1 Special Treatments/Programs: Radiation Pre-admit Code

CHAR 1227 1 0 O0100B2 Special Treatments/Programs: Radiation Post-admit Code

CHAR 1228 1 0 O0100C1 Special Treatments/Programs: Oxygen Pre-admit Code

CHAR 1229 1 0 O0100C2 Special Treatments/Programs: Oxygen Post-admit Code

CHAR 1230 1 0 O0100D1 Special Treatments/Programs: Suctioning Pre-admit Code

CHAR 1231 1 0 O0100D2 Special Treatments/Programs: Suctioning Post-admit Code

CHAR 1232 1 0 O0100E1 Special Treatments/Programs: Tracheostomy Pre-admit Code

CHAR 1233 1 0 O0100E2 Special Treatments/Programs: Tracheostomy Post-admit Code

CHAR 1234 1 0 O0100F1 Special Treatments/Programs: Ventilator Pre-admit Code

CHAR 1235 1 0 O0100F2 Special Treatments/Programs: Ventilator Post-admit Code

CHAR 1236 1 0 O0100G1 Special Treatments/Programs: Continuous Positive Airway Pressure Pre-admit Code

CHAR 1237 1 0 O0100G2 Special Treatments/Programs: Continuous Positive Airway Pressure Post-admit Code

CHAR 1238 1 0 O0100H1 Special Treatments/Programs: Intravenous Medication Pre-admit Code

CHAR 1239 1 0 O0100H2 Special Treatments/Programs: Intravenous Medication Post-admit Code

CHAR 1240 1 0 O0100I1 Special Treatments/Programs: Transfusion Pre-admit Code

CHAR 1241 1 0 O0100I2 Special Treatments/Programs: Transfusion Post-admit Code

CHAR 1242 1 0 O0100J1 Special Treatments/Programs: Dialysis Pre-admit Code

CHAR 1243 1 0 O0100J2 Special Treatments/Programs: Dialysis Post-admit Code

CHAR 1244 1 0 O0100K1 Special Treatments/Programs: Hospice Pre-admit Code

CHAR 1245 1 0 O0100K2 Special Treatments/Programs: Hospice Post-admit Code

CHAR 1246 1 0 O0100L2 Special Treatments/Programs: Respite Post-admit Code

CHAR 1247 1 0 O0100M1 Special Treatments/Programs: Isolation Pre-admit Code

CHAR 1248 1 0 O0100M2 Special Treatments/Programs: Isolation Post-admit Code

CHAR 1249 1 0 O0100Z1 Special Treatments/Programs: None of Above Pre-admit Treatment Prior Code

CHAR 1250 1 0 O0100Z2 Special Treatments/Programs: None of Above Treatment Post-admit Code

CHAR 1251 1 0 O0250A Influenza Received Code

CHAR 1252 8 0 O0250B Influenza Received Date

CHAR 1260 1 0 O0250C Reason Influenza Not Received Code

CHAR 1261 1 0 O0300A Pneumococcal Vaccination Code

CHAR 1262 1 0 O0300B Reason Pneumococcal Vaccination Not Received Code

CHAR 1263 4 0 O0400A1 Speech Therapy/Audiology Individual Minutes Number

CHAR 1267 4 0 O0400A2 Speech Therapy/Audiology Concurrent Minutes Number

CHAR 1271 4 0 O0400A3 Speech Therapy/Audiology Group Minutes Number

CHAR 1275 4 0 O0400A3A Number of Speech Therapy/Audiology Co-treatment Minutes

CHAR 1279 1 0 O0400A4 Number of Days Speech Therapy/Audiology Administered

CHAR 1280 8 0 O0400A5 Speech Therapy/Audiology Start Date

CHAR 1288 8 0 O0400A6 Speech Therapy/Audiology End Date

CHAR 1296 4 0 O0400B1 Occupational Therapy Individual Minutes Number

CHAR 1300 4 0 O0400B2 Occupational Therapy Concurrent Minutes Number

CHAR 1304 4 0 O0400B3 Occupational Therapy Group Minutes Number

CHAR 1308 4 0 O0400B3A Number of Occupational Therapy Co-treatment Minutes

CHAR 1312 1 0 O0400B4 Number of Days Occupational Therapy Administered

CHAR 1313 8 0 O0400B5 Occupational Therapy Start Date

CHAR 1321 8 0 O0400B6 Occupational Therapy End Date

CHAR 1329 4 0 O0400C1 Physical Therapy Individual Minutes Number

CHAR 1333 4 0 O0400C2 Physical Therapy Concurrent Minutes Number

CHAR 1337 4 0 O0400C3 Physical Therapy Group Minutes Number

CHAR 1341 4 0 O0400C3A Number of Physical Therapy Co-treatment Minutes

CHAR 1345 1 0 O0400C4 Number of Days Physical Therapy Administered

CHAR 1346 8 0 O0400C5 Physical Therapy Start Date

CHAR 1354 8 0 O0400C6 Physical Therapy End Date

CHAR 1362 4 0 O0400D1 Respiratory Therapy Minutes Number

CHAR 1366 1 0 O0400D2 Number of Days Respiratory Therapy Administered

CHAR 1367 4 0 O0400E1 Psychological Therapy Minutes Number

CHAR 1371 1 0 O0400E2 Number of Days Psychological Therapy Administered

CHAR 1372 4 0 O0400F1 Recreational Therapy Minutes Number

CHAR 1376 1 0 O0400F2 Number of Days Recreational Therapy Administered

CHAR 1377 1 0 O0420 Distinct Number of Days Therapy Administered

CHAR 1378 1 0 O0450A Has Therapy Resumed Code

CHAR 1379 8 0 O0450B Date Therapy Resumed

CHAR 1387 1 0 O0500A Restorative Nursing: Passive Range of Motion Number

CHAR 1388 1 0 O0500B Restorative Nursing: Active Range of Motion Number

CHAR 1389 1 0 O0500C Restorative Nursing: Splint/Brace Assistance Number

CHAR 1390 1 0 O0500D Restorative Nursing: Bed Mobility Training Number

CHAR 1391 1 0 O0500E Restorative Nursing: Transfer Training Number

CHAR 1392 1 0 O0500F Restorative Nursing: Walking Training Number

CHAR 1393 1 0 O0500G Restorative Nursing: Dressing/Grooming Training Number

CHAR 1394 1 0 O0500H Restorative Nursing: Eating/Swallowing Training Number

CHAR 1395 1 0 O0500I Restorative Nursing: Amputation/Prosthesis Care Training Number

CHAR 1396 1 0 O0500J Restorative Nursing: Communication Training Number

CHAR 1397 2 0 O0600 Physician Examination Day Number

CHAR 1399 2 0 O0700 Physician Order Day Number

CHAR 1401 1 0 P0100A Physical Restraints in Bed: Bed Rail Code

CHAR 1402 1 0 P0100B Physical Restraints in Bed: Trunk Restraint Bed Code

CHAR 1403 1 0 P0100C Physical Restraints in Bed: Limb Restraint Bed Code

CHAR 1404 1 0 P0100D Physical Restraints in Bed: Other Restraint Bed Code

CHAR 1405 1 0 P0100E Physical Restraints in Chair: Trunk Restraint Chair Code

CHAR 1406 1 0 P0100F Physical Restraints in Chair: Limb Restraint Chair Code

CHAR 1407 1 0 P0100G Physical Restraints in Chair: Chair Prevent Rise Code

CHAR 1408 1 0 P0100H Physical Restraints in Chair: Other Restraint Chair Code

CHAR 1409 2 0 V0100A Prior Assessment Federal OBRA Reason for Assessment Code

CHAR 1411 2 0 V0100B Prior Assessment PPS Reason for Assessment Code

CHAR 1413 8 0 V0100C Prior Assessment Reference Date

CHAR 1421 2 0 V0100D Prior Assessment Brief Interview for Mental Status (BIMS) Summary Score Number

CHAR 1423 2 0 V0100E Prior Assessment Resident Mood Interview (PHQ-9) Total Severity Score Number

CHAR 1425 2 0 V0100F Prior Assessment Staff Assessment of Resident Mood (PHQ-9) Total Severity Score Number

CHAR 1427 1 0 V0200A01A Delirium Care Area Trigger Code

CHAR 1428 1 0 V0200A01B Delirium Addressed in Care Plan Code

CHAR 1429 1 0 V0200A02A Dementia Care Area Trigger Code

CHAR 1430 1 0 V0200A02B Dementia Addressed in Care Plan Code

CHAR 1431 1 0 V0200A03A Visual Function Care Area Trigger Code

CHAR 1432 1 0 V0200A03B Visual Function Addressed in Care Plan Code

CHAR 1433 1 0 V0200A04A Communication Care Area Trigger Code

CHAR 1434 1 0 V0200A04B Communication Addressed in Care Plan Code

CHAR 1435 1 0 V0200A05A ADL Care Area Trigger Code

CHAR 1436 1 0 V0200A05B ADL Addressed in Care Plan Code

CHAR 1437 1 0 V0200A06A Urinary Care Area Trigger Code

CHAR 1438 1 0 V0200A06B Urinary Addressed in Care Plan Code

CHAR 1439 1 0 V0200A07A Psychosocial Care Area Trigger Code

CHAR 1440 1 0 V0200A07B Psychosocial Addressed in Care Plan Code

CHAR 1441 1 0 V0200A08A Mood Care Area Trigger Code

CHAR 1442 1 0 V0200A08B Mood Addressed in Care Plan Code

CHAR 1443 1 0 V0200A09A Behavioral Care Area Trigger Code

CHAR 1444 1 0 V0200A09B Behavioral Addressed in Care Plan Code

CHAR 1445 1 0 V0200A10A Activity Care Area Trigger Code

CHAR 1446 1 0 V0200A10B Activity Addressed in Care Plan Code

CHAR 1447 1 0 V0200A11A Fall Care Area Trigger Code

CHAR 1448 1 0 V0200A11B Fall Addressed in Care Plan Code

CHAR 1449 1 0 V0200A12A Nutritional Care Area Trigger Code

CHAR 1450 1 0 V0200A12B Nutritional Addressed in Care Plan Code

CHAR 1451 1 0 V0200A13A Feeding Tube Care Area Trigger Code

CHAR 1452 1 0 V0200A13B Feeding Tube Addressed in Care Plan Code

CHAR 1453 1 0 V0200A14A Dehydration Care Area Trigger Code

CHAR 1454 1 0 V0200A14B Dehydration Addressed in Care Plan Code

CHAR 1455 1 0 V0200A15A Dental Care Area Trigger Code

CHAR 1456 1 0 V0200A15B Dental Addressed in Care Plan Code

CHAR 1457 1 0 V0200A16A Pressure Ulcer Care Area Trigger Code

CHAR 1458 1 0 V0200A16B Pressure Ulcer Addressed in Care Plan Code

CHAR 1459 1 0 V0200A17A Psychotropic Drug Care Area Trigger Code

CHAR 1460 1 0 V0200A17B Psychotropic Drug Addressed in Care Plan Code

CHAR 1461 1 0 V0200A18A Restraint Care Area Trigger Code

CHAR 1462 1 0 V0200A18B Restraint Addressed in Care Plan Code

CHAR 1463 1 0 V0200A19A Pain Care Area Trigger Code

CHAR 1464 1 0 V0200A19B Pain Addressed in Care Plan Code

CHAR 1465 1 0 V0200A20A Return to Community Care Area Trigger Code

CHAR 1466 1 0 V0200A20B Return to Community Addressed in Care Plan Code

CHAR 1467 8 0 V0200B2 Care Area Assessment Completion Date

CHAR 1475 8 0 V0200C2 Care Plan Completion Date

CHAR 1483 1 0 X0150 Correction Provider Type Code

CHAR 1484 1 0 X0300 Correction Gender Code

CHAR 1485 8 0 X0400 Correction Birth Date

CHAR 1493 9 0 X0500 Correction Social Security Number

CHAR 1502 2 0 X0600A Correction Federal OBRA Reason for Assessment Code

CHAR 1504 2 0 X0600B Correction PPS Reason for Assessment Code

CHAR 1506 1 0 X0600C Correction PPS Other Medicare Required Assessment (OMRA) Code

CHAR 1507 1 0 X0600D Correction Swing Bed Clinical Change Code

CHAR 1508 2 0 X0600F Correction Entry/Discharge Code

CHAR 1510 1 0 X0600H Correction Type of Assessment: SNF PPS Part A Discharge Assessment

CHAR 1511 8 0 X0700A Correction Assessment Reference Date

CHAR 1519 8 0 X0700B Correction Discharge Date

CHAR 1527 8 0 X0700C Correction Entry Date

CHAR 1535 2 0 X0800 Correction Number

CHAR 1537 1 0 X0900A Reason for Modification: Transcription Error Code

CHAR 1538 1 0 X0900B Reason for Modification: Data Entry Error Code

CHAR 1539 1 0 X0900C Reason for Modification: Software Product Error Code

CHAR 1540 1 0 X0900D Reason for Modification: Item Coding Error Code

CHAR 1541 1 0 X0900E Modification Reason - Add Resume Therapy Date

CHAR 1542 1 0 X0900Z Reason for Modification: Other Error Requiring Modification Code

CHAR 1543 1 0 X1050A Reason for Inactivation: Event Did Not Occur Code

CHAR 1544 1 0 X1050Z Reason for Inactivation: Other Error Requiring Inactivation Code

CHAR 1545 8 0 X1100E Attestation Date

CHAR 1553 7 0 Z0100A Medicare Part A HIPPS Code Text

CHAR 1560 10 0 Z0100B Medicare Part A RUG Version Text

CHAR 1570 1 0 Z0100C Medicare Part A Short Stay Assessment Code

CHAR 1571 7 0 Z0150A Medicare Part A Non-therapy HIPPS Code Text

CHAR 1578 10 0 Z0150B Medicare Non-therapy Part A RUG Version Text

CHAR 1588 10 0 Z0200A State Medicaid RUG Case Mix Group Text

CHAR 1598 10 0 Z0200B State Medicaid RUG Version Text

CHAR 1608 10 0 Z0250A Alternate State Medicaid RUG Case Mix Group Text

CHAR 1618 10 0 Z0250B Alternate State Medicaid RUG Version Text

DATE 1628 8 0 Z0500B Date RN Assessment Coordinator Signed Assessment as Complete