This is the ValueSet that contains all the codes in US Core Survey Codes (http://hl7.org/fhir/us/core/ValueSet/us-core-survey-codes) and Screening and Assesment Survey Codes (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.13). E.g. what you have to deal with if you get resources containing codes in either of them
Generated Narrative: ValueSet c34bfb41-7b3a-4863-989f-334c9b1c6d3a-173
This value set includes codes based on the following rules:
http://loinc.org where CLASSTYPE = 4http://loinc.org where CLASSTYPE = 2http://loinc.org where CLASS = PANEL.NEONAThttp://loinc.org| Code | Display |
| 100002-5 | Specimen care is maintained |
| 100003-3 | Team communication is maintained throughout care |
| 100004-1 | Demonstrates knowledge of the expected psychosocial responses to the procedure |
| 100005-8 | Demonstrates knowledge of nutritional management related to the procedure |
| 100006-6 | Demonstrates knowledge of medication management |
| 100007-4 | Demonstrates knowledge of pain management |
| 100008-2 | Demonstrates knowledge of wound management |
| 100009-0 | Demonstrates knowledge of the procedure and expected results |
| 100010-8 | No injury related to procedure equipment, medical supplies, or instrumentation |
| 100011-6 | No injury related to an electrical source |
| 100012-4 | Participates in decisions affecting the patient's plan of care |
| 100013-2 | Participates in the discharge process |
| 100014-0 | Psychosocial health is maintained at or improved from baseline |
| 100015-7 | No injury related to positioning due to care or procedure |
| 100016-5 | No injury related to a laser source |
| 100017-3 | Perioperative nursing data set outcomes panel [PNDS] |
| 100030-6 | Axis I: Temporal aspects score [Mainz Pain Staging System] |
| 100031-4 | Axis II: Spatial aspects score [Mainz Pain Staging System] |
| 100032-2 | Axis III: Drug taking behavior score [Mainz Pain Staging System] |
| 100033-0 | Axis IV: Utilization of the health care system score [Mainz Pain Staging System] |
| 100159-3 | Knee Society Score pre-op panel [Knee Society Score] |
| 100168-4 | Knee pain severity with level walking |
| 100169-2 | Knee pain severity with stairs or inclines |
| 100170-0 | Knee feels normal |
| 100171-8 | Satisfaction with level of knee pain while sitting |
| 100172-6 | Satisfaction with level of knee pain while lying in bed |
| 100173-4 | Satisfaction with knee function while getting out of bed |
| 100174-2 | Satisfaction with knee function while performing light household duties |
| 100175-9 | Satisfaction with knee function while performing recreational activities |
| 100176-7 | Expect surgery to relieve pain |
| 100177-5 | Expect surgery will improve ability to perform activities of daily living |
| 100178-3 | Expect surgery will improve ability to perform leisure, recreational, or sports activities |
| 100179-1 | Walk without assistive mobility devices |
| 100180-9 | Assistive mobility devices used |
| 100181-7 | Assistive mobility devices used due to health condition |
| 100182-5 | Duration of standing before sitting due to knee discomfort |
| 100183-3 | Duration of walking before stopping due to knee discomfort |
| 100184-1 | How bothersome is knee when walking on an uneven surface |
| 100185-8 | How bothersome is knee when turning or pivoting leg |
| 100186-6 | How bothersome is knee when climbing up or down a flight of stairs |
| 100187-4 | How bothersome is knee when getting up from a low seat without armrests |
| 100188-2 | How bothersome is knee when getting into or out of a car |
| 100189-0 | How bothersome is knee when moving laterally |
| 100190-8 | How bothersome is knee when climbing a ladder or step stool |
| 100191-6 | How bothersome is knee when carrying a bag for one block |
| 100192-4 | How bothersome is knee when squatting |
| 100193-2 | How bothersome is knee when kneeling |
| 100194-0 | How bothersome is knee when running |
| 100195-7 | Pain severity--during activity |
| 100196-5 | Pre-op total score [Knee Society Score] |
| 100197-3 | Exercise activity and pain severity panel |
| 100198-1 | Pre-op objective knee indicators score [Knee Society Score] |
| 100199-9 | Pre-op symptoms score [Knee Society Score] |
| 100200-5 | Pre-op patient expectations score [Knee Society Score] |
| 100201-3 | Pre-op functional activities score [Knee Society Score] |
| 100202-1 | Pre-op discretionary knee activities score [Knee Society Score] |
| 100203-9 | Knee Society Score post-op panel [Knee Society Score] |
| 100204-7 | Accuracy of pre-surgery expectations of pain relief |
| 100205-4 | Accuracy of pre-surgery expectations to perform activities of daily living |
| 100206-2 | Accuracy of pre-surgery expectations to perform leisure, recreational, or sports activities |
| 100207-0 | Post-op total score [Knee Society Score] |
| 100208-8 | Post-op objective knee indicators score [Knee Society Score] |
| 100209-6 | Post-op symptoms score [Knee Society Score] |
| 100210-4 | Post-op patient expectations score [Knee Society Score] |
| 100211-2 | Post-op functional activities score [Knee Society Score] |
| 100212-0 | Post-op discretionary knee activities score [Knee Society Score] |
| 100232-8 | Impacts of Events Scale-Revised panel |
| 100233-6 | Reminders brought back feelings about adverse event |
| 100234-4 | Trouble staying asleep |
| 100235-1 | Other things triggered persistent thoughts about adverse event |
| 100236-9 | Felt irritable AndOr angry |
| 100237-7 | Avoided getting upset when unintentionally thought about adverse event |
| 100238-5 | Thought about adverse event unintentionally |
| 100239-3 | Felt as if adverse event did not happen |
| 100240-1 | Avoided reminders of adverse event |
| 100241-9 | Experienced mental images of adverse event |
| 100242-7 | Easily startled |
| 100243-5 | Tried to not think of adverse event |
| 100244-3 | Aware of feelings about adverse event, but did not address them |
| 100245-0 | Feelings about adverse event were numb |
| 100246-8 | Acted or felt the same as during adverse event |
| 100247-6 | Trouble falling asleep |
| 100248-4 | Waves of strong feelings about adverse event |
| 100249-2 | Tried to remove adverse event from memory |
| 100250-0 | Trouble concentrating |
| 100251-8 | Reminders of adverse event caused physical reactions |
| 100252-6 | Had dreams about adverse event |
| 100253-4 | Felt watchful and on-guard |
| 100254-2 | Tried not to talk about adverse event |
| 100255-9 | Total score [Impact of Event Scale-Revised] |
| 100259-1 | Aware of tactile sensations |
| 100260-9 | Easy to describe thoughts AndOr feelings |
| 100261-7 | Critical of own thoughts AndOr feelings |
| 100262-5 | Able to notice distressing thoughts AndOr feelings without having to react |
| 100263-3 | Easily distracted |
| 100264-1 | Able to notice thoughts AndOr feelings without being overwhelmed |
| 100265-8 | Aware of dietary intake impact on self |
| 100266-6 | Difficult to describe thoughts AndOr feelings |
| 100267-4 | Aware of auditory stimuli |
| 100268-2 | Able to avoid immediate reaction in difficult situations |
| 100269-0 | Do things without paying attention |
| 100270-8 | Recover quickly from distressing thoughts AndOr images |
| 100271-6 | Aware of olfactory stimuli |
| 100272-4 | Aware of visual stimuli |
| 100273-2 | Aware of emotions affect on thoughts AndOr behavior |
| 100274-0 | Observing score [FFMQ] |
| 100275-7 | Describing score [FFMQ] |
| 100276-5 | Acting with awareness score [FFMQ] |
| 100277-3 | Nonjudging score [FFMQ] |
| 100278-1 | Nonreactivity score [FFMQ] |
| 100279-9 | Total score [FFMQ] |
| 100280-7 | Five Facet Mindfulness Questionnaire panel [FFMQ] |
| 100283-1 | Harris Hip Score panel [Harris Hip Score] |
| 100284-9 | Walking - functional ability |
| 100285-6 | Comfortable seated position |
| 100286-4 | Able to board public transportation |
| 100287-2 | Put on shoes and socks |
| 100288-0 | Absence of deformity score [Harris Hip Score] |
| 100289-8 | Absence of hip deformity measurements |
| 100290-6 | Range of motion score [Harris Hip Score] |
| 100291-4 | Total score [Harris Hip Score] |
| 100292-2 | Pre-op patient satisfaction score [Knee Society Score] |
| 100293-0 | Hip Flexion range of motion |
| 100294-8 | Hip Abduction range of motion |
| 100295-5 | Hip Adduction range of motion |
| 100296-3 | Hip External rotation range of motion |
| 100297-1 | Hip Internal rotation range of motion |
| 100299-7 | Post-op patient satisfaction score [Knee Society Score] |
| 100307-8 | Behavioral screening elder mistreatment |
| 100308-6 | Need help getting to essential places |
| 100309-4 | Activity support person |
| 100310-2 | Reliability of support person |
| 100311-0 | Need help to make sure there is enough food, medicines or any other things needed in house |
| 100312-8 | Person or persons that makes sure there is enough food, medicines or any other things needed in house |
| 100313-6 | Need help with household things such as cook meals, help feed, or provide correct medicines each day |
| 100314-4 | Need help with house cleaning or yard work |
| 100315-1 | Need help getting out of bed, showered, or dressed |
| 100316-9 | Need help to make sure bills get paid |
| 100317-7 | Relationship of usual support person for daily activities |
| 100318-5 | Have help with finances AndOr financial decisions |
| 100319-3 | Relationship of financial support person |
| 100320-1 | Financial support person usually asks for permission before making decisions |
| 100321-9 | Financial support person usually makes good decisions about finances |
| 100322-7 | Have access to paperwork for financial decisions made |
| 100323-5 | Financial support person forged signature |
| 100324-3 | Coercion of financial support person for signing a document in order to get money or possessions |
| 100325-0 | Experienced theft by support person |
| 100326-8 | Money spent or property sold without permission |
| 100327-6 | Stranger forged signature for financial gain |
| 100328-4 | Stranger forced document signature for financial gain |
| 100329-2 | Feared for safety due to verbal attack |
| 100330-0 | Felt humiliated due to ridicule |
| 100331-8 | Coerced to do something |
| 100332-6 | Ignored by close friend or relative for extended period |
| 100333-4 | Physically hit or threatened |
| 100334-2 | Been physically hurt with some degree of injury |
| 100335-9 | Coerced sexual activity |
| 100336-7 | Coerced touching of private body parts of self or others |
| 100337-5 | Coerced to undress or expose private body area |
| 100338-3 | Photographed in any degree of nudity without consent |
| 100339-1 | Experienced attempted physical restraint |
| 100340-9 | Range of motion panel Hip |
| 100353-2 | Norwalk Community Health Center Screening Tool [NCHC] |
| 100354-0 | Frequency of participating in multi-modal communication without assistance |
| 100355-7 | Frequency of participating in spoken language expression communication without assistance |
| 100360-7 | Brief Resilience Scale panel [BRS] |
| 100361-5 | Quickly recover from bad events |
| 100362-3 | Difficulty making it through stressful events |
| 100363-1 | Easily recover from a stressful event |
| 100364-9 | Difficulty recovering from bad events |
| 100365-6 | Easily recover from difficulties |
| 100366-4 | Lengthy recovery from setbacks |
| 100367-2 | Total Score BRS |
| 100766-5 | Center for Epidemiologic Studies Depression Scale panel [CES-D] |
| 100767-3 | Bothered by things that are not usually bothersome |
| 100768-1 | Poor appetite |
| 100769-9 | Unhappy even with help from my family or friends |
| 100770-7 | Feeling just as good as others |
| 100771-5 | Trouble focusing |
| 100772-3 | Feeling depressed |
| 100773-1 | Feeling everything is too much of an effort |
| 100774-9 | Feeling hopeful about the future |
| 100775-6 | Feeling life had been a failure |
| 100776-4 | Feeling fearful |
| 100777-2 | Restless sleep |
| 100778-0 | Feeling happy |
| 100779-8 | Quieter than usual |
| 100780-6 | Feeling lonely |
| 100781-4 | People were unfriendly |
| 100782-2 | Enjoying life |
| 100783-0 | Crying spells |
| 100784-8 | Feeling sad |
| 100785-5 | Feeling people dislike me |
| 100786-3 | Lack of energy |
| 100787-1 | Total Score CES-D |
| 100916-6 | User satisfaction score [R-Outcomes] |
| 100917-4 | Product of interest effectiveness |
| 100918-2 | Product of interest usability |
| 100919-0 | Access to help with product of interest |
| 100920-8 | Satisfied with product of interest |
| 100921-6 | User satisfaction panel [R-Outcomes] |
| 100922-4 | Privacy panel [R-Outcomes] |
| 100923-2 | Privacy score [R-Outcomes] |
| 100924-0 | Safe and secure healthcare data |
| 100925-7 | Healthcare data exchanged as needed |
| 100926-5 | Access to review healthcare data |
| 100927-3 | Satisfied with healthcare data use |
| 100928-1 | Digital confidence panel [R-Outcomes] |
| 100929-9 | Digital confidence score [R-Outcomes] |
| 100930-7 | Digital device use |
| 100931-5 | Friends use digital devices |
| 100932-3 | Access to help with digital devices |
| 100933-1 | Confident using digital devices |
| 100934-9 | Personal safety panel [R-Outcomes] |
| 100935-6 | Personal safety score [R-Outcomes] |
| 100936-4 | Feel safe at home |
| 100937-2 | Feel respected at home |
| 100938-0 | Feel safe outside home |
| 100939-8 | Feel respected outside home |
| 100940-6 | Neighbor relationships panel [R-Outcomes] |
| 100941-4 | Neighbor relationships score [R-Outcomes] |
| 100942-2 | Neighbors and I know each other |
| 100943-0 | Neighbors and I trust each other |
| 100944-8 | Neighbors and I share information |
| 100945-5 | Neighbors and I help each other |
| 100946-3 | Loneliness (ONS) score |
| 100947-1 | Frequency of having no one to talk to |
| 100948-9 | Frequency of feeling left out |
| 100949-7 | Frequency of feeling alone |
| 100950-5 | Frequency of feeling lonely |
| 100951-3 | Loneliness Office of National Statistics panel |
| 100952-1 | Product confidence panel [R-Outcomes] |
| 100953-9 | Product confidence score [R-Outcomes] |
| 100954-7 | Product of interest use |
| 100955-4 | Confident using product of interest |
| 100956-2 | Understand potential benefits of product of interest |
| 100957-0 | Understand potential problems of product of interest |
| 100958-8 | Digital readiness panel [R-Outcomes] |
| 100959-6 | Digital readiness score [R-Outcomes] |
| 100960-4 | New ideas are needed in field of work |
| 100961-2 | Follow new ideas in field of work |
| 101104-8 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.18.11 during assessment period [CMS Assessment] |
| 101105-5 | MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 101106-3 | MDS v3.0 - RAI v1.18.11 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 101107-1 | MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 101108-9 | MDS v3.0 - RAI v1.18.11 - Nursing home and Swing bed tracking (NT and ST) item set [CMS Assessment] |
| 101109-7 | MDS v3.0 - RAI v1.18.11 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 101110-5 | MDS v3.0 - RAI v1.18.11 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 101111-3 | MDS v3.0 - RAI v1.18.11 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 101112-1 | MDS v3.0 - RAI v1.18.11 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 101113-9 | MDS v3.0 - RAI v1.18.11 - Swing bed discharge (SD) item set during assessment period [CMS Assessment] |
| 101258-2 | MDS v3.0 - RAI v1.18.11 - Identification Information during assessment period [CMS Assessment] |
| 101259-0 | MDS v3.0 - RAI v1.18.11 - Hearing, Speech, and Vision during assessment period [CMS Assessment] |
| 101260-8 | MDS v3.0 - RAI v1.18.11 - Cognitive Patterns during assessment period [CMS Assessment] |
| 101261-6 | MDS v3.0 - RAI v1.18.11 - Mood during assessment period [CMS Assessment] |
| 101262-4 | MDS v3.0 - RAI v1.18.11 - Behavior during assessment period [CMS Assessment] |
| 101263-2 | MDS v3.0 - RAI v1.18.11 - Preferences for Customary Routine and Activities during assessment period [CMS Assessment] |
| 101264-0 | MDS v3.0 - RAI v1.18.11 - Functional Abilities and Goals during assessment period [CMS Assessment] |
| 101265-7 | MDS v3.0 - RAI v1.18.11 - Functional Abilities and Goals - Admission during assessment period [CMS Assessment] |
| 101266-5 | MDS v3.0 - RAI v1.18.11 - Functional Abilities and Goals - Discharge during assessment period [CMS Assessment] |
| 101267-3 | MDS v3.0 - RAI v1.18.11 - Functional Abilities and Goals - OBRA/Interim during assessment period [CMS Assessment] |
| 101268-1 | MDS v3.0 - RAI v1.18.11 - Bladder and Bowel during assessment period [CMS Assessment] |
| 101269-9 | MDS v3.0 - RAI v1.18.11 - Active Diagnoses during assessment period [CMS Assessment] |
| 101270-7 | MDS v3.0 - RAI v1.18.11 - Health Conditions during assessment period [CMS Assessment] |
| 101271-5 | MDS v3.0 - RAI v1.18.11 - Swallowing/Nutritional Status during assessment period [CMS Assessment] |
| 101272-3 | MDS v3.0 - RAI v1.18.11 - Oral/Dental Status during assessment period [CMS Assessment] |
| 101273-1 | MDS v3.0 - RAI v1.18.11 - Skin Conditions during assessment period [CMS Assessment] |
| 101274-9 | MDS v3.0 - RAI v1.18.11 - Medications during assessment period [CMS Assessment] |
| 101275-6 | MDS v3.0 - RAI v1.18.11 - Header - Special Treatments, Procedures, and Programs [CMS Assessment] |
| 101276-4 | MDS v3.0 - RAI v1.18.11 - Restraints and Alarms during assessment period [CMS Assessment] |
| 101277-2 | MDS v3.0 - RAI v1.18.11 - Header - Participation in Assessment and Goal Setting [CMS Assessment] |
| 101278-0 | MDS v3.0 - RAI v1.18.11 - Care Area Assessment (CAA) Summary during assessment period [CMS Assessment] |
| 101279-8 | MDS v3.0 - RAI v1.18.11 - Correction Request during assessment period [CMS Assessment] |
| 101280-6 | MDS v3.0 - RAI v1.18.11 - Assessment Administration during assessment period [CMS Assessment] |
| 101321-8 | MDS v3.0 - RAI v1.18.11 - Self-Care - Admission Performance |
| 101322-6 | MDS v3.0 - RAI v1.18.11 - Self-Care - Discharge Goal |
| 101323-4 | MDS v3.0 - RAI v1.18.11 - Mobility - Admission Performance during assessment period [CMS Assessment] |
| 101324-2 | MDS v3.0 - RAI v1.18.11 - Mobility - Discharge Goal during assessment period [CMS Assessment] |
| 101325-9 | MDS v3.0 - RAI v1.18.11 - Tub/shower transfer - functional goal [CMS Assessment] |
| 101326-7 | MDS v3.0 - RAI v1.18.11 - Pain assessment interview during assessment period [CMS Assessment] |
| 101327-5 | MDS v3.0 - RAI v1.18.11 - Nutritional approaches - on admission during assessment period [CMS Assessment] |
| 101328-3 | MDS v3.0 - RAI v1.18.11 - Nutritional approaches - at discharge during assessment period [CMS Assessment] |
| 101329-1 | MDS v3.0 - RAI v1.18.11 - Participation in assessment and goal setting [CMS Assessment] |
| 101330-9 | MDS v3.0 - RAI v1.18.11 - Number of venous and arterial ulcers during assessment period [CMS Assessment] |
| 101331-7 | MDS v3.0 - RAI v1.18.11 - Ulcers, wounds and skin problems during assessment period [CMS Assessment] |
| 101332-5 | MDS v3.0 - RAI v1.18.11 - Reason referral to local contact agency not made [CMS Assessment] |
| 101333-3 | MDS v3.0 - RAI v1.18.11 - Determination of pressure injury risk [CMS Assessment] |
| 101337-4 | Treatment preferences under certain health conditions [Reported] |
| 101346-5 | MDS v3.0 - RAI v1.18.11 - Special Treatments, Procedures, and Programs [CMS Assessment] |
| 101347-3 | MDS v3.0 - RAI v1.18.11 - Return to community [CMS Assessment] |
| 101351-5 | Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living during assessment period [CMS Assessment] |
| 101374-7 | MDS v3.0 - RAI v1.18.11 - Referral has been made to the local contact agency Patient education material [CMS Assessment] |
| 101429-9 | MDS v3.0 - RAI v1.18.11 - Self-care - discharge performance during assessment period [CMS Assessment] |
| 101430-7 | MDS v3.0 - RAI v1.18.11 - Self-Care - OBRA/Interim Performance |
| 101431-5 | MDS v3.0 - RAI v1.18.11 - Mobility - discharge performance [CMS Assessment] |
| 101432-3 | MDS v3.0 - RAI v1.18.11 - Mobility - OBRA/Interim Performance |
| 101435-6 | MDS v3.0 - RAI v1.18.11 - Referral [CMS Assessment] |
| 101436-4 | MDS v3.0 - RAI v1.18.11 - Discharge plan [CMS Assessment] |
| 101591-6 | CMS - Identification Information during assessment period [CMS Assessment] |
| 101592-4 | CMS - Cognitive Patterns during assessment period [CMS Assessment] |
| 101593-2 | CMS - Delirium during assessment period [CMS Assessment] |
| 101594-0 | CMS - Mood during assessment period [CMS Assessment] |
| 101595-7 | CMS - Functional Abilities and Goals during assessment period [CMS Assessment] |
| 101596-5 | CMS - Prior functioning: everyday activities during assessment period [CMS Assessment] |
| 101597-3 | CMS - Tub and or shower transfer - functional goal [CMS Assessment] |
| 101598-1 | CMS - Functional Abilities and Goals - OBRA and or Interim [CMS Assessment] |
| 101599-9 | CMS - Self-Care - OBRA during assessment period [CMS Assessment] |
| 101600-5 | CMS - Mobility - OBRA during assessment period [CMS Assessment] |
| 101601-3 | CMS - Active Diagnoses during assessment period [CMS Assessment] |
| 101602-1 | CMS - Health Conditions during assessment period [CMS Assessment] |
| 101603-9 | CMS - Pain assessment interview during assessment period [CMS Assessment] |
| 101604-7 | CMS - Swallowing and or Nutritional Status [CMS Assessment] |
| 101605-4 | CMS - Nutritional approaches - at discharge during assessment period [CMS Assessment] |
| 101606-2 | CMS - Oral and or Dental Status [CMS Assessment] |
| 101607-0 | CMS - Skin Conditions during assessment period [CMS Assessment] |
| 101608-8 | CMS - Determination of Pressure Ulcer during assessment period [CMS Assessment] |
| 101609-6 | CMS - Number of Venous and Arterial Ulcers during assessment period [CMS Assessment] |
| 101610-4 | CMS - Other Ulcers, Wounds and Skin Problems during assessment period [CMS Assessment] |
| 101611-2 | CMS - Current number of unhealed pressure injuries at each stage during assessment period [CMS Assessment] |
| 101612-0 | CMS - High risk drug classes - use and indication during assessment period [CMS Assessment] |
| 101613-8 | CMS - Header - Special Treatments, Procedures, and Programs during assessment period [CMS Assessment] |
| 101614-6 | CMS - Special Treatments, Procedures, and Programs during assessment period [CMS Assessment] |
| 101615-3 | CMS - Header - Participation in Assessment and Goal Setting during assessment period [CMS Assessment] |
| 101616-1 | CMS - Participation in assessment and goal setting during assessment period [CMS Assessment] |
| 101617-9 | CMS - Discharge Plan during assessment period [CMS Assessment] |
| 101618-7 | CMS - Return to Community during assessment period [CMS Assessment] |
| 101619-5 | CMS - Referral during assessment period [CMS Assessment] |
| 101620-3 | CMS - Referral has been made to the local contact agency during assessment period [CMS Assessment] Patient education material |
| 101621-1 | CMS - Reason referral to local contact agency not made during assessment period [CMS Assessment] |
| 101622-9 | CMS - Correction Request during assessment period [CMS Assessment] |
| 101632-8 | CMS - Nutritional approaches - on admission during assessment period [CMS Assessment] |
| 101697-1 | Post traumatic stress disorder checklist - civilian version DSM-5 [PCL-5] |
| 101698-9 | PTSD PCL-5 score [PCL-5] |
| 101699-7 | Having strong negative beliefs about yourself, others, or the world [PCL-5] |
| 101700-3 | Blaming yourself or someone else for the stressful experience or what happened after it [PCL-5] |
| 101701-1 | Having strong negative feelings such as fear, horror, anger, guilt, or shame [PCL-5] |
| 101702-9 | Taking too many risks or doing things that could cause you harm [PCL-5] |
| 101703-7 | Repeated, disturbing, and unwanted memories of the stressful experience [PCL-5] |
| 101704-5 | Repeated, disturbing dreams of the stressful experience [PCL-5] |
| 101705-2 | Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it) [PCL-5] |
| 101706-0 | Feeling very upset when something reminded you of the stressful experience [PCL-5] |
| 101707-8 | Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating) [PCL-5] |
| 101708-6 | Avoiding memories, thoughts, or feelings related to the stressful experience [PCL-5] |
| 101709-4 | Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations) [PCL-5] |
| 101710-2 | Trouble remembering important parts of the stressful experience [PCL-5] |
| 101711-0 | Loss of interest in activities that you used to enjoy [PCL-5] |
| 101712-8 | Feeling distant or cut off from other people [PCL-5] |
| 101713-6 | Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you) [PCL-5] |
| 101714-4 | Irritable behavior, angry outbursts, or acting aggressively [PCL-5] |
| 101715-1 | Being superalert or watchful or on guard [PCL-5] |
| 101716-9 | Feeling jumpy or easily startled [PCL-5] |
| 101717-7 | Having difficulty concentrating [PCL-5] |
| 101718-5 | Trouble falling or staying asleep [PCL-5] |
| 101967-8 | Neonatal infant pain scale panel (NIPS) |
| 102010-6 | The Primary Care PTSD Screen for DSM-5 [PC-PTSD-5] |
| 102011-4 | Have you experienced a frightening, horrible, or traumatic event [PC-PTSD-5] |
| 102012-2 | Have you had nightmares or thoughts about the event(s) when you did not want to [PC-PTSD-5] |
| 102013-0 | Have you tried not to think about or avoided situations that reminded you of the event(s) [PC-PTSD-5] |
| 102014-8 | Have you been constantly on guard, watchful, or easily startled [PC-PTSD-5] |
| 102015-5 | Have you felt numb or detached from people, activities, or your surroundings [PC-PTSD-5] |
| 102016-3 | Have you felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused [PC-PTSD-5] |
| 102017-1 | PC-PTSD-5 score [PC-PTSD-5] |
| 103563-3 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.19.1 [CMS Assessment] |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 103568-2 | MDS v3.0 - RAI v1.19.1 - COVID-19 Vaccine [CMS Assessment] |
| 103569-0 | MDS v3.0 - RAI v1.19.1 - Is the resident's COVID-19 vaccination up to date? [CMS Assessment] |
| 103692-0 | Body height during assessment period [CMS Assessment] |
| 103693-8 | Body weight during assessment period [CMS Assessment] |
| 103694-6 | Brief interview for mental status during assessment period [CMS Assessment] |
| 103695-3 | Recall during assessment period [CMS Assessment] |
| 103696-1 | Repetition of three words during assessment period [CMS Assessment] |
| 103697-9 | Temporal orientation - current year during assessment period [CMS Assessment] |
| 103698-7 | Temporal orientation - current month during assessment period [CMS Assessment] |
| 103699-5 | Recall - sock during assessment period [CMS Assessment] |
| 103700-1 | Recall - blue during assessment period [CMS Assessment] |
| 103701-9 | Recall - bed during assessment period [CMS Assessment] |
| 103702-7 | Temporal orientation (orientation to year, month, and day) during assessment period [CMS Assessment] |
| 103703-5 | Temporal orientation - current day of the week [CMS Assessment] |
| 103704-3 | Brief Interview for Mental Status - summary score during assessment period [CMS Assessment] |
| 103705-0 | Mood interview total severity score during assessment period [CMS Assessment] |
| 103706-8 | Staff assessment of resident mood (PHQ-9-OV) during assessment period [CMS Assessment] |
| 103707-6 | Staff assessment of resident mood total severity score during assessment period [CMS Assessment] |
| 103708-4 | Race during assessment period [CMS Assessment] |
| 103709-2 | How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy during assessment period [CMS Assessment] |
| 103846-2 | How many hours per day have you spent surfing the net over the last 2 weeks |
| 103931-2 | How many hours per day have you spent on social media platforms over the past 2 weeks |
| 103932-0 | How many hours per day have you spent watching news on television over the past 2 weeks |
| 103933-8 | How many hours per day have you spent speaking with friends or family over the past 2 weeks |
| 103934-6 | How many hours per day have you spent on streaming platforms over the past 2 weeks |
| 103935-3 | Are you in a committed relationship |
| 103936-1 | Which household type do you live in |
| 103937-9 | What would you say how is the mental health of your partner is |
| 103938-7 | What would you say is the quality of your partnership |
| 103939-5 | Do you have underage persons in your household |
| 103941-1 | For each underage person what would you say how is the mental health of underage person |
| 103942-9 | Mental health of household members comments |
| 103946-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 during assessment period [CMS Assessment] |
| 103947-8 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.1 during assessment period [CMS Assessment] |
| 103948-6 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 5.1 during assessment period [CMS Assessment] |
| 103949-4 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.1 during assessment period [CMS Assessment] |
| 103978-3 | Information to tell doctors if you have a sudden injury or illness with a good chance of recovery [Reported] |
| 103979-1 | Information to tell the medical team if you stop breathing or your heart stops beating [Reported] |
| 103980-9 | Pharmacy preference [Reported] |
| 103981-7 | Do you feel physically or emotionally unsafe where you currently live |
| 103982-5 | Do you have a food insecurity |
| 103983-3 | Do you have a housing insecurity |
| 103984-1 | Do you have a travel insecurity |
| 103985-8 | Do you have utilities insecurity |
| 103986-6 | Do you have a personal safety insecurity |
| 103991-6 | CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment] |
| 103996-5 | In 2020 was it you or who was in charge of taking care of these underage persons |
| 103998-1 | IRF-PAI v4.2, LCDS v5.1, MDS v1.19.1 - Functional abilities - admission during assessment period [CMS Assessment] |
| 103999-9 | IRF-PAI v4.2, LCDS v5.1, MDS v1.19.1 - Functional abilities - discharge during assessment period [CMS Assessment] |
| 104005-4 | Information to tell doctors if you experience failing health with a low chance of recovery [Reported] |
| 104028-6 | Hendrich II fall risk model [Hendrich II] |
| 104039-3 | Have you experienced a delay in healthcare due to time needed to obtain an appointment was too long in past 12 months |
| 104040-1 | Unmet Healthcare Needs panel |
| 104041-9 | Have you had a delay in healthcare due to distance or transport problems in past 12 months |
| 104042-7 | Was there any time when you needed medical care, but could not afford it in past 12 months |
| 104043-5 | Was there any time when you needed dental care but could not afford it in past 12 months |
| 104049-2 | Was there any time when you needed prescribed medicines but could not afford it in past 12 months |
| 104050-0 | Was there any time when the following kinds of mental health care but could not afford it in the past 12 months |
| 104052-6 | Lifestyle Factors panel |
| 104053-4 | Have you been in lockdown in last 2 weeks |
| 104054-2 | Have the schools been closed in last 2 weeks |
| 104055-9 | Did you work remotely at home completely or only on several days per week during last 2 weeks |
| 104056-7 | Were you obliged to wear masks in closed public areas in last 2 weeks |
| 104057-5 | Were you obliged to wear masks in open public areas in last 2 weeks |
| 104058-3 | Were you obliged to follow the vaccinated-tested-recovered rule in last 2 weeks |
| 104059-1 | Have you been to any other places or events not yet specified |
| 104060-9 | When contacting people outside of household have you kept a minimum of 1.5 to 2 meters away |
| 104077-3 | Are underage people living in household |
| 104078-1 | Number of underage persons in household |
| 104079-9 | Frequency of you or who was in charge of taking care of these underage persons in last 3 months |
| 104080-7 | Childcare from a provider or person outside the household was available in 2020 |
| 104081-5 | Childcare from a provider or person outside the household was available in past 3 months |
| 104082-3 | In 2020 how would you rate the balance between your work and family commitments at the time |
| 104083-1 | Rate of the balance between your work and family commitments in last 3 months |
| 104084-9 | Children and work family balance panel |
| 104104-5 | Mental Health Household Members panel |
| 104120-1 | Prevention Orchestra Project panel |
| 104135-9 | Feeling down, depressed, irritable, or hopeless in last 2 weeks [Reported.PHQ] |
| 104136-7 | Little interest or pleasure in doing things in last 2 weeks [Reported.PHQ] |
| 104138-3 | Poor appetite, weight loss, or overeating in last 2 weeks [Reported.PHQ] |
| 104141-7 | Trouble concentrating on things like school work, reading, or watching TV in last 2 weeks |
| 104552-5 | MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 104554-1 | MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 104601-0 | No harm related to unintentional sterile field/wound contamination |
| 104606-9 | MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 104607-7 | MDS v3.0 - RAI v1.19.1 - Swing Bed discharge (SD) item set during assessment period [CMS Assessment] |
| 104608-5 | MDS v3.0 - RAI v1.19.1 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 104609-3 | MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 105008-7 | MDS v3.0 - RAI v1.19.1 - Nursing home and Swing bed tracking (NT ST) item set during assessment period [CMS Assessment] |
| 105042-6 | Ramsay sedation scale [Reported.RSS] |
| 105043-4 | Sedation level [Reported.RSS] |
| 105044-2 | Ramsay sedation scale total score [Reported.RSS] |
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 105201-8 | MDS v3.0 - RAI v1.19.1 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 106220-7 | Ventilator Liberation Rate during assessment period [CMS Assessment] |
| 106345-2 | NICHQ Vanderbilt Assessment Scale - Parent Informant |
| 106346-0 | Is this evaluation based on a time when the child |
| 106347-8 | Does not pay attention to details or makes careless mistakes with, for example, homework |
| 106348-6 | Has difficulty keeping attention to what needs to be done |
| 106349-4 | Does not seem to listen when spoken to directly |
| 106350-2 | Does not follow through when given directions and fails to finish activities (not due to refusal or failure to understand) |
| 106351-0 | Has difficulty organizing tasks and activities |
| 106352-8 | Avoids, dislikes, or does not want to start tasks that require ongoing mental effort |
| 106353-6 | Loses things necessary for tasks or activities (toys, assignments, pencils, or books) |
| 106354-4 | Is easily distracted by noises or other stimuli |
| 106355-1 | Is forgetful in daily activities |
| 106356-9 | Fidgets with hands or feet or squirms in seat |
| 106357-7 | Leaves seat when remaining seated is expected |
| 106358-5 | Runs about or climbs too much when remaining seated is expected |
| 106359-3 | Has difficulty playing or beginning quiet play activities |
| 106360-1 | Is on the go or often acts as if driven by a motor |
| 106361-9 | Talks too much |
| 106362-7 | Blurts out answers before questions have been completed |
| 106363-5 | Has difficulty waiting his or her turn |
| 106364-3 | Interrupts or intrudes in on others' conversations or activities |
| 106365-0 | Argues with adults |
| 106366-8 | Loses temper |
| 106367-6 | Actively defies or refuses to go along with adults' requests or rules |
| 106368-4 | Deliberately annoys people |
| 106369-2 | Blames others for his or her mistakes or misbehaviors |
| 106370-0 | Is touchy or easily annoyed by others |
| 106371-8 | Is angry or resentful |
| 106372-6 | Is spiteful and wants to get even |
| 106373-4 | Bullies, threatens, or intimidates others |
| 106374-2 | Starts physical fights |
| 106375-9 | Lies to get out of trouble or to avoid obligations (ie cons others) |
| 106376-7 | Is truant from school (skips school) without permission |
| 106377-5 | Is physically cruel to people |
| 106378-3 | Has stolen things that have value |
| 106379-1 | Deliberately destroys others' property |
| 106380-9 | Has used a weapon that can cause serious harm (bat, knife, brick, gun) |
| 106381-7 | Is physically cruel to animals |
| 106382-5 | Has deliberately set fires to cause damage |
| 106383-3 | Has broken into someone else's home, business, or car |
| 106384-1 | Has stayed out at night without permission |
| 106385-8 | Has run away from home overnight |
| 106386-6 | Has forced someone into sexual activity |
| 106387-4 | Is fearful, anxious, or worried |
| 106388-2 | Is afraid to try new things for fear of making mistakes |
| 106389-0 | Feels worthless or inferior |
| 106390-8 | Blames self for problems, feels guilty |
| 106391-6 | Feels lonely, unwanted, or unloved; complains that no one loves him or her |
| 106392-4 | Is sad, unhappy, or depressed |
| 106393-2 | Is self-conscious or easily embarrassed |
| 106394-0 | Overall school performance |
| 106395-7 | Reading |
| 106396-5 | Writing |
| 106397-3 | Mathematics |
| 106398-1 | Relationship with parents |
| 106399-9 | Relationship with siblings |
| 106400-5 | Relationship with peers |
| 106401-3 | Participation in organized activities (eg, teams) |
| 106402-1 | Inattention Score |
| 106403-9 | Hyperactivity or impulsivity score |
| 106404-7 | Inattention and hyperactivity or impulsivity score |
| 106405-4 | Oppositional-defiant score |
| 106406-2 | Conduct Disorder Score |
| 106407-0 | Anxiety or depression score |
| 106408-8 | Performance Score |
| 106409-6 | Average Performance Score |
| 28079-2 | Activities of daily living alteration [CCC] |
| 28080-0 | Activity alteration [CCC] |
| 28081-8 | Activity intolerance [CCC] |
| 28082-6 | Activity intolerance risk [CCC] |
| 28083-4 | Acute pain [CCC] |
| 28084-2 | Adjustment impairment [CCC] |
| 28085-9 | Airway clearance impairment [CCC] |
| 28086-7 | Decisional conflict [CCC] |
| 28087-5 | Defensive coping [CCC] |
| 28088-3 | Denial [CCC] |
| 28089-1 | Diarrhea [CCC] |
| 28090-9 | Disabled family coping Family [CCC] |
| 28091-7 | Disuse syndrome [CCC] |
| 28092-5 | Diversional activity deficit [CCC] |
| 28093-3 | Dressing/grooming deficit [CCC] |
| 28094-1 | Dying process [CCC] |
| 28095-8 | Dysfunctional grieving [CCC] |
| 28096-6 | Autonomic dysreflexia [CCC] |
| 28097-4 | Endocrine alteration [CCC] |
| 28098-2 | Family coping impairment Family [CCC] |
| 28099-0 | Family process alteration Family [CCC] |
| 28100-6 | Fatigue [CCC] |
| 28101-4 | Fear [CCC] |
| 28102-2 | Fecal impaction [CCC] |
| 28103-0 | Feeding deficit [CCC] |
| 28104-8 | Fluid volume alteration [CCC] |
| 28105-5 | Fluid volume deficit [CCC] |
| 28106-3 | Fluid volume deficit risk [CCC] |
| 28107-1 | Fluid volume excess [CCC] |
| 28108-9 | Fluid volume excess risk [CCC] |
| 28109-7 | Functional urinary incontinence [CCC] |
| 28110-5 | Gas exchange impairment [CCC] |
| 28111-3 | Gastrointestinal alteration [CCC] |
| 28112-1 | Grieving [CCC] |
| 28113-9 | Growth and development alteration [CCC] |
| 28114-7 | Gustatory alteration [CCC] |
| 28115-4 | Health maintenance alteration [CCC] |
| 28116-2 | Health-seeking behavior alteration [CCC] |
| 28117-0 | Home maintenance alteration [CCC] |
| 28118-8 | Hopelessness [CCC] |
| 28119-6 | Hypothermia [CCC] |
| 28120-4 | Hyperthermia [CCC] |
| 28121-2 | Immunologic alteration [CCC] |
| 28122-0 | Individual coping impairment [CCC] |
| 28123-8 | Infection risk [CCC] |
| 28124-6 | Infection [CCC] |
| 28125-3 | Injury risk [CCC] |
| 28126-1 | Instrumental activity of daily living (IADLS) alteration [CCC] |
| 28127-9 | Kinesthetic alteration [CCC] |
| 28128-7 | Knowledge deficit [CCC] |
| 28129-5 | Knowledge deficit of diagnostic test [CCC] |
| 28130-3 | Knowledge deficit of dietary regimen [CCC] |
| 28131-1 | Knowledge deficit of disease process [CCC] |
| 28132-9 | Knowledge deficit of fluid volume [CCC] |
| 28133-7 | Knowledge deficit of medication regimen [CCC] |
| 28134-5 | Anticipatory grieving [CCC] |
| 28135-2 | Anxiety [CCC] |
| 28136-0 | Aspiration risk [CCC] |
| 28137-8 | Auditory alteration [CCC] |
| 28138-6 | Bathing/hygiene deficit [CCC] |
| 28139-4 | Blood pressure alteration [CCC] |
| 28140-2 | Body image disturbance [CCC] |
| 28141-0 | Body nutrition deficit [CCC] |
| 28142-8 | Body nutrition deficit risk [CCC] |
| 28143-6 | Body nutrition excess [CCC] |
| 28144-4 | Body nutrition excess risk [CCC] |
| 28145-1 | Bowel elimination alteration [CCC] |
| 28146-9 | Bowel incontinence [CCC] |
| 28147-7 | Breastfeeding impairment [CCC] |
| 28148-5 | Breathing pattern impairment [CCC] |
| 28149-3 | Cardiac output alteration [CCC] |
| 28150-1 | Cardiovascular alteration [CCC] |
| 28151-9 | Cerebral alteration [CCC] |
| 28152-7 | Chronic low self-esteem disturbance [CCC] |
| 28153-5 | Chronic pain [CCC] |
| 28155-0 | Comfort alteration [CCC] |
| 28156-8 | Communication impairment [CCC] |
| 28158-4 | May choose to self-deliver at the end [Living with HIV] |
| 28159-2 | Meaningful life [Living with HIV] |
| 28160-0 | Medications are taking over my life [Living with HIV] |
| 28161-8 | Need help letting go [Living with HIV] |
| 28162-6 | No energy to fight back [Living with HIV] |
| 28163-4 | Not enjoying life [Living with HIV] |
| 28164-2 | Pain is hard to manage [Living with HIV] |
| 28165-9 | So many things yet undone [Living with HIV] |
| 28166-7 | Somewhat disconnected [Living with HIV] |
| 28167-5 | Stay at home and receive treatment [Living with HIV] |
| 28168-3 | Take time for important things [Living with HIV] |
| 28169-1 | Use time wisely [Living with HIV] |
| 28170-9 | Want to die at home [Living with HIV] |
| 28171-7 | Knowledge deficit of safety precautions [CCC] |
| 28172-5 | Knowledge deficit of therapeutic regimen [CCC] |
| 28173-3 | Meaningfulness alteration [CCC] |
| 28174-1 | Medication risk [CCC] |
| 28175-8 | Musculoskeletal alteration [CCC] |
| 28176-6 | Noncompliance [CCC] |
| 28177-4 | Noncompliance with diagnostic test [CCC] |
| 28178-2 | Noncompliance with dietary regimen [CCC] |
| 28179-0 | Noncompliance with safety precautions [CCC] |
| 28180-8 | Noncompliance with therapeutic regimen [CCC] |
| 28181-6 | Nutrition alteration [CCC] |
| 28182-4 | Olfactory alteration [CCC] |
| 28183-2 | Oral mucous membranes impairment [CCC] |
| 28184-0 | Parental role conflict [CCC] |
| 28185-7 | Parenting alteration [CCC] |
| 28186-5 | Perceived constipation [CCC] |
| 28187-3 | Peripheral alteration [CCC] |
| 28188-1 | Personal identity disturbance [CCC] |
| 28189-9 | Physical mobility impairment [CCC] |
| 28190-7 | Physical regulation alteration [CCC] |
| 28191-5 | Poisoning risk [CCC] |
| 28192-3 | Polypharmacy [CCC] |
| 28193-1 | Post-trauma response [CCC] |
| 28194-9 | Powerlessness [CCC] |
| 28196-4 | Rape trauma syndrome [CCC] |
| 28197-2 | Reflex urinary incontinence [CCC] |
| 28198-0 | Renal alteration [CCC] |
| 28199-8 | Respiration alteration [CCC] |
| 28200-4 | Role performance alteration [CCC] |
| 28201-2 | Self-care deficit [CCC] |
| 28202-0 | Self-concept alteration [CCC] |
| 28203-8 | Sensory perceptual alteration [CCC] |
| 28204-6 | Sexual dysfunction [CCC] |
| 28205-3 | Sexuality patterns alteration [CCC] |
| 28206-1 | Situational self-esteem disturbance [CCC] |
| 28207-9 | Skin incision [CCC] |
| 28208-7 | Skin integrity impairment [CCC] |
| 28209-5 | Skin integrity impairment risk [CCC] |
| 28210-3 | Sleep pattern disturbance [CCC] |
| 28211-1 | Social interaction alteration [CCC] |
| 28212-9 | Social isolation [CCC] |
| 28213-7 | Spiritual distress [CCC] |
| 28214-5 | Spiritual state alteration [CCC] |
| 28215-2 | Stress urinary incontinence [CCC] |
| 28216-0 | Suffocation risk [CCC] |
| 28217-8 | Sanitation Behavior Family [OMAHA] |
| 28218-6 | Sanitation Knowledge Family [OMAHA] |
| 28219-4 | Sanitation Status Family [OMAHA] |
| 28220-2 | Residence Behavior Family [OMAHA] |
| 28221-0 | Residence Knowledge Family [OMAHA] |
| 28222-8 | Residence Status Family [OMAHA] |
| 28223-6 | Neighborhood/workplace safety.behavior Family [OMAHA] |
| 28224-4 | Neighborhood/workplace safety..knowledge Family [OMAHA] |
| 28225-1 | Neighborhood/workplace safety.status Family [OMAHA] |
| 28226-9 | Swallowing impairment [CCC] |
| 28227-7 | Tactile alteration [CCC] |
| 28228-5 | Thermoregulation impairment [CCC] |
| 28229-3 | Thought process alteration [CCC] |
| 28230-1 | Tissue perfusion alteration [CCC] |
| 28231-9 | Toileting deficit [CCC] |
| 28233-5 | Trauma risk [CCC] |
| 28234-3 | Unilateral neglect [CCC] |
| 28235-0 | Constipation [CCC] |
| 28236-8 | Pain [CCC] |
| 28237-6 | Urge urinary incontinence [CCC] |
| 28238-4 | Urinary elimination alteration [CCC] |
| 28239-2 | Urinary retention [CCC] |
| 28240-0 | Verbal impairment [CCC] |
| 28241-8 | Violence risk [CCC] |
| 28242-6 | Visual alteration [CCC] |
| 28243-4 | Abuse Behavior [OMAHA] |
| 28244-2 | Abuse Knowledge [OMAHA] |
| 28245-9 | Abuse Status [OMAHA] |
| 28246-7 | Antepartum/postpartum.behavior [OMAHA] |
| 28247-5 | Antepartum/postpartum.status [OMAHA] |
| 28248-3 | Bowel Function Behavior [OMAHA] |
| 28249-1 | Bowel Function Knowledge [OMAHA] |
| 28250-9 | Bowel Function Status [OMAHA] |
| 28251-7 | Caretaking/parenting.behavior [OMAHA] |
| 28252-5 | Caretaking/parenting.knowledge [OMAHA] |
| 28253-3 | Caretaking/parenting.status [OMAHA] |
| 28254-1 | Circulation Behavior [OMAHA] |
| 28255-8 | Circulation Knowledge [OMAHA] |
| 28256-6 | Circulation Status [OMAHA] |
| 28257-4 | Cognition Behavior [OMAHA] |
| 28258-2 | Cognition Knowledge [OMAHA] |
| 28259-0 | Cognition Status [OMAHA] |
| 28260-8 | Communication With Community Resources Behavior [OMAHA] |
| 28261-6 | Communication With Community Resources Knowledge [OMAHA] |
| 28262-4 | Communication With Community Resources Status [OMAHA] |
| 28263-2 | Consciousness Behavior [OMAHA] |
| 28264-0 | Consciousness Knowledge [OMAHA] |
| 28265-7 | Consciousness Status [OMAHA] |
| 28266-5 | Dentition.behavior [OMAHA] |
| 28267-3 | Dentition.knowledge [OMAHA] |
| 28268-1 | Dentition.status [OMAHA] |
| 28269-9 | Digestion-hydration Behavior [OMAHA] |
| 28270-7 | Digestion-hydration Knowledge [OMAHA] |
| 28271-5 | Digestion-hydration Status [OMAHA] |
| 28272-3 | Mental Health Behavior [OMAHA] |
| 28273-1 | Mental Health Knowledge [OMAHA] |
| 28274-9 | Mental Health Status [OMAHA] |
| 28275-6 | Family Planning Behavior [OMAHA] |
| 28276-4 | Family Planning Knowledge [OMAHA] |
| 28277-2 | Family Planning Status [OMAHA] |
| 28278-0 | Genito-urinary function.behavior [OMAHA] |
| 28279-8 | Genito-urinary function.knowledge [OMAHA] |
| 28280-6 | Genito-urinary function.status [OMAHA] |
| 28281-4 | Grief Behavior [OMAHA] |
| 28282-2 | Grief Knowledge [OMAHA] |
| 28283-0 | Grief Status [OMAHA] |
| 28284-8 | Growth And Development Behavior [OMAHA] |
| 28285-5 | Growth And Development Knowledge [OMAHA] |
| 28286-3 | Growth And Development Status [OMAHA] |
| 28287-1 | Health Care Supervision Behavior [OMAHA] |
| 28288-9 | Health Care Supervision Knowledge [OMAHA] |
| 28289-7 | Health Care Supervision Status [OMAHA] |
| 28290-5 | Hearing Behavior [OMAHA] |
| 28291-3 | Hearing Knowledge [OMAHA] |
| 28292-1 | Hearing Status [OMAHA] |
| 28293-9 | Sexuality Behavior [OMAHA] |
| 28294-7 | Sexuality Knowledge [OMAHA] |
| 28295-4 | Sexuality Status [OMAHA] |
| 28296-2 | Income Behavior [OMAHA] |
| 28297-0 | Income Knowledge [OMAHA] |
| 28298-8 | Income Status [OMAHA] |
| 28299-6 | Skin Behavior [OMAHA] |
| 28300-2 | Skin Knowledge [OMAHA] |
| 28301-0 | Skin Status [OMAHA] |
| 28302-8 | Interpersonal Relationship Behavior [OMAHA] |
| 28303-6 | Interpersonal Relationship Knowledge [OMAHA] |
| 28304-4 | Interpersonal Relationship Status [OMAHA] |
| 28305-1 | Neglect Behavior [OMAHA] |
| 28306-9 | Neglect Knowledge [OMAHA] |
| 28307-7 | Neglect Status [OMAHA] |
| 28308-5 | Neighborhood/workplace safety.behavior [OMAHA] |
| 28309-3 | Neighborhood/workplace safety..knowledge [OMAHA] |
| 28310-1 | Neighborhood/workplace safety.status [OMAHA] |
| 28311-9 | Neuro-musculo-skeletal Function Behavior [OMAHA] |
| 28312-7 | Neuro-musculo-skeletal Function Knowledge [OMAHA] |
| 28313-5 | Neuro-musculo-skeletal Function Status [OMAHA] |
| 28314-3 | Nutrition Behavior [OMAHA] |
| 28315-0 | Nutrition Knowledge [OMAHA] |
| 28316-8 | Nutrition Status [OMAHA] |
| 28317-6 | Pain Behavior [OMAHA] |
| 28318-4 | Pain Knowledge [OMAHA] |
| 28319-2 | Pain Status [OMAHA] |
| 28320-0 | Personal Care Behavior [OMAHA] |
| 28321-8 | Personal Care Knowledge [OMAHA] |
| 28322-6 | Personal Care Status [OMAHA] |
| 28323-4 | Physical Activity Behavior [OMAHA] |
| 28324-2 | Physical Activity Knowledge [OMAHA] |
| 28325-9 | Physical Activity Status [OMAHA] |
| 28326-7 | Medication Regimen Behavior [OMAHA] |
| 28327-5 | Medication Regimen Knowledge [OMAHA] |
| 28328-3 | Medication Regimen Status [OMAHA] |
| 28329-1 | Residence Behavior [OMAHA] |
| 28330-9 | Residence Knowledge [OMAHA] |
| 28331-7 | Residence Status [OMAHA] |
| 28332-5 | Respiration Behavior [OMAHA] |
| 28333-3 | Respiration Knowledge [OMAHA] |
| 28334-1 | Respiration Status [OMAHA] |
| 28335-8 | Role Change Behavior [OMAHA] |
| 28336-6 | Role Change Knowledge [OMAHA] |
| 28337-4 | Role Change Status [OMAHA] |
| 28338-2 | Sanitation Behavior [OMAHA] |
| 28339-0 | Sanitation Knowledge [OMAHA] |
| 28340-8 | Sanitation Status [OMAHA] |
| 28341-6 | Sleep And Rest Pattern Behavior [OMAHA] |
| 28342-4 | Sleep And Rest Pattern Knowledge [OMAHA] |
| 28343-2 | Sleep And Rest Pattern Status [OMAHA] |
| 28344-0 | Social Contact Behavior [OMAHA] |
| 28345-7 | Social Contact Knowledge [OMAHA] |
| 28346-5 | Social Contact Status [OMAHA] |
| 28347-3 | Speech And Language Behavior [OMAHA] |
| 28348-1 | Speech And Language Knowledge [OMAHA] |
| 28349-9 | Speech And Language Status [OMAHA] |
| 28350-7 | Spirituality Behavior [OMAHA] |
| 28351-5 | Spirituality Knowledge [OMAHA] |
| 28352-3 | Spirituality Status [OMAHA] |
| 28353-1 | Substance Use Behavior [OMAHA] |
| 28354-9 | Substance Use Knowledge [OMAHA] |
| 28355-6 | Substance Use Status [OMAHA] |
| 28356-4 | Technical procedure.behavior [OMAHA] |
| 28357-2 | Technical procedure.knowledge [OMAHA] |
| 28358-0 | Technical procedure.status [OMAHA] |
| 28359-8 | Vision Behavior [OMAHA] |
| 28360-6 | Vision Knowledge [OMAHA] |
| 28361-4 | Vision Status [OMAHA] |
| 28362-2 | Anxiety [QAM] |
| 28363-0 | Fear [QAM] |
| 28364-8 | Afraid of pain and suffering [Living with HIV] |
| 28365-5 | Afraid to die [Living with HIV] |
| 28366-3 | Comfortable and well cared for [Living with HIV] |
| 28367-1 | Don't want high technology to keep me alive [Living with HIV] |
| 28368-9 | Don't have to keep fighting [Living with HIV] |
| 28369-7 | Embarrassed by the way I look [Living with HIV] |
| 28370-5 | Extra effort to do things [Living with HIV] |
| 28371-3 | Feel spiritual as I near the end [Living with HIV] |
| 28372-1 | Financial situation is distressing [Living with HIV] |
| 28373-9 | Frightened over little control [Living with HIV] |
| 28374-7 | Giving up things [Living with HIV] |
| 28375-4 | Anxiety [HIV-SSC] |
| 28376-2 | Chills [HIV-SSC] |
| 28377-0 | Day sweats [HIV-SSC] |
| 28378-8 | Depression [HIV-SSC] |
| 28379-6 | Diarrhea [HIV-SSC] |
| 28380-4 | Difficulty concentrating [HIV-SSC] |
| 28381-2 | Disorientation [HIV-SSC] |
| 28382-0 | Dry mouth [HIV-SSC] |
| 28383-8 | Fatigue [HIV-SSC] |
| 28384-6 | Fear [HIV-SSC] |
| 28385-3 | Fever [HIV-SSC] |
| 28386-1 | Gas /bloating [HIV-SSC] |
| 28387-9 | Lack of appetite [HIV-SSC] |
| 28388-7 | Loose stools [HIV-SSC] |
| 28389-5 | Memory loss [HIV-SSC] |
| 28390-3 | Muscle aches [HIV-SSC] |
| 28391-1 | Nausea [HIV-SSC] |
| 28392-9 | Night sweats [HIV-SSC] |
| 28393-7 | Painful joints [HIV-SSC] |
| 28394-5 | Shortness of breath at rest [HIV-SSC] |
| 28395-2 | Shortness of breath with activity [HIV-SSC] |
| 28396-0 | Thirsty [HIV-SSC] |
| 28397-8 | Vomiting [HIV-SSC] |
| 28398-6 | Weakness [HIV-SSC] |
| 28399-4 | Wheezing [HIV-SSC] |
| 28400-0 | I live for today [Living with HIV] |
| 28401-8 | Important to be in charge [Living with HIV] |
| 28402-6 | Important to be surrounded by those I love [Living with HIV] |
| 28403-4 | Independence [Living with HIV] |
| 28404-2 | Live life day to day [Living with HIV] |
| 28405-9 | Losing my looks is devastating [Living with HIV] |
| 28406-7 | Loss of independence [Living with HIV] |
| 28407-5 | Lots of regrets [Living with HIV] |
| 28408-3 | Toileting [QAM] |
| 28409-1 | Dressing [QAM] |
| 28410-9 | Grooming [QAM] |
| 28411-7 | Personal hygiene [QAM] |
| 28412-5 | Physical performance [QAM] |
| 28413-3 | Ambulation [QAM] |
| 28414-1 | Activity [QAM] |
| 28415-8 | Communication With Community Resources Behavior Family [OMAHA] |
| 28416-6 | Communication With Community Resources Knowledge Family [OMAHA] |
| 28417-4 | Communication With Community Resources Status Family [OMAHA] |
| 28418-2 | Social Contact Behavior Family [OMAHA] |
| 28419-0 | Social Contact Knowledge Family [OMAHA] |
| 28420-8 | Social Contact Status Family [OMAHA] |
| 28421-6 | Role Change Behavior Family [OMAHA] |
| 28422-4 | Role Change Knowledge Family [OMAHA] |
| 28423-2 | Role Change Status Family [OMAHA] |
| 28424-0 | Interpersonal Relationship Knowledge Family [OMAHA] |
| 28425-7 | Interpersonal Relationship Status Family [OMAHA] |
| 28426-5 | Neglect Behavior Family [OMAHA] |
| 28427-3 | Spirituality Behavior Family [OMAHA] |
| 28428-1 | Spirituality Knowledge Family [OMAHA] |
| 28429-9 | Spirituality Status Family [OMAHA] |
| 28430-7 | Grief Behavior Family [OMAHA] |
| 28431-5 | Grief Knowledge Family [OMAHA] |
| 28432-3 | Grief Status Family [OMAHA] |
| 28433-1 | Mental Health Behavior Family [OMAHA] |
| 28434-9 | Mental Health Knowledge Family [OMAHA] |
| 28435-6 | Mental Health Status Family [OMAHA] |
| 28436-4 | Sexuality Behavior Family [OMAHA] |
| 28437-2 | Sexuality Knowledge Family [OMAHA] |
| 28438-0 | Sexuality Status Family [OMAHA] |
| 28439-8 | Interpersonal Relationship Behavior Family [OMAHA] |
| 28440-6 | Caretaking/parenting.behavior Family [OMAHA] |
| 28441-4 | Caretaking/parenting.knowledge Family [OMAHA] |
| 28442-2 | Caretaking/parenting.status Family [OMAHA] |
| 28443-0 | Neglect Knowledge Family [OMAHA] |
| 28444-8 | Neglect Status Family [OMAHA] |
| 28445-5 | Abuse Behavior Family [OMAHA] |
| 28446-3 | Abuse Knowledge Family [OMAHA] |
| 28447-1 | Abuse Status Family [OMAHA] |
| 28448-9 | Growth And Development Behavior Family [OMAHA] |
| 28449-7 | Growth And Development Knowledge Family [OMAHA] |
| 28450-5 | Growth And Development Status Family [OMAHA] |
| 28451-3 | Hearing Behavior Family [OMAHA] |
| 28452-1 | Hearing Status Family [OMAHA] |
| 28453-9 | Vision Behavior Family [OMAHA] |
| 28454-7 | Vision Knowledge Family [OMAHA] |
| 28455-4 | Vision Status Family [OMAHA] |
| 28456-2 | Speech And Language Behavior Family [OMAHA] |
| 28457-0 | Speech And Language Knowledge Family [OMAHA] |
| 28458-8 | Speech And Language Status Family [OMAHA] |
| 28459-6 | Dentition.behavior Family [OMAHA] |
| 28460-4 | Dentition.knowledge Family [OMAHA] |
| 28461-2 | Dentition.status Family [OMAHA] |
| 28462-0 | Cognition Behavior Family [OMAHA] |
| 28463-8 | Cognition Knowledge Family [OMAHA] |
| 28464-6 | Cognition Status Family [OMAHA] |
| 28465-3 | Pain Behavior Family [OMAHA] |
| 28466-1 | Pain Knowledge Family [OMAHA] |
| 28467-9 | Pain Status Family [OMAHA] |
| 28468-7 | Consciousness Behavior Family [OMAHA] |
| 28469-5 | Consciousness Knowledge Family [OMAHA] |
| 28470-3 | Consciousness Status Family [OMAHA] |
| 28471-1 | Skin Behavior Family [OMAHA] |
| 28472-9 | Skin Knowledge Family [OMAHA] |
| 28473-7 | Skin Status Family [OMAHA] |
| 28474-5 | Neuro-musculo-skeletal Function Behavior Family [OMAHA] |
| 28475-2 | Neuro-musculo-skeletal Function Knowledge Family [OMAHA] |
| 28476-0 | Neuro-musculo-skeletal Function Status Family [OMAHA] |
| 28477-8 | Respiration Behavior Family [OMAHA] |
| 28478-6 | Respiration Knowledge Family [OMAHA] |
| 28479-4 | Respiration Status Family [OMAHA] |
| 28480-2 | Circulation Behavior Family [OMAHA] |
| 28481-0 | Circulation Knowledge Family [OMAHA] |
| 28482-8 | Circulation Status Family [OMAHA] |
| 28483-6 | Digestion-hydration Behavior Family [OMAHA] |
| 28484-4 | Digestion-hydration Knowledge Family [OMAHA] |
| 28485-1 | Digestion-hydration Status Family [OMAHA] |
| 28486-9 | Bowel Function Behavior Family [OMAHA] |
| 28487-7 | Bowel Function Knowledge Family [OMAHA] |
| 28488-5 | Bowel Function Status Family [OMAHA] |
| 28489-3 | Genito-urinary function.behavior Family [OMAHA] |
| 28490-1 | Genito-urinary function.knowledge Family [OMAHA] |
| 28491-9 | Genito-urinary function.status Family [OMAHA] |
| 28492-7 | Antepartum/postpartum.behavior Family [OMAHA] |
| 28493-5 | Antepartum/postpartum.status Family [OMAHA] |
| 28494-3 | Antepartum/postpartum.knowledge Family [OMAHA] |
| 28495-0 | Nutrition Behavior Family [OMAHA] |
| 28496-8 | Nutrition Knowledge Family [OMAHA] |
| 28497-6 | Nutrition Status Family [OMAHA] |
| 28498-4 | Sleep And Rest Pattern Behavior Family [OMAHA] |
| 28499-2 | Sleep And Rest Pattern Knowledge Family [OMAHA] |
| 28500-7 | Sleep And Rest Pattern Status Family [OMAHA] |
| 28501-5 | Physical Activity Behavior Family [OMAHA] |
| 28502-3 | Physical Activity Knowledge Family [OMAHA] |
| 28503-1 | Physical Activity Status Family [OMAHA] |
| 28504-9 | Personal Care Behavior Family [OMAHA] |
| 28505-6 | Personal Care Knowledge Family [OMAHA] |
| 28506-4 | Personal Care Status Family [OMAHA] |
| 28507-2 | Substance Use Behavior Family [OMAHA] |
| 28508-0 | Substance Use Knowledge Family [OMAHA] |
| 28509-8 | Substance Use Status Family [OMAHA] |
| 28510-6 | Family Planning Behavior Family [OMAHA] |
| 28511-4 | Family Planning Knowledge Family [OMAHA] |
| 28512-2 | Family Planning Status Family [OMAHA] |
| 28513-0 | Health Care Supervision Behavior Family [OMAHA] |
| 28514-8 | Health Care Supervision Knowledge Family [OMAHA] |
| 28515-5 | Health Care Supervision Status Family [OMAHA] |
| 28516-3 | Medication Regimen Behavior Family [OMAHA] |
| 28517-1 | Medication Regimen Knowledge Family [OMAHA] |
| 28518-9 | Medication Regimen Status Family [OMAHA] |
| 28519-7 | Technical procedure.behavior Family [OMAHA] |
| 28520-5 | Technical procedure.knowledge Family [OMAHA] |
| 28521-3 | Technical procedure.status Family [OMAHA] |
| 28522-1 | Income Status Family [OMAHA] |
| 28523-9 | Noncompliance with fluid volume [CCC] |
| 28524-7 | Noncompliance with medication regimen [CCC] |
| 28525-4 | Socialization alteration [CCC] |
| 28526-2 | Skin integrity alteration [CCC] |
| 28527-0 | Family embarrassed [Living with HIV] |
| 28528-8 | No good church experience [Living with HIV] |
| 28529-6 | Strength from family [Living with HIV] |
| 28530-4 | Family does what needs done [Living with HIV] |
| 28531-2 | My hometown means a lot [Living with HIV] |
| 28532-0 | No purpose in life [Living with HIV] |
| 28533-8 | Antepartum/postpartum.knowledge [OMAHA] |
| 28534-6 | Bathing [QAM] |
| 28535-3 | Income Knowledge Family [OMAHA] |
| 28536-1 | Income Behavior Family [OMAHA] |
| 28537-9 | Hearing Knowledge Family [OMAHA] |
| 28538-7 | Abdominal pain [HIV-SSC] |
| 42819-3 | Failure to thrive [CCC] |
| 42820-1 | Intracranial adaptive capacity impairment [CCC] |
| 42821-9 | Caregiver role strain Caregiver [CCC] |
| 42822-7 | Relocation stress syndrome [CCC] |
| 42823-5 | Suicide risk [CCC] |
| 42824-3 | Self mutilation risk [CCC] |
| 42825-0 | Perioperative injury risk [CCC] |
| 42826-8 | Perioperative positioning injury [CCC] |
| 42827-6 | Surgical recovery delay [CCC] |
| 42828-4 | Substance abuse [CCC] |
| 42829-2 | Tobacco abuse [CCC] |
| 42830-0 | Alcohol abuse [CCC] |
| 42831-8 | Drug abuse [CCC] |
| 42832-6 | Latex allergy response [CCC] |
| 42833-4 | Reproductive risk [CCC] |
| 42834-2 | Fertility risk [CCC] |
| 42835-9 | Infertility risk [CCC] |
| 42836-7 | Contraception risk [CCC] |
| 42837-5 | Perinatal risk [CCC] |
| 42838-3 | Pregnancy risk [CCC] |
| 42839-1 | Labor risk [CCC] |
| 42840-9 | Delivery risk [CCC] |
| 42841-7 | Postpartum risk [CCC] |
| 42847-4 | Sleep deprivation [CCC] |
| 42848-2 | Nausea [CCC] |
| 42849-0 | Confusion [CCC] |
| 42850-8 | Memory impairment [CCC] |
| 42851-6 | Infant feeding pattern impairment [CCC] |
| 42853-2 | Ventilatory weaning impairment [CCC] |
| 42854-0 | Community coping impairment Community [CCC] |
| 44249-1 | PHQ-9 quick depression assessment panel [Reported.PHQ] |
| 44250-9 | Little interest or pleasure in doing things in last 2 weeks |
| 44251-7 | Poor appetite or overeating in last 2 weeks [Reported.PHQ] |
| 44252-5 | Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks [Reported.PHQ] |
| 44253-3 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2 weeks [Reported.PHQ] |
| 44254-1 | Feeling tired or having little energy in last 2 weeks [Reported.PHQ] |
| 44255-8 | Feeling down, depressed, or hopeless in last 2 weeks |
| 44256-6 | Perceived difficulty in last 2 weeks [Reported.PHQ] |
| 44258-2 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2 weeks [Reported.PHQ] |
| 44259-0 | Trouble falling or staying asleep, or sleeping too much in last 2 weeks [Reported.PHQ] |
| 44260-8 | Thoughts that you would be better off dead, or of hurting yourself in some way in last 2 weeks [Reported.PHQ] |
| 44261-6 | Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] |
| 45399-3 | Federal provider number Facility |
| 45405-8 | Ability to understand others [Minimum Data Set] |
| 45406-6 | Change in communication/hearing [Minimum Data Set] |
| 45407-4 | Vision [Minimum Data Set] |
| 45408-2 | Primary reason for assessment [Minimum Data Set (MDS) basic] |
| 45409-0 | Codes for assessments required for Medicare PPS or the State [Minimum Data Set] |
| 45410-8 | Admitted from (at entry) Facility [Minimum Data Set] |
| 45411-6 | Lived alone prior to admission [Minimum Data Set] |
| 45412-4 | History of prior stay at this nursing home [Minimum Data Set] |
| 45413-2 | History of stay in other nursing home [Minimum Data Set] |
| 45414-0 | History of stay in other residential facility [Minimum Data Set] |
| 45415-7 | History of stay at mental health/psychiatric setting [Minimum Data Set] |
| 45417-3 | None of the listed prior residential settings [Minimum Data Set] |
| 45419-9 | Language.other [Minimum Data Set] |
| 45420-7 | Mental health history [Minimum Data Set] |
| 45422-3 | Down's syndrome [Minimum Data Set] |
| 45423-1 | Autism [Minimum Data Set] |
| 45424-9 | Epilepsy [Minimum Data Set] |
| 45427-2 | Date background information form completed [Minimum Data Set] |
| 45428-0 | Stays up late at night [Minimum Data Set] |
| 45429-8 | Naps regularly during day [Minimum Data Set] |
| 45430-6 | Goes out 1 or more days a week [Minimum Data Set] |
| 45431-4 | Stays busy with hobbies, reading or fixed daily routine [Minimum Data Set] |
| 45432-2 | Spends most time alone or watching TV [Minimum Data Set] |
| 45433-0 | Moves independently indoors [Minimum Data Set] |
| 45434-8 | Use of tobacco products at least daily [Minimum Data Set] |
| 45435-5 | None of the listed cycle of daily events [Minimum Data Set] |
| 45436-3 | Distinct food preferences [Minimum Data Set] |
| 45437-1 | Eats between meals all or most days [Minimum Data Set] |
| 45438-9 | Use of alcohol at least weekly [Minimum Data Set] |
| 45439-7 | None of the listed eating patterns [Minimum Data Set] |
| 45440-5 | In bedclothes much of day [Minimum Data Set] |
| 45441-3 | Wakens to toilet all or most nights [Minimum Data Set] |
| 45442-1 | Has irregular bowel movement pattern [Minimum Data Set] |
| 45443-9 | Showers for bathing [Minimum Data Set] |
| 45444-7 | Bathing in PM [Minimum Data Set] |
| 45445-4 | None of the listed additional ADL patterns [Minimum Data Set] |
| 45446-2 | Daily contact with relatives/close friends [Minimum Data Set] |
| 45447-0 | Usually attends church, temple, etc. [Minimum Data Set] |
| 45448-8 | Finds strength in faith [Minimum Data Set] |
| 45449-6 | Daily animal companion/presence [Minimum Data Set] |
| 45450-4 | Involved in group activities [Minimum Data Set] |
| 45451-2 | None of the listed involvement patterns [Minimum Data Set] |
| 45452-0 | Unknown customary routine - resident/family unable to provide information [Minimum Data Set] |
| 45453-8 | Date of last day of MDS observation period [Minimum Data Set] |
| 45454-6 | Original or corrected copy of form # [Minimum Data Set] |
| 45455-3 | Date of reentry to facility [Minimum Data Set] |
| 45456-1 | Medicaid per diem [Minimum Data Set] |
| 45457-9 | Medicare per diem [Minimum Data Set] |
| 45458-7 | Medicare ancillary part A [Minimum Data Set] |
| 45459-5 | Medicare ancillary part B [Minimum Data Set] |
| 45460-3 | CHAMPUS Per Diem [Minimum Data Set] |
| 45461-1 | VA Per Diem [Minimum Data Set] |
| 45462-9 | Self or family pays for full per diem [Minimum Data Set] |
| 45463-7 | Medicaid resident liability or Medicare copayment [Minimum Data Set] |
| 45464-5 | Private insurance per diem [Minimum Data Set] |
| 45465-2 | Other per diem [Minimum Data Set] |
| 45466-0 | Legal guardian [Minimum Data Set] |
| 45467-8 | Other legal oversight [Minimum Data Set] |
| 45468-6 | Health care durable power attorney [Minimum Data Set] |
| 45469-4 | Financial durable power attorney [Minimum Data Set] |
| 45470-2 | Family member responsible [Minimum Data Set] |
| 45471-0 | Patient responsible for self [Minimum Data Set] |
| 45472-8 | Responsibility - none of above [Minimum Data Set] |
| 45474-4 | Advance directive - do not resuscitate [Minimum Data Set] |
| 45475-1 | Advance directive - do not hospitalize [Minimum Data Set] |
| 45476-9 | Advance directive - organ donation [Minimum Data Set] |
| 45477-7 | Advance directive - autopsy request [Minimum Data Set] |
| 45478-5 | Advance directive - feeding restrictions [Minimum Data Set] |
| 45479-3 | Advance directive - medication restrictions [Minimum Data Set] |
| 45480-1 | Advance directive - other treatment restrictions [Minimum Data Set] |
| 45481-9 | Advance directive - none [Minimum Data Set] |
| 45483-5 | Short-term memory OK [Minimum Data Set] |
| 45484-3 | Long-term memory OK [Minimum Data Set] |
| 45485-0 | Can recall current season [Minimum Data Set] |
| 45486-8 | Can recall location of own room [Minimum Data Set] |
| 45487-6 | Can recall staff names/faces [Minimum Data Set] |
| 45488-4 | Can recall that he or she is in nursing home [Minimum Data Set] |
| 45489-2 | Memory/recall - none of above are recalled [Minimum Data Set] |
| 45490-0 | Cognitive skills for daily decision making [Minimum Data Set] |
| 45491-8 | Easily distracted [Minimum Data Set] |
| 45492-6 | Periods of altered perception or awareness of surroundings [Minimum Data Set] |
| 45493-4 | Episodes of disorganized speech [Minimum Data Set] |
| 45494-2 | Periods of restlessness [Minimum Data Set] |
| 45495-9 | Periods of lethargy [Minimum Data Set] |
| 45496-7 | Mental function varies over the course of the day [Minimum Data Set] |
| 45497-5 | Change in cognitive status [Minimum Data Set] |
| 45498-3 | Hearing [Minimum Data Set] |
| 45499-1 | Hearing aid present and used [Minimum Data Set] |
| 45500-6 | Hearing aid present and not used regularly [Minimum Data Set] |
| 45501-4 | Other receptive communication techniques used [Minimum Data Set] |
| 45502-2 | No communication device [Minimum Data Set] |
| 45503-0 | Uses speech [Minimum Data Set] |
| 45504-8 | Uses written messages to express or clarify needs [Minimum Data Set] |
| 45505-5 | Uses American sign language or Braille [Minimum Data Set] |
| 45506-3 | Uses signs/gestures/sounds [Minimum Data Set] |
| 45507-1 | Uses communication board [Minimum Data Set] |
| 45508-9 | Uses other modes of expression [Minimum Data Set] |
| 45509-7 | Modes of expression - none of above [Minimum Data Set] |
| 45510-5 | Making self understood [Minimum Data Set] |
| 45511-3 | Speech clarity [Minimum Data Set] |
| 45512-1 | Side vision problems [Minimum Data Set] |
| 45513-9 | Sees halos or rings around lights, flashes of light, or curtains over eyes [Minimum Data Set] |
| 45514-7 | No visual limitations [Minimum Data Set] |
| 45515-4 | Visual appliances [Minimum Data Set] |
| 45516-2 | Resident made negative statements [Minimum Data Set] |
| 45517-0 | Repetitive questions [Minimum Data Set] |
| 45518-8 | Repetitive verbalizations [Minimum Data Set] |
| 45519-6 | Persistent anger with self or others [Minimum Data Set] |
| 45520-4 | Self deprecation [Minimum Data Set] |
| 45521-2 | Expression of what appear to be unrealistic fears [Minimum Data Set] |
| 45522-0 | Recurrent statements that something terrible is about to happen [Minimum Data Set] |
| 45523-8 | Balance while sitting - position, trunk control [Minimum Data Set] |
| 45524-6 | Range of motion Neck [Minimum Data Set] |
| 45525-3 | Voluntary movement Neck [Minimum Data Set] |
| 45526-1 | Range of motion Upper extremity [Minimum Data Set] |
| 45527-9 | Voluntary movement Upper extremity [Minimum Data Set] |
| 45528-7 | Range of motion Hand [Minimum Data Set] |
| 45529-5 | Voluntary movement Hand [Minimum Data Set] |
| 45530-3 | Range of motion Lower extremity [Minimum Data Set] |
| 45531-1 | Voluntary movement Lower extremity [Minimum Data Set] |
| 45532-9 | Range of motion Foot [Minimum Data Set] |
| 45533-7 | Voluntary movement Foot [Minimum Data Set] |
| 45534-5 | Other limitation or loss - range of motion [Minimum Data Set] |
| 45535-2 | Other limitation or loss - voluntary movement [Minimum Data Set] |
| 45536-0 | Uses cane, walker or crutch [Minimum Data Set] |
| 45537-8 | Wheeled self [Minimum Data Set] |
| 45538-6 | Other person wheeled [Minimum Data Set] |
| 45539-4 | Wheelchair primary mode of locomotion [Minimum Data Set] |
| 45540-2 | No modes of locomotion [Minimum Data Set] |
| 45541-0 | Bedfast all or most of the time [Minimum Data Set] |
| 45542-8 | Bed rails used for bed mobility or transfer [Minimum Data Set] |
| 45543-6 | Lifted manually [Minimum Data Set] |
| 45544-4 | Lifted mechanically [Minimum Data Set] |
| 45545-1 | Transfer aid [Minimum Data Set] |
| 45546-9 | No mode of transfer [Minimum Data Set] |
| 45547-7 | Repetitive health complaints [Minimum Data Set] |
| 45548-5 | Repetitive anxious complaints or concerns [Minimum Data Set] |
| 45549-3 | Unpleasant mood in morning [Minimum Data Set] |
| 45550-1 | Insomnia/change in sleeping pattern [Minimum Data Set] |
| 45551-9 | Sad, pained, or worried facial expressions [Minimum Data Set] |
| 45552-7 | Crying or tearfulness [Minimum Data Set] |
| 45553-5 | Repetitive physical movements [Minimum Data Set] |
| 45554-3 | Withdrawal from activities of interest [Minimum Data Set] |
| 45555-0 | Reduced social interaction [Minimum Data Set] |
| 45556-8 | Mood persistence [Minimum Data Set] |
| 45557-6 | Change in mood [Minimum Data Set] |
| 45558-4 | Frequency of wandering [Minimum Data Set] |
| 45559-2 | Alterability of wandering [Minimum Data Set] |
| 45560-0 | Frequency of verbally abusive behavioral symptoms [Minimum Data Set] |
| 45561-8 | Alterability of verbally abusive behavioral symptoms [Minimum Data Set] |
| 45562-6 | Frequency of physically abusive behavioral symptoms [Minimum Data Set] |
| 45563-4 | Alterability of physically abusive behavioral symptoms [Minimum Data Set] |
| 45564-2 | Frequency of socially inappropriate or disruptive behavioral symptoms [Minimum Data Set] |
| 45565-9 | Alterability of socially inappropriate or disruptive behavioral symptoms [Minimum Data Set] |
| 45566-7 | Frequency of resists care [Minimum Data Set] |
| 45567-5 | Alterability of resists care [Minimum Data Set] |
| 45568-3 | Change in behavioral symptoms [Minimum Data Set] |
| 45569-1 | At ease interacting with others [Minimum Data Set] |
| 45570-9 | At ease doing planned or structured activities [Minimum Data Set] |
| 45571-7 | At ease doing self-initiated activities [Minimum Data Set] |
| 45572-5 | Establishes own goals [Minimum Data Set] |
| 45573-3 | Pursues involvement in life of facility [Minimum Data Set] |
| 45574-1 | Accepts invitations to most group activities [Minimum Data Set] |
| 45575-8 | Sense of initiative - none of above [Minimum Data Set] |
| 45576-6 | Covert/open conflict with or repeated criticism of staff [Minimum Data Set] |
| 45577-4 | Unhappy with roommate [Minimum Data Set] |
| 45578-2 | Unhappy with residents other than roommate [Minimum Data Set] |
| 45579-0 | Openly expresses conflict/anger with family/friends [Minimum Data Set] |
| 45580-8 | Absence of contact with family/friends [Minimum Data Set] |
| 45581-6 | Recent loss of close family member/friend [Minimum Data Set] |
| 45582-4 | Does not adjust easily to change in routines [Minimum Data Set] |
| 45583-2 | No unsettled relationships [Minimum Data Set] |
| 45584-0 | Strong identification with past roles and life status [Minimum Data Set] |
| 45585-7 | Expresses sadness/anger/empty feeling over lost roles/status [Minimum Data Set] |
| 45586-5 | Resident perceives that daily routine (customary routine, activities) is very different from prior pattern in the community [Minimum Data Set] |
| 45587-3 | Past roles - none of above [Minimum Data Set] |
| 45588-1 | Bed mobility - self-performance during assessment period [CMS Assessment] |
| 45589-9 | Bed mobility - support provided during assessment period [CMS Assessment] |
| 45590-7 | Transfer - self-performance during assessment period [CMS Assessment] |
| 45591-5 | Transfer - support provided during assessment period [CMS Assessment] |
| 45592-3 | Walk in room - self-performance during assessment period [CMS Assessment] |
| 45593-1 | Walk in room - support provided during assessment period [CMS Assessment] |
| 45594-9 | Walk in corridor - self-performance during assessment period [CMS Assessment] |
| 45595-6 | Walk in corridor - support provided during assessment period [CMS Assessment] |
| 45596-4 | Locomotion on unit - self-performance during assessment period [CMS Assessment] |
| 45597-2 | Locomotion on unit - support provided during assessment period [CMS Assessment] |
| 45598-0 | Locomotion off unit - self-performance during assessment period [CMS Assessment] |
| 45599-8 | Locomotion off unit - support provided during assessment period [CMS Assessment] |
| 45600-4 | Dressing - self-performance during assessment period [CMS Assessment] |
| 45601-2 | Dressing - support provided during assessment period [CMS Assessment] |
| 45602-0 | Eating - self-performance during assessment period [CMS Assessment] |
| 45603-8 | Eating - support provided during assessment period [CMS Assessment] |
| 45604-6 | Toilet use - self-performance during assessment period [CMS Assessment] |
| 45605-3 | Toilet use - support provided during assessment period [CMS Assessment] |
| 45606-1 | Personal hygiene - self-performance during assessment period [CMS Assessment] |
| 45607-9 | Personal hygiene - support provided during assessment period [CMS Assessment] |
| 45608-7 | Bathing - self-performance during assessment period [CMS Assessment] |
| 45609-5 | Bathing - support provided during assessment period [CMS Assessment] |
| 45610-3 | Balance while standing [Minimum Data Set] |
| 45611-1 | Task segmentation [Minimum Data Set] |
| 45612-9 | Resident believes he or she is capable of increased independence in at least some ADLs [Minimum Data Set] |
| 45613-7 | Direct care staff believe resident is capable of increased independence in at least some ADLs during assessment period [CMS Assessment] |
| 45614-5 | Resident able to perform tasks or activity but is very slow [Minimum Data Set] |
| 45615-2 | Difference in ADL Self-Performance or ADL Support, comparing mornings to evenings [Minimum Data Set] |
| 45616-0 | Activities of daily living rehabilitation potential - none of above [Minimum Data Set] |
| 45617-8 | Change in activities of daily living function [Minimum Data Set] |
| 45618-6 | Bowel continence [Minimum Data Set] |
| 45619-4 | Bladder continence [Minimum Data Set] |
| 45620-2 | Bowel elimination pattern regular - at least one movement every three days [Minimum Data Set] |
| 45621-0 | Constipation [Minimum Data Set] |
| 45622-8 | Diarrhea [Minimum Data Set] |
| 45623-6 | Fecal impaction [Minimum Data Set] |
| 45624-4 | Bowel elimination pattern - none of above [Minimum Data Set] |
| 45625-1 | Any scheduled toileting plan [Minimum Data Set] |
| 45626-9 | Bladder retraining program [Minimum Data Set] |
| 45627-7 | External catheter [Minimum Data Set] |
| 45628-5 | Indwelling catheter [Minimum Data Set] |
| 45629-3 | Intermittent catheter [Minimum Data Set] |
| 45630-1 | Did not use toilet room/commode/urinal [Minimum Data Set] |
| 45631-9 | Pads/briefs used [Minimum Data Set] |
| 45632-7 | Enemas/irrigation [Minimum Data Set] |
| 45633-5 | Ostomy present [Minimum Data Set] |
| 45634-3 | Continence appliances and programs - none of above [Minimum Data Set] |
| 45635-0 | Change in urinary continence [Minimum Data Set] |
| 45636-8 | Diabetes mellitus [Minimum Data Set] |
| 45637-6 | Hyperthyroidism [Minimum Data Set] |
| 45638-4 | Hypothyroidism [Minimum Data Set] |
| 45639-2 | Arteriosclerotic heart disease [Minimum Data Set] |
| 45640-0 | Cardiac dysrhythmias [Minimum Data Set] |
| 45641-8 | Congestive heart failure [Minimum Data Set] |
| 45642-6 | Deep vein thrombosis [Minimum Data Set] |
| 45643-4 | Hypertension [Minimum Data Set] |
| 45644-2 | Hypotension [Minimum Data Set] |
| 45645-9 | Peripheral vascular disease [Minimum Data Set] |
| 45646-7 | Other cardiovascular disease [Minimum Data Set] |
| 45647-5 | Arthritis [Minimum Data Set] |
| 45648-3 | Hip fracture [Minimum Data Set] |
| 45649-1 | Missing limb [Minimum Data Set] |
| 45650-9 | Osteoporosis [Minimum Data Set] |
| 45651-7 | Pathological bone fracture [Minimum Data Set] |
| 45652-5 | Alzheimer's disease [Minimum Data Set] |
| 45653-3 | Aphasia [Minimum Data Set] |
| 45654-1 | Cerebral palsy [Minimum Data Set] |
| 45655-8 | Cerebrovascular accident [Minimum Data Set] |
| 45656-6 | Dementia other than Alzheimer's disease [Minimum Data Set] |
| 45657-4 | Hemiplegia or hemiparesis [Minimum Data Set] |
| 45658-2 | Multiple sclerosis [Minimum Data Set] |
| 45659-0 | Paraplegia [Minimum Data Set] |
| 45660-8 | Parkinson's disease [Minimum Data Set] |
| 45661-6 | Quadriplegia [Minimum Data Set] |
| 45662-4 | Seizure disorder [Minimum Data Set] |
| 45663-2 | Transient ischemic attack [Minimum Data Set] |
| 45664-0 | Traumatic brain injury [Minimum Data Set] |
| 45665-7 | Anxiety disorder [Minimum Data Set] |
| 45666-5 | Depression [Minimum Data Set] |
| 45667-3 | Manic depression [Minimum Data Set] |
| 45668-1 | Schizophrenia [Minimum Data Set] |
| 45669-9 | Asthma [Minimum Data Set] |
| 45670-7 | Emphysema or COPD [Minimum Data Set] |
| 45671-5 | Cataracts [Minimum Data Set] |
| 45672-3 | Diabetic retinopathy [Minimum Data Set] |
| 45673-1 | Glaucoma [Minimum Data Set] |
| 45674-9 | Macular degeneration [Minimum Data Set] |
| 45676-4 | Anemia [Minimum Data Set] |
| 45677-2 | Cancer [Minimum Data Set] |
| 45678-0 | Renal failure [Minimum Data Set] |
| 45679-8 | None of the listed diseases or conditions [Minimum Data Set] |
| 45680-6 | Antibiotic resistant infection [Minimum Data Set] |
| 45681-4 | Infection with Clostridioides difficile [Minimum Data Set] |
| 45682-2 | Conjunctivitis [Minimum Data Set] |
| 45683-0 | HIV infection [Minimum Data Set] |
| 45684-8 | Pneumonia [Minimum Data Set] |
| 45685-5 | Respiratory infection [Minimum Data Set] |
| 45686-3 | Septicemia [Minimum Data Set] |
| 45687-1 | Sexually transmitted diseases [Minimum Data Set] |
| 45688-9 | Tuberculosis [Minimum Data Set] |
| 45689-7 | Urinary tract infection in last 30 days [Minimum Data Set] |
| 45690-5 | Viral hepatitis [Minimum Data Set] |
| 45691-3 | Wound infection [Minimum Data Set] |
| 45692-1 | Infections - none of above [Minimum Data Set] |
| 45693-9 | Other current or more detailed diagnoses and ICD9 codes [Minimum Data Set] |
| 45694-7 | Weight gain or loss of 3+ Lbs. within a 7 day period [Minimum Data Set] |
| 45695-4 | Inability to lie flat due to shortness of breath [Minimum Data Set] |
| 45696-2 | Dehydrated [Minimum Data Set] |
| 45697-0 | Insufficient fluid; did NOT consume all or almost all liquids provided during last 3 days [Minimum Data Set] |
| 45698-8 | Delusions [Minimum Data Set] |
| 45699-6 | Dizziness or vertigo [Minimum Data Set] |
| 45700-2 | Edema [Minimum Data Set] |
| 45701-0 | Fever [Minimum Data Set] |
| 45702-8 | Hallucinations [Minimum Data Set] |
| 45703-6 | Internal bleeding [Minimum Data Set] |
| 45704-4 | Recurrent lung aspirations in last 90 days [Minimum Data Set] |
| 45705-1 | Shortness of breath [Minimum Data Set] |
| 45706-9 | Syncope [Minimum Data Set] |
| 45707-7 | Unsteady gait [Minimum Data Set] |
| 45708-5 | Vomiting [Minimum Data Set] |
| 45709-3 | Problem conditions - none of above [Minimum Data Set] |
| 45710-1 | Pain frequency [Minimum Data Set] |
| 45711-9 | Pain intensity [Minimum Data Set] |
| 45712-7 | Back pain [Minimum Data Set] |
| 45713-5 | Bone pain [Minimum Data Set] |
| 45714-3 | Chest pain while doing usual activities [Minimum Data Set] |
| 45715-0 | Headache [Minimum Data Set] |
| 45716-8 | Hip pain |
| 45717-6 | Incisional pain [Minimum Data Set] |
| 45718-4 | Joint pain [Minimum Data Set] |
| 45719-2 | Soft tissue pain [Minimum Data Set] |
| 45720-0 | Stomach pain [Minimum Data Set] |
| 45721-8 | Other pain [Minimum Data Set] |
| 45722-6 | Fell in past 30 days [Minimum Data Set] |
| 45723-4 | Fell in past 31-180 days [Minimum Data Set] |
| 45724-2 | Hip fracture in last 180 days [Minimum Data Set] |
| 45725-9 | Other fracture in last 180 days [Minimum Data Set] |
| 45726-7 | Accidents - none of above [Minimum Data Set] |
| 45727-5 | Conditions/diseases make resident's cognitive, ADL, mood or behavior patterns unstable [Minimum Data Set] |
| 45728-3 | Resident experiencing an acute episode or a flare-up of a recurrent or chronic problem [Minimum Data Set] |
| 45729-1 | End-Stage disease, 6 or fewer months to live [Minimum Data Set] |
| 45730-9 | Stability of conditions - none of above [Minimum Data Set] |
| 45731-7 | Chewing problem [Minimum Data Set] |
| 45732-5 | Swallowing problem [Minimum Data Set] |
| 45733-3 | Mouth pain [Minimum Data Set] |
| 45734-1 | Oral problems - none of above [Minimum Data Set] |
| 45735-8 | Weight loss [Minimum Data Set] |
| 45736-6 | Weight gain [Minimum Data Set] |
| 45737-4 | Complains about the taste of many foods [Minimum Data Set] |
| 45738-2 | Regular or repetitive complaints of hunger [Minimum Data Set] |
| 45739-0 | Leaves 25%+ food uneaten at most meals [Minimum Data Set] |
| 45740-8 | Nutritional problems - none of above [Minimum Data Set] |
| 45741-6 | Parenteral IV [Minimum Data Set] |
| 45742-4 | Feeding tube [Minimum Data Set] |
| 45743-2 | Mechanically altered diet [Minimum Data Set] |
| 45744-0 | Syringe or oral feeding [Minimum Data Set] |
| 45745-7 | Therapeutic diet [Minimum Data Set] |
| 45746-5 | Dietary supplement between meals [Minimum Data Set] |
| 45747-3 | Plate guard, stabilized built-up utensil, etc. [Minimum Data Set] |
| 45748-1 | On a planned weight change program [Minimum Data Set] |
| 45749-9 | Nutritional approaches - none of above [Minimum Data Set] |
| 45750-7 | Proportion of total calories received through parenteral or tube feeding in last 7 days [Minimum Data Set] |
| 45752-3 | Ventilator or respirator [Minimum Data Set] |
| 45753-1 | Alcohol or drug treatment program |
| 45754-9 | Alzheimer's or dementia special care unit [Minimum Data Set] |
| 45755-6 | Hospice care [Minimum Data Set] |
| 45756-4 | Pediatric unit [Minimum Data Set] |
| 45757-2 | Respite care [Minimum Data Set] |
| 45758-0 | Training in skills required to return to the community [Minimum Data Set] |
| 45759-8 | Special treatments/programs - none of above [Minimum Data Set] |
| 45760-6 | Number of days with at least 15 minutes of speech language pathology and audiology services in the last 7 days [CMS Assessment] |
| 45761-4 | Total minutes of speech language pathology and audiology services in the last 7 days [Minimum Data Set] |
| 45762-2 | Number of days with at least 15 minutes of occupational therapy in the last 7 days [CMS Assessment] |
| 45763-0 | Total minutes of occupational therapy in the last 7 days [Minimum Data Set] |
| 45764-8 | Number of days with at least 15 minutes of physical therapy in the last 7 days [CMS Assessment] |
| 45765-5 | Total minutes of physical therapy in the last 7 days [Minimum Data Set] |
| 45766-3 | Number of days with at least 15 minutes of respiratory therapy in the last 7 days [CMS Assessment] |
| 45767-1 | Total minutes of respiratory therapy in the last 7 days [CMS Assessment] |
| 45768-9 | Number of days with at least 15 minutes of psychological therapy by any licensed mental health professional in the last 7 days [CMS Assessment] |
| 45769-7 | Debris - soft, easily movable substances - present in mouth prior to going to bed at night [Minimum Data Set] |
| 45770-5 | Has dentures or removable bridge [Minimum Data Set] |
| 45771-3 | Some or all natural teeth lost but does not have or use dentures or partial plates [Minimum Data Set] |
| 45772-1 | Broken, loose, or carious teeth [Minimum Data Set] |
| 45773-9 | Inflamed, swollen, or bleeding gums, oral abscesses; ulcers or rashes [Minimum Data Set] |
| 45774-7 | Daily cleaning of teeth or dentures or mouth care by resident or staff [Minimum Data Set] |
| 45775-4 | Oral status/disease prevention - none of above [Minimum Data Set] |
| 45776-2 | Ulcers.stage 1 # [Minimum Data Set] |
| 45777-0 | Ulcers.stage 2 # [Minimum Data Set] |
| 45778-8 | Ulcers.stage 3 # [Minimum Data Set] |
| 45779-6 | Ulcers.stage 4 # [Minimum Data Set] |
| 45780-4 | Pressure injury stage [Minimum Data Set] |
| 45781-2 | Stasis ulcer stage [Minimum Data Set] |
| 45782-0 | History of resolved ulcers [Minimum Data Set] |
| 45783-8 | Abrasions or bruises [Minimum Data Set] |
| 45784-6 | Second or third degree burns [Minimum Data Set] |
| 45785-3 | Open lesions other than ulcers, rashes, cuts [Minimum Data Set] |
| 45786-1 | Rashes [Minimum Data Set] |
| 45787-9 | Skin desensitized to pain or pressure [Minimum Data Set] |
| 45788-7 | Skin tears or cuts (other than surgery) [Minimum Data Set] |
| 45789-5 | Surgical wounds [Minimum Data Set] |
| 45790-3 | Other skin problems - none of above [Minimum Data Set] |
| 45791-1 | Pressure relieving devices for chair [Minimum Data Set] |
| 45792-9 | Pressure relieving devices for bed [Minimum Data Set] |
| 45793-7 | Turning or repositioning program [Minimum Data Set] |
| 45794-5 | Nutrition or hydration intervention to manage skin problems [Minimum Data Set] |
| 45795-2 | Ulcer care [Minimum Data Set] |
| 45796-0 | Surgical wound care [Minimum Data Set] |
| 45797-8 | Application of dressings (with or without topical medications) other than to feet [Minimum Data Set] |
| 45798-6 | Application of ointments or medications other than to feet [Minimum Data Set] |
| 45799-4 | Other preventative or protective skin care other than to feet [Minimum Data Set] |
| 45800-0 | Skin treatments - none of above [Minimum Data Set] |
| 45801-8 | One or more foot problems [Minimum Data Set] |
| 45802-6 | Infection of foot [Minimum Data Set] |
| 45803-4 | Open lesions on the foot [Minimum Data Set] |
| 45804-2 | Nails/calluses trimmed during last 90 days [Minimum Data Set] |
| 45805-9 | Received preventative or protective foot care [Minimum Data Set] |
| 45806-7 | Application of dressings (foot) - with or without topical medications [Minimum Data Set] |
| 45807-5 | Foot problems and care - none of above [Minimum Data Set] |
| 45808-3 | Awake in morning [Minimum Data Set] |
| 45809-1 | Awake in afternoon [Minimum Data Set] |
| 45810-9 | Awake in evening [Minimum Data Set] |
| 45811-7 | Time awake - none of above [Minimum Data Set] |
| 45812-5 | Average time involved in activities [Minimum Data Set] |
| 45813-3 | Preferred activity setting - own room [Minimum Data Set] |
| 45814-1 | Preferred activity setting - day or activity room [Minimum Data Set] |
| 45815-8 | Preferred activity setting - inside NH/off unit [Minimum Data Set] |
| 45816-6 | Preferred activity setting - outside facility [Minimum Data Set] |
| 45817-4 | Preferred activitty setting - none of above [Minimum Data Set] |
| 45818-2 | Activity preferences - cards or other games [Minimum Data Set] |
| 45819-0 | Activity preferences - crafts or arts [Minimum Data Set] |
| 45820-8 | Activity preferences - exercise or sports [Minimum Data Set] |
| 45821-6 | Activity preferences - music [Minimum Data Set] |
| 45822-4 | Activity preferences - reading or writing [Minimum Data Set] |
| 45823-2 | Activity preferences - spiritual or religious activities [Minimum Data Set] |
| 45824-0 | Activity preferences - trips or shopping [Minimum Data Set] |
| 45825-7 | Activity preferences - walking or wheeling outdoors [Minimum Data Set] |
| 45826-5 | Activity preferences - watching TV [Minimum Data Set] |
| 45827-3 | Activity preferences - gardening or plants [Minimum Data Set] |
| 45828-1 | Activity preferences - talking or conversing [Minimum Data Set] |
| 45829-9 | Activity preferences - helping others [Minimum Data Set] |
| 45830-7 | Activity preferences - none of above [Minimum Data Set] |
| 45831-5 | Type of activities in which resident is currently involved [Minimum Data Set] |
| 45832-3 | Extent of resident involvement in activities [Minimum Data Set] |
| 45833-1 | Number of medications [Minimum Data Set] |
| 45834-9 | New medications [Minimum Data Set] |
| 45835-6 | Number of days injections received [Minimum Data Set] |
| 45836-4 | Number of days antipsychotic medication received [Minimum Data Set] |
| 45837-2 | Number of days antianxiety medication received [Minimum Data Set] |
| 45838-0 | Number of days antidepressant medication received [Minimum Data Set] |
| 45839-8 | Number of days hypnotic medication received [Minimum Data Set] |
| 45840-6 | Number of days diuretic medication received [Minimum Data Set] |
| 45841-4 | Chemotherapy [Minimum Data Set] |
| 45842-2 | Dialysis [Minimum Data Set] |
| 45843-0 | IV medication [Minimum Data Set] |
| 45844-8 | Intake/output [Minimum Data Set] |
| 45845-5 | Monitoring of acute medical condition [Minimum Data Set] |
| 45846-3 | Ostomy care [Minimum Data Set] |
| 45847-1 | Oxygen therapy [Minimum Data Set] |
| 45848-9 | Radiation [Minimum Data Set] |
| 45849-7 | Suctioning [Minimum Data Set] |
| 45850-5 | Tracheostomy care [Minimum Data Set] |
| 45851-3 | Transfusions [Minimum Data Set] |
| 45852-1 | Total minutes of psychological therapy by any licensed mental health professional in the last 7 days [CMS Assessment] |
| 45853-9 | Special behavior symptom evaluation program [Minimum Data Set] |
| 45854-7 | Evaluation by a licensed mental health specialist in last 90 days [Minimum Data Set] |
| 45855-4 | Group therapy [Minimum Data Set] |
| 45856-2 | Resident-specific deliberate changes in the environment to address mood/behavior patterns [Minimum Data Set] |
| 45857-0 | Reorientation [Minimum Data Set] |
| 45858-8 | Mood, behavior, cognitive loss programs - none of above [Minimum Data Set] |
| 45859-6 | Number of days of passive range of motion [Minimum Data Set] |
| 45860-4 | Number of days of active range of motion [Minimum Data Set] |
| 45861-2 | Number of days of splint or brace assistance [Minimum Data Set] |
| 45862-0 | Number of days of training and skill practice in bed mobility [Minimum Data Set] |
| 45863-8 | Number of days of training and skill practice in transfer [Minimum Data Set] |
| 45864-6 | Number of days of training and skill practice in walking [Minimum Data Set] |
| 45865-3 | Number of days of training and skill practice in dressing or grooming [Minimum Data Set] |
| 45866-1 | Number of days of training and skill practice in eating or swallowing [Minimum Data Set] |
| 45867-9 | Number of days of training and skill practice in amputation or prosthesis care [Minimum Data Set] |
| 45868-7 | Number of days of training and skill practice in communication [Minimum Data Set] |
| 45869-5 | Number of days of other rehabilitation or restorative techniques or procedures [Minimum Data Set] |
| 45870-3 | Bed rails - full bed rails on all open sides of bed [Minimum Data Set] |
| 45871-1 | Bed rails - other types of side rails used [Minimum Data Set] |
| 45872-9 | Trunk restraint [Minimum Data Set] |
| 45873-7 | Limb restraint [Minimum Data Set] |
| 45874-5 | Chair prevents rising [Minimum Data Set] |
| 45875-2 | Number hospital admissions in last 90 days [Minimum Data Set] |
| 45876-0 | Number of emergency room visits in last 90 days [Minimum Data Set] |
| 45877-8 | Number of physician visits in last 14 days [Minimum Data Set] |
| 45878-6 | Number of days physician orders changed in last 14 days [Minimum Data Set] |
| 45879-4 | Abnormal lab values in last 90 days [Minimum Data Set] |
| 45880-2 | Resident expresses/indicates preference to return to the community [Minimum Data Set] |
| 45881-0 | Resident has a support person who is positive towards discharge [Minimum Data Set] |
| 45882-8 | Stay projected to be of a short duration - discharge projected within 90 days [Minimum Data Set] |
| 45883-6 | Overall change in care needs [Minimum Data Set] |
| 45884-4 | Participation in assessment [Minimum Data Set] |
| 45885-1 | Participation in assessment Family [Minimum Data Set] |
| 45886-9 | Number of days recreation therapy administered for greater than 15 minutes [Minimum Data Set] |
| 45887-7 | Total recreation therapy in last 7 days [Minimum Data Set] |
| 45888-5 | Therapy orders to begin in 1st 14 days of stay [Minimum Data Set] |
| 45889-3 | Through day 15, provide an estimate of the number of days when at least 1 therapy service can be expected to have been delivered [Minimum Data Set] |
| 45890-1 | Through day 15, provide an estimate of the number of therapy minutes (across the therapies) that can be expected to be delivered [Minimum Data Set] |
| 45891-9 | Furthest distance walked without sitting down during this episode [Minimum Data Set] |
| 45892-7 | Time walked without sitting down during this episode [Minimum Data Set] |
| 45893-5 | Self-Performance in walking during this episode [Minimum Data Set] |
| 45894-3 | Walking support provided [Minimum Data Set] |
| 45895-0 | Parallel bars used by resident in association with this episode [Minimum Data Set] |
| 45896-8 | Delirium trigger [Minimum Data Set] |
| 45897-6 | Cognitive loss or dementia trigger [Minimum Data Set] |
| 45898-4 | Visual function trigger [Minimum Data Set] |
| 45899-2 | Communication trigger [Minimum Data Set] |
| 45900-8 | ADL-rehabilitation trigger A [Minimum Data Set] |
| 45901-6 | ADL-rehabilitation trigger B [Minimum Data Set] |
| 45902-4 | Urinary incontinence and indwelling catherter trigger [Minimum Data Set] |
| 45903-2 | Psychosocial well-being trigger [Minimum Data Set] |
| 45904-0 | Mood state trigger [Minimum Data Set] |
| 45905-7 | Behavioral symptoms trigger [Minimum Data Set] |
| 45906-5 | Activities trigger A [Minimum Data Set] |
| 45907-3 | Activities trigger B [Minimum Data Set] |
| 45908-1 | Falls trigger [Minimum Data Set] |
| 45909-9 | Nutritional status trigger [Minimum Data Set] |
| 45910-7 | Feeding tubes trigger [Minimum Data Set] |
| 45911-5 | Dehydration/fluid maintenance trigger [Minimum Data Set] |
| 45912-3 | Dental care trigger [Minimum Data Set] |
| 45913-1 | Pressure injuries trigger [Minimum Data Set] |
| 45914-9 | Psychotropic drug use trigger [Minimum Data Set] |
| 45915-6 | Physical restraints trigger [Minimum Data Set] |
| 45916-4 | Resident assessment protocol 1--Delirium - triggered [Minimum Data Set] |
| 45917-2 | Resident assessment protocol 1--Delirium - proceed with care [Minimum Data Set] |
| 45918-0 | Resident assessment protocol 2--Cognitive loss - triggered [Minimum Data Set] |
| 45919-8 | Resident assessment protocol 2--Cognitive loss - proceed with care [Minimum Data Set] |
| 45920-6 | Resident assessment protocol 3--Visual function - triggered [Minimum Data Set] |
| 45921-4 | Resident assessment protocol 3--Visual function - proceed with care [Minimum Data Set] |
| 45922-2 | Resident assessment protocol 4--Communication - triggered [Minimum Data Set] |
| 45923-0 | Resident assessment protocol 4--Communication - proceed with care [Minimum Data Set] |
| 45924-8 | Resident assessment protocol 5--ADL functional/Rehab - triggered [Minimum Data Set] |
| 45925-5 | Resident assessment protocol 5--ADL functional/Rehab - proceed with care [Minimum Data Set] |
| 45926-3 | Resident assessment protocol 6--Urinary incontinence - triggered [Minimum Data Set] |
| 45927-1 | Resident assessment protocol 6--Urinary incontinence - proceed with care [Minimum Data Set] |
| 45928-9 | Resident assessment protocol 7--Psychosocial - triggered [Minimum Data Set] |
| 45929-7 | Resident assessment protocol 7--Psychosocial - proceed with care [Minimum Data Set] |
| 45930-5 | Resident assessment protocol 8--Mood state - triggered [Minimum Data Set] |
| 45931-3 | Resident assessment protocol 8--Mood state - proceed with care [Minimum Data Set] |
| 45932-1 | Resident assessment protocol 9--Behavioral symptoms - triggered [Minimum Data Set] |
| 45933-9 | Resident assessment protocol 9--Behavioral symptoms - proceed with care [Minimum Data Set] |
| 45934-7 | Resident assessment protocol 10--Activities - triggered [Minimum Data Set] |
| 45935-4 | Resident assessment protocol 10--Activities - proceed with care [Minimum Data Set] |
| 45936-2 | Resident assessment protocol 11--Falls - triggered [Minimum Data Set] |
| 45937-0 | Resident assessment protocol 11--Falls - proceed with care [Minimum Data Set] |
| 45938-8 | Resident assessment protocol 12--Nutritional status - triggered [Minimum Data Set] |
| 45939-6 | Resident assessment protocol 12--Nutritional status - proceed with care [Minimum Data Set] |
| 45940-4 | Resident assessment protocol 13--Feeding tubes - triggered [Minimum Data Set] |
| 45941-2 | Resident assessment protocol 13--Feeding tubes - proceed with care [Minimum Data Set] |
| 45942-0 | Resident assessment protocol 14--Dehydration/Fluid maint - triggered [Minimum Data Set] |
| 45943-8 | Resident assessment protocol 14--Dehydration/Fluid maint - proceed with care [Minimum Data Set] |
| 45944-6 | Resident assessment protocol 15--Dental care - triggered [Minimum Data Set] |
| 45945-3 | Resident assessment protocol 15--Dental care - proceed with care [Minimum Data Set] |
| 45946-1 | Resident assessment protocol 16--Pressure injuries - triggered [Minimum Data Set] |
| 45947-9 | Resident assessment protocol 16--Pressure injuries - proceed with care [Minimum Data Set] |
| 45948-7 | Resident assessment protocol 17--Psychotropic drug - triggered [Minimum Data Set] |
| 45949-5 | Resident assessment protocol 17--Psychotropic drug - proceed with care [Minimum Data Set] |
| 45950-3 | Resident assessment protocol 18--Physical restraints - triggered [Minimum Data Set] |
| 45951-1 | Resident assessment protocol 18--Physical restraints - proceed with care [Minimum Data Set] |
| 45952-9 | National provider ID |
| 45955-2 | Pneumococcal vaccine status up to date [Minimum Data Set] |
| 45956-0 | Reason pneumococcal vaccine not received during assessment period [CMS Assessment] |
| 45957-8 | Participation in assessment Significant other [Minimum Data Set] |
| 45958-6 | Other current or more detailed diagnoses and ICD9 codes # 2 [Minimum Data Set] |
| 45959-4 | Other current or more detailed diagnoses and ICD9 codes # 3 [Minimum Data Set] |
| 45960-2 | Other current or more detailed diagnoses and ICD9 codes # 4 [Minimum Data Set] |
| 45961-0 | Other current or more detailed diagnoses and ICD9 codes # 5 [Minimum Data Set] |
| 45962-8 | Minimum data set for nursing home resident assessment and care screen |
| 45964-4 | Identification information section |
| 45965-1 | Name Set |
| 45966-9 | Social Security and Medicare numbers |
| 45967-7 | Facility provider numbers Set |
| 45968-5 | Reasons for assessment (basic) Set |
| 45970-1 | Demographic information section |
| 45971-9 | Residential history 5 years prior to entry Set |
| 45972-7 | Language Set |
| 45975-0 | Customary routine section |
| 45976-8 | Customary routine in year prior to date of entry Set |
| 45977-6 | Cycle of daily events Set |
| 45978-4 | Eating patterns Set |
| 45979-2 | ADL patterns Set |
| 45980-0 | Involvement patterns Set |
| 45982-6 | Identification and background information section |
| 45984-2 | Current payment sources for nursing home stay Set |
| 45985-9 | Responsibility/legal guardian Set |
| 45986-7 | Advance directives Set |
| 45987-5 | Cognitive patterns section |
| 45988-3 | Memory Set |
| 45989-1 | Memory recall/ability Set |
| 45990-9 | Indicators of delirium - periodic disorded thinking or awareness Set |
| 45991-7 | Communication and hearing patterns section |
| 45992-5 | Communication devices and techniques Set |
| 45993-3 | Modes of expression Set |
| 45994-1 | Vision patterns section |
| 45995-8 | Visual limitations and dificulties Set |
| 45996-6 | Mood and behavior patterns section |
| 45997-4 | Indicators of depression, anxiety, sad mood Set |
| 45998-2 | Verbal expressions of distress Set |
| 45999-0 | Sleep-cycle issues Set |
| 46000-6 | Sad, apethetic, anxious appearance Set |
| 46001-4 | Behavioral symptoms Set |
| 46002-2 | Psychosocial well-being section |
| 46003-0 | Sense of initiative/involvement Set |
| 46004-8 | Unsettled releationships Set |
| 46005-5 | Past roles Set |
| 46006-3 | Physical functioning and stuctural problems section Set |
| 46007-1 | ADL self performance or support Set |
| 46008-9 | Bathing during assessment period [CMS Assessment] |
| 46009-7 | Test for balance Set |
| 46010-5 | Functional limitation in range of motion Set |
| 46011-3 | Modes of locomotion Set |
| 46012-1 | Modes of transfer Set |
| 46013-9 | ADL functional rehabilitation potential Set |
| 46014-7 | Continence in last 14 days section Set |
| 46015-4 | Continence self-control categories Set |
| 46016-2 | Bowel elimination pattern Set |
| 46017-0 | Continence appliances and programs Set |
| 46018-8 | Disease or condition diagnoses section |
| 46019-6 | Diseases or conditions Set |
| 46020-4 | Endocrine, metabolic or nutritional diseases or conditions Set |
| 46021-2 | Heart or circulation diseases or conditions Set |
| 46022-0 | Musculoskeletal diseases or conditions Set |
| 46023-8 | Neurological diseases or conditions Set |
| 46024-6 | Psychiatric or mood diseases or conditions Set |
| 46025-3 | Pulmonary diseases or conditions Set |
| 46026-1 | Sensory diseases or conditions Set |
| 46027-9 | Other diseases or conditions Set |
| 46028-7 | Infections Set |
| 46029-5 | Other current or more detailed diagnoses and ICD9 codes Set |
| 46030-3 | Health conditions section |
| 46031-1 | Indicators of fluid status Set |
| 46032-9 | Other indicators Set |
| 46033-7 | Pain symptoms Set |
| 46034-5 | Pain site Set |
| 46035-2 | Accidents Set |
| 46036-0 | Stability of conditions Set |
| 46037-8 | Oral and nutritional status section |
| 46038-6 | Oral problems Set |
| 46039-4 | Height and weight Set |
| 46040-2 | Weight change Set |
| 46041-0 | Nutritional problems Set |
| 46042-8 | Nutritional approaches Set |
| 46043-6 | Parenteral or enteral intake Set |
| 46044-4 | Oral or dental status section |
| 46045-1 | Oral status and disease prevention Set |
| 46046-9 | Skin condition section |
| 46047-7 | Ulcers Set |
| 46048-5 | Type of ulcer Set |
| 46049-3 | Other skin problems or lesions present Set |
| 46050-1 | Skin treatments Set |
| 46051-9 | Foot problems and care Set |
| 46052-7 | Activity pursuit patterns section |
| 46053-5 | Time awake Set |
| 46054-3 | Preferred activity settings Set |
| 46055-0 | General activity preferences Set |
| 46056-8 | Prefers change in daily routine Set |
| 46057-6 | Medications section |
| 46058-4 | Days received the following medication Set |
| 46059-2 | Special treatments and procedures section |
| 46060-0 | Special treatments, procedures and programs Set |
| 46061-8 | Special care Set |
| 46062-6 | Treatments Set |
| 46063-4 | Programs Set |
| 46064-2 | Therapies Set |
| 46065-9 | Intervention programs for mood, behavior and cognitive loss Set |
| 46066-7 | Nursing rehabilitation and restorative care Set |
| 46067-5 | Devices and restraints Set |
| 46068-3 | Discharge potential and overall status section |
| 46069-1 | Discharge potential Set |
| 46070-9 | Assessment information section |
| 46071-7 | Participation in assessment Set |
| 46072-5 | Therapy supplement for Medicare PPS section |
| 46073-3 | Special treatments and procedures Set |
| 46074-1 | Recreational therapy Set |
| 46075-8 | Walking when most self sufficient Set |
| 46077-4 | Influenza vaccine Set |
| 46078-2 | Pneumococcal vaccine Set |
| 46079-0 | Resident assessment protocol summary section |
| 46101-2 | Ordered therapies Set |
| 46105-3 | Problem conditions Set |
| 46107-9 | Loss of interest Set |
| 46139-2 | Nutritional approaches (quarterly) Set |
| 46140-0 | Problem conditions (quarterly) Set |
| 46141-8 | Other current diagnoses and ICD9 codes (quarterly) Set |
| 46142-6 | Infections (quarterly) Set |
| 46143-4 | Continence appliances and programs (quarterly) Set |
| 46144-2 | Bowel elimination pattern (quarterly) Set |
| 46145-9 | Modes of transfer (quarterly) Set |
| 46146-7 | Bathing (quarterly) |
| 46147-5 | ADL self performance or support (quarterly) Set |
| 46148-3 | Nutritional approaches (quarterly RUG-III) Set |
| 46149-1 | Problem conditions (quarterly RUG-III) Set |
| 46150-9 | Diseases (quarterly RUG-III) Set |
| 46151-7 | Bowel elimination pattern (quarterly RUG-III) Set |
| 46152-5 | Diseases (quarterly RUG-III 97 update) Set |
| 46153-3 | Oral problems (quarterly RUG-II) Set |
| 46456-0 | CMS certification number (CCN) Agency [OASIS] |
| 46457-8 | Inpatient discharge facility [OASIS] |
| 46458-6 | Inpatient facililty diagnoses |
| 46459-4 | Changed medical regimen diagnoses |
| 46460-2 | Number of pressure injuries at each stage |
| 46461-0 | Emergent care [OASIS] |
| 46464-4 | Current payment sources for home care [OASIS] |
| 46465-1 | Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days [OASIS] |
| 46466-9 | Therapeutic substance administered at home during assessment period [CMS Assessment] |
| 46468-5 | Current living arrangement |
| 46469-3 | Assisting person(s) other than home care agency staff [OASIS] |
| 46470-1 | Type of primary caregiver assistance |
| 46471-9 | At home respiratory treatments [OASIS] |
| 46472-7 | Depressive feelings [OASIS] |
| 46473-5 | Cognitive, behavioral, and psychiatric symptoms demonstrated at least one time per week during assessment period [CMS Assessment] |
| 46474-3 | Emergent care reason [OASIS] |
| 46475-0 | Discharge support services or assistance [OASIS] |
| 46476-8 | Reason for hospitalization [OASIS] |
| 46477-6 | Reason for nursing home admission [OASIS] |
| 46478-4 | Grooming |
| 46479-2 | Ability to dress upper body |
| 46480-0 | Ability to dress lower body |
| 46481-8 | Toileting [OASIS] |
| 46482-6 | Transferring [OASIS] |
| 46483-4 | Locomotion |
| 46484-2 | Feeding or eating [OASIS] |
| 46485-9 | Planning and preparing light meals |
| 46486-7 | Transportation |
| 46487-5 | Laundry |
| 46488-3 | Housekeeping |
| 46489-1 | Shopping |
| 46490-9 | Ability to use telephone |
| 46491-7 | Management of oral medications |
| 46492-5 | Management of inhalant /mist medications |
| 46493-3 | Medicaid provider number Agency [OASIS] |
| 46494-1 | State location of agency branch [CMS Assessment] |
| 46495-8 | Branch number during assessment period [CMS Assessment] Agency |
| 46496-6 | Agency patient number during assessment period [CMS Assessment] |
| 46497-4 | Start of care date during assessment period [CMS Assessment] |
| 46498-2 | Resumption of care date during assessment period [CMS Assessment] |
| 46500-5 | Discipline of Person Completing Assessment during assessment period [CMS Assessment] Provider |
| 46501-3 | Date assessment information completed during assessment period [CMS Assessment] |
| 46502-1 | Reason for assessment [OASIS] |
| 46504-7 | Inpatient stay within last 14 days - ICD code [CMS Assessment] |
| 46505-4 | Inpatient stay within last 14 days - ICD code # 2 [OASIS] |
| 46506-2 | Medical or treatment regimen change in past 14 days [OASIS] |
| 46507-0 | Regimen change in past 14 days - ICD code [CMS Assessment] |
| 46508-8 | Regimen change in past 14 days - ICD code # 2 [OASIS] |
| 46509-6 | Regimen change in past 14 days - ICD code # 3 [OASIS] |
| 46510-4 | Regimen change in past 14 days - ICD code # 4 [OASIS] |
| 46512-0 | Primary diagnosis severity rating [OASIS] |
| 46513-8 | Other diagnosis 1 - ICD code [OASIS] |
| 46514-6 | Other diagnosis 1 - severity rating [OASIS] |
| 46515-3 | Other diagnosis 2 - ICD code [OASIS] |
| 46516-1 | Other diagnosis 2 - severity rating [OASIS] |
| 46517-9 | Other diagnosis 3 - ICD code [OASIS] |
| 46518-7 | Other diagnosis 3 - severity rating [OASIS] |
| 46519-5 | Other diagnosis 4 - ICD code [OASIS] |
| 46520-3 | Other diagnosis 4 - severity rating [OASIS] |
| 46521-1 | Other diagnosis 5 - ICD code [OASIS] |
| 46522-9 | Other diagnosis 5 - severity rating [OASIS] |
| 46523-7 | Overall prognosis for recovery from this episode [OASIS] |
| 46524-5 | Rehabilitative prognosis [OASIS] |
| 46525-2 | Life expectancy [OASIS] |
| 46526-0 | Current residence [OASIS] |
| 46527-8 | Primary caregiver [OASIS] |
| 46528-6 | Frequency of primary caregiver assistance [OASIS] |
| 46529-4 | Sensory status - vision [OASIS] |
| 46530-2 | Sensory status - hearing and ability to understand spoken language [OASIS] |
| 46531-0 | Sensory status - speech and oral expression of language [OASIS] |
| 46532-8 | Sensory status - frequency of pain [OASIS] |
| 46533-6 | Experiencing intractable pain [OASIS] |
| 46534-4 | Skin lesion or open wound during assessment period [CMS Assessment] |
| 46535-1 | Pressure injury [OASIS] |
| 46536-9 | Number of pressure injuries - stage 1 Ord [CMS Assessment] |
| 46540-1 | Unobserved pressure injury [OASIS] |
| 46541-9 | Stage of most problematic pressure injury [OASIS] |
| 46542-7 | Status of most problematic pressure injury [OASIS] |
| 46543-5 | Stasis ulcer [OASIS] |
| 46544-3 | Number of stasis ulcers [OASIS] |
| 46545-0 | Unobserved stasis pressure injury [OASIS] |
| 46546-8 | Status of most problematic stasis ulcer [OASIS] |
| 46547-6 | Surgical wound [OASIS] |
| 46548-4 | Number of surgical wounds [OASIS] |
| 46549-2 | Unobserved surgical wound [OASIS] |
| 46550-0 | Status of most problematic surgical wound [OASIS] |
| 46551-8 | When short of breath [OASIS] |
| 46552-6 | Treated for urinary tract infection in past 14 days [CMS Assessment] |
| 46553-4 | Urinary incontinence or urinary catheter present during assessment period [CMS Assessment] |
| 46554-2 | Prior - ambulation [OASIS] |
| 46555-9 | Current ability - ambulation [OASIS] |
| 46556-7 | Prior - feeding [OASIS] |
| 46557-5 | Current ability - feeding [OASIS] |
| 46558-3 | Prior - prepare light meals [OASIS] |
| 46559-1 | Current ability - prepare light meals [OASIS] |
| 46560-9 | Prior - transportation [OASIS] |
| 46561-7 | Current ability - transportation [OASIS] |
| 46562-5 | Prior - laundry [OASIS] |
| 46563-3 | Current ability - laundry [OASIS] |
| 46564-1 | Prior - housekeeping [OASIS] |
| 46565-8 | Current ability - housekeeping [OASIS] |
| 46566-6 | Prior - shopping [OASIS] |
| 46567-4 | Current ability - shopping [OASIS] |
| 46568-2 | Prior - telephone use [OASIS] |
| 46569-0 | Telephone use - functional ability during assessment period [CMS Assessment] |
| 46570-8 | Prior - management of oral medications [OASIS] |
| 46571-6 | Current ability - management of oral medications [OASIS] |
| 46572-4 | Prior - management of inhalant medications [OASIS] |
| 46573-2 | Current ability - management of inhalant medications [OASIS] |
| 46574-0 | Prior - management of injectable medications [OASIS] |
| 46575-7 | Current ability - management of injectable medications [OASIS] |
| 46576-5 | Management of equipment [OASIS] |
| 46577-3 | Management of equipment Caregiver [OASIS] |
| 46578-1 | Admitted to during assessment period [CMS Assessment] Inpatient facility |
| 46580-7 | Acute care hospitalization reason [OASIS] |
| 46581-5 | Date of last home visit during assessment period [CMS Assessment] |
| 46582-3 | Discharge, transfer, death date |
| 46583-1 | Therapy need [OASIS] |
| 46584-9 | Payment diagnosis - primary ICD code [OASIS] |
| 46585-6 | Payment diagnosis - first secondary ICD [OASIS] |
| 46586-4 | When urinary incontinence occurs [OASIS] |
| 46587-2 | Bowel incontinence frequency during assessment period [CMS Assessment] |
| 46588-0 | Ostomy for bowel elimination [OASIS] |
| 46589-8 | Cognitive functioning during assessment period [CMS Assessment] |
| 46590-6 | When confused [OASIS] |
| 46591-4 | When anxious [OASIS] |
| 46592-2 | Frequency of behavior problems during assessment period [CMS Assessment] |
| 46593-0 | Receives psychiatric nursing during assessment period [CMS Assessment] |
| 46594-8 | Prior - grooming [OASIS] |
| 46595-5 | Grooming - functional ability during assessment period [CMS Assessment] |
| 46596-3 | Prior - dress upper body [OASIS] |
| 46597-1 | Dress upper body - functional ability during assessment period [CMS Assessment] |
| 46598-9 | Prior - dress lower body [OASIS] |
| 46599-7 | Dress lower body - functional ability during assessment period [CMS Assessment] |
| 46600-3 | Prior - bathing [OASIS] |
| 46601-1 | Current ability - bathing [OASIS] |
| 46602-9 | Prior - toileting [OASIS] |
| 46603-7 | Current ability - toileting [OASIS] |
| 46604-5 | Prior - transferring [OASIS] |
| 46605-2 | Current ability - transferring [OASIS] |
| 46606-0 | Bathing ability |
| 46608-6 | Primary referring physician ID Provider |
| 46609-4 | Diagnosis and severity index |
| 46610-2 | Payment diagnosis |
| 46611-0 | Mental residual functional capacity (RFC) assessment form |
| 46612-8 | Summary conclusions Set |
| 46613-6 | Remembers locations and worklike procedures [RFC] |
| 46614-4 | Understands and remembers very short and simple instructions [RFC] |
| 46615-1 | Understands and remembers detailed instructions [RFC] |
| 46616-9 | Carries out very short and simple instructions [RFC] |
| 46617-7 | Carries out detailed instructions [RFC] |
| 46618-5 | Maintains attention and concentration for extended periods [RFC] |
| 46619-3 | Performs activities within a schedule, maintains regular attendance, is punctual within customary tolerances [RFC] |
| 46620-1 | Sustains an ordinary routine without special supervision [RFC] |
| 46621-9 | Works in coordination with or proximity to others without being distracted by them [RFC] |
| 46622-7 | Makes simple work-related decisions [RFC] |
| 46623-5 | Completes normal workday and week WO interruptions from psych symptoms and performs at consistent pace WO unreasonable number and length of rests [RFC] |
| 46624-3 | Interacts appropriately with the general public [RFC] |
| 46625-0 | Asks simple questions or request assistance [RFC] |
| 46626-8 | Accepts instructions and respond appropriately to criticism from supervisors [RFC] |
| 46627-6 | Gets along with coworkers or peers WO distracting them or exhibiting behavioral extremes [RFC] |
| 46628-4 | Maintains socially appropriate behavior and adheres to basic standards of neatness and cleanliness [RFC] |
| 46629-2 | Responds appropriately to changes in the work setting [RFC] |
| 46630-0 | Aware of normal hazards and take appropriate precautions [RFC] |
| 46631-8 | Travels in unfamiliar places or use public transportation [RFC] |
| 46632-6 | Sets realistic goals or make plans independently of others [RFC] |
| 46633-4 | Remarks [RFC] |
| 46634-2 | Functional capacity assessment [RFC] |
| 46635-9 | Categories [RFC] |
| 46637-5 | Residual physical functional capacity (RFC) assessment form [RFC] |
| 46638-3 | IP CDB claim numberholder [RFC] |
| 46639-1 | Primary diagnosis [RFC] |
| 46640-9 | Secondary diagnosis [RFC] |
| 46641-7 | Other alleged impairments [RFC] |
| 46642-5 | Limitations section Set [RFC] |
| 46643-3 | Exertional limitations Set [RFC] |
| 46644-1 | No exertional limitations [RFC] |
| 46645-8 | Occasionally lift/carry [RFC] |
| 46646-6 | Frequently lift/carry [RFC] |
| 46647-4 | Stand/walk [RFC] |
| 46648-2 | Sit [RFC] |
| 46649-0 | Push/pull [RFC] |
| 46650-8 | Exertional limitations [RFC] |
| 46651-6 | Postural limitations Set [RFC] |
| 46652-4 | No postural limitations [RFC] |
| 46653-2 | Climbing [RFC] |
| 46654-0 | Balancing [RFC] |
| 46655-7 | Stooping [RFC] |
| 46656-5 | Kneeling [RFC] |
| 46657-3 | Crouching [RFC] |
| 46658-1 | Crawling [RFC] |
| 46659-9 | Postural limitations [RFC] |
| 46660-7 | Manipulative limitations Set [RFC] |
| 46661-5 | No manipulative limitations [RFC] |
| 46662-3 | Reaching in all directions [RFC] |
| 46663-1 | Handling [RFC] |
| 46664-9 | Fingering [RFC] |
| 46665-6 | Feeling [RFC] |
| 46666-4 | Manipulative limitations [RFC] |
| 46667-2 | Visual limitations Set [RFC] |
| 46668-0 | No visual limitations [RFC] |
| 46669-8 | Near acuity [RFC] |
| 46670-6 | Far acuity [RFC] |
| 46671-4 | Depth perception [RFC] |
| 46672-2 | Accommodation [RFC] |
| 46673-0 | Color vision [RFC] |
| 46674-8 | Field of vision [RFC] |
| 46675-5 | Visual limitations [RFC] |
| 46676-3 | Communicative limitation Set [RFC] |
| 46677-1 | No communicative limitations [RFC] |
| 46678-9 | Hearing [RFC] |
| 46679-7 | Speaking [RFC] |
| 46680-5 | Communicative limitation [RFC] |
| 46681-3 | Environmental limitations Set [RFC] |
| 46682-1 | Extreme cold [RFC] |
| 46683-9 | Extreme heat [RFC] |
| 46684-7 | Wetness [RFC] |
| 46685-4 | Humidity [RFC] |
| 46686-2 | Noise [RFC] |
| 46687-0 | Vibrations [RFC] |
| 46688-8 | Fumes, odors, dusts, gases, poor ventilation, etc [RFC] |
| 46689-6 | Hazards [RFC] |
| 46690-4 | Environmental limitations [RFC] |
| 46691-2 | Symptoms [RFC] |
| 46692-0 | Treatment or examining source statements Set [RFC] |
| 46693-8 | Treating or examining source statement regarding claimant's physical capacities in file [RFC] |
| 46694-6 | Treating or examining source conclusions about the claimant's limitations or restrictions which are significantly different from your file [RFC] |
| 46695-3 | Why conclusions are not supported by the evidence in file [RFC] |
| 46696-1 | Additional comments [RFC] |
| 46697-9 | Date [RFC] |
| 46783-7 | Abuse Behavior Community [OMAHA] |
| 46784-5 | Abuse Knowledge Community [OMAHA] |
| 46785-2 | Abuse Status Community [OMAHA] |
| 46786-0 | Bowel Function Behavior Community [OMAHA] |
| 46787-8 | Bowel Function Knowledge Community [OMAHA] |
| 46788-6 | Bowel Function Status Community [OMAHA] |
| 46789-4 | Caretaking/parenting.behavior Community [OMAHA] |
| 46790-2 | Caretaking/parenting.knowledge Community [OMAHA] |
| 46791-0 | Caretaking/parenting.status Community [OMAHA] |
| 46792-8 | Circulation Behavior Community [OMAHA] |
| 46793-6 | Circulation Knowledge Community [OMAHA] |
| 46794-4 | Circulation Status Community [OMAHA] |
| 46795-1 | Cognition Behavior Community [OMAHA] |
| 46796-9 | Cognition Knowledge Community [OMAHA] |
| 46797-7 | Cognition Status Community [OMAHA] |
| 46798-5 | Communicable/infectious condition function.behavior Community [OMAHA] |
| 46799-3 | Communicable/infectious condition function.knowledge Community [OMAHA] |
| 46800-9 | Communicable/infectious condition function.status Community [OMAHA] |
| 46801-7 | Communication With Community Resources Behavior Community [OMAHA] |
| 46802-5 | Communication With Community Resources Knowledge Community [OMAHA] |
| 46803-3 | Communication With Community Resources Status Community [OMAHA] |
| 46804-1 | Consciousness Behavior Community [OMAHA] |
| 46805-8 | Consciousness Knowledge Community [OMAHA] |
| 46806-6 | Consciousness Status Community [OMAHA] |
| 46807-4 | Digestion-hydration Behavior Community [OMAHA] |
| 46808-2 | Digestion-hydration Knowledge Community [OMAHA] |
| 46809-0 | Digestion-hydration Status Community [OMAHA] |
| 46810-8 | Family Planning Behavior Community [OMAHA] |
| 46811-6 | Family Planning Knowledge Community [OMAHA] |
| 46812-4 | Family Planning Status Community [OMAHA] |
| 46813-2 | Grief Behavior Community [OMAHA] |
| 46814-0 | Grief Knowledge Community [OMAHA] |
| 46815-7 | Grief Status Community [OMAHA] |
| 46816-5 | Growth And Development Behavior Community [OMAHA] |
| 46817-3 | Growth And Development Knowledge Community [OMAHA] |
| 46818-1 | Growth And Development Status Community [OMAHA] |
| 46819-9 | Health Care Supervision Behavior Community [OMAHA] |
| 46820-7 | Health Care Supervision Knowledge Community [OMAHA] |
| 46821-5 | Health Care Supervision Status Community [OMAHA] |
| 46822-3 | Hearing Behavior Community [OMAHA] |
| 46823-1 | Hearing Knowledge Community [OMAHA] |
| 46824-9 | Hearing Status Community [OMAHA] |
| 46825-6 | Income Behavior Community [OMAHA] |
| 46826-4 | Income Knowledge Community [OMAHA] |
| 46827-2 | Income Status Community [OMAHA] |
| 46828-0 | Interpersonal Relationship Behavior Community [OMAHA] |
| 46829-8 | Interpersonal Relationship Knowledge Community [OMAHA] |
| 46830-6 | Interpersonal Relationship Status Community [OMAHA] |
| 46831-4 | Medication Regimen Behavior Community [OMAHA] |
| 46832-2 | Medication Regimen Knowledge Community [OMAHA] |
| 46833-0 | Medication Regimen Status Community [OMAHA] |
| 46834-8 | Mental Health Behavior Community [OMAHA] |
| 46835-5 | Mental Health Knowledge Community [OMAHA] |
| 46836-3 | Mental Health Status Community [OMAHA] |
| 46837-1 | Neglect Behavior Community [OMAHA] |
| 46838-9 | Neglect Knowledge Community [OMAHA] |
| 46839-7 | Neglect Status Community [OMAHA] |
| 46840-5 | Neighborhood/workplace safety.behavior Community [OMAHA] |
| 46841-3 | Neighborhood/workplace safety..knowledge Community [OMAHA] |
| 46842-1 | Neighborhood/workplace safety.status Community [OMAHA] |
| 46843-9 | Neuro-musculo-skeletal Function Behavior Community [OMAHA] |
| 46844-7 | Neuro-musculo-skeletal Function Knowledge Community [OMAHA] |
| 46845-4 | Neuro-musculo-skeletal Function Status Community [OMAHA] |
| 46846-2 | Nutrition Behavior Community [OMAHA] |
| 46847-0 | Nutrition Knowledge Community [OMAHA] |
| 46848-8 | Nutrition Status Community [OMAHA] |
| 46849-6 | Oral Health Behavior Community [OMAHA] |
| 46850-4 | Oral Health Knowledge Community [OMAHA] |
| 46851-2 | Oral Health Status Community [OMAHA] |
| 46852-0 | Pain Behavior Community [OMAHA] |
| 46853-8 | Pain Knowledge Community [OMAHA] |
| 46854-6 | Pain Status Community [OMAHA] |
| 46855-3 | Personal Care Behavior Community [OMAHA] |
| 46856-1 | Personal Care Knowledge Community [OMAHA] |
| 46857-9 | Personal Care Status Community [OMAHA] |
| 46858-7 | Physical Activity Behavior Community [OMAHA] |
| 46859-5 | Physical Activity Knowledge Community [OMAHA] |
| 46860-3 | Physical Activity Status Community [OMAHA] |
| 46861-1 | Postpartum Function Behavior Community [OMAHA] |
| 46862-9 | Postpartum Function Knowledge Community [OMAHA] |
| 46863-7 | Postpartum Function Status Community [OMAHA] |
| 46864-5 | Pregnancy Function Behavior Community [OMAHA] |
| 46865-2 | Pregnancy Function Knowledge Community [OMAHA] |
| 46866-0 | Pregnancy Function Status Community [OMAHA] |
| 46867-8 | Reproductive Function Behavior Community [OMAHA] |
| 46868-6 | Reproductive Function Knowledge Community [OMAHA] |
| 46869-4 | Reproductive Function Status Community [OMAHA] |
| 46870-2 | Residence Behavior Community [OMAHA] |
| 46871-0 | Residence Knowledge Community [OMAHA] |
| 46872-8 | Residence Status Community [OMAHA] |
| 46873-6 | Respiration Behavior Community [OMAHA] |
| 46874-4 | Respiration Knowledge Community [OMAHA] |
| 46875-1 | Respiration Status Community [OMAHA] |
| 46876-9 | Role Change Behavior Community [OMAHA] |
| 46877-7 | Role Change Knowledge Community [OMAHA] |
| 46878-5 | Role Change Status Community [OMAHA] |
| 46879-3 | Sanitation Behavior Community [OMAHA] |
| 46880-1 | Sanitation Knowledge Community [OMAHA] |
| 46881-9 | Sanitation Status Community [OMAHA] |
| 46882-7 | Sexuality Behavior Community [OMAHA] |
| 46883-5 | Sexuality Knowledge Community [OMAHA] |
| 46884-3 | Sexuality Status Community [OMAHA] |
| 46885-0 | Skin Behavior Community [OMAHA] |
| 46886-8 | Skin Knowledge Community [OMAHA] |
| 46887-6 | Skin Status Community [OMAHA] |
| 46888-4 | Sleep And Rest Pattern Behavior Community [OMAHA] |
| 46889-2 | Sleep And Rest Pattern Knowledge Community [OMAHA] |
| 46890-0 | Sleep And Rest Pattern Status Community [OMAHA] |
| 46891-8 | Social Contact Behavior Community [OMAHA] |
| 46892-6 | Social Contact Knowledge Community [OMAHA] |
| 46893-4 | Social Contact Status Community [OMAHA] |
| 46894-2 | Speech And Language Behavior Community [OMAHA] |
| 46895-9 | Speech And Language Knowledge Community [OMAHA] |
| 46896-7 | Speech And Language Status Community [OMAHA] |
| 46897-5 | Spirituality Behavior Community [OMAHA] |
| 46898-3 | Spirituality Knowledge Community [OMAHA] |
| 46899-1 | Spirituality Status Community [OMAHA] |
| 46900-7 | Substance Use Behavior Community [OMAHA] |
| 46901-5 | Substance Use Knowledge Community [OMAHA] |
| 46902-3 | Substance Use Status Community [OMAHA] |
| 46903-1 | Urinary Function Behavior Community [OMAHA] |
| 46904-9 | Urinary Function Knowledge Community [OMAHA] |
| 46905-6 | Urinary Function Status Community [OMAHA] |
| 46906-4 | Vision Behavior Community [OMAHA] |
| 46907-2 | Vision Knowledge Community [OMAHA] |
| 46908-0 | Vision Status Community [OMAHA] |
| 46909-8 | Communicable/infectious condition function.behavior Family [OMAHA] |
| 46910-6 | Communicable/infectious condition function.knowledge Family [OMAHA] |
| 46911-4 | Communicable/infectious condition function.status Family [OMAHA] |
| 46912-2 | Oral Health Behavior Family [OMAHA] |
| 46913-0 | Oral Health Knowledge Family [OMAHA] |
| 46914-8 | Oral Health Status Family [OMAHA] |
| 46915-5 | Postpartum Function Behavior Family [OMAHA] |
| 46916-3 | Postpartum Function Knowledge Family [OMAHA] |
| 46917-1 | Postpartum Function Status Family [OMAHA] |
| 46918-9 | Pregnancy Function Behavior Family [OMAHA] |
| 46919-7 | Pregnancy Function Knowledge Family [OMAHA] |
| 46920-5 | Pregnancy Function Status Family [OMAHA] |
| 46921-3 | Reproductive Function Behavior Family [OMAHA] |
| 46922-1 | Reproductive Function Knowledge Family [OMAHA] |
| 46923-9 | Reproductive Function Status Family [OMAHA] |
| 46924-7 | Urinary Function Behavior Family [OMAHA] |
| 46925-4 | Urinary Function Knowledge Family [OMAHA] |
| 46926-2 | Urinary Function Status Family [OMAHA] |
| 46927-0 | Communicable/infectious condition function.behavior [OMAHA] |
| 46928-8 | Communicable/infectious condition function.knowledge [OMAHA] |
| 46929-6 | Communicable/infectious condition function.status [OMAHA] |
| 46930-4 | Oral Health Behavior [OMAHA] |
| 46931-2 | Oral Health Knowledge [OMAHA] |
| 46932-0 | Oral Health Status [OMAHA] |
| 46933-8 | Postpartum Function Behavior [OMAHA] |
| 46934-6 | Postpartum Function Knowledge [OMAHA] |
| 46935-3 | Postpartum Function Status [OMAHA] |
| 46936-1 | Pregnancy Function Behavior [OMAHA] |
| 46937-9 | Pregnancy Function Knowledge [OMAHA] |
| 46938-7 | Pregnancy Function Status [OMAHA] |
| 46939-5 | Reproductive Function Behavior [OMAHA] |
| 46940-3 | Reproductive Function Knowledge [OMAHA] |
| 46941-1 | Reproductive Function Status [OMAHA] |
| 46942-9 | Urinary Function Behavior [OMAHA] |
| 46943-7 | Urinary Function Knowledge [OMAHA] |
| 46944-5 | Urinary Function Status [OMAHA] |
| 48332-1 | 10 minute Apgar panel |
| 48333-9 | 5 minute Apgar panel |
| 48334-7 | 1 minute Apgar panel |
| 48512-8 | Are you basically satisfied with your life [GDS] |
| 48513-6 | Have you dropped many of your activities and interests [GDS] |
| 48514-4 | Do you feel that your life is empty [GDS] |
| 48515-1 | Do you often get bored [GDS] |
| 48516-9 | Are you hopeful about the future [GDS] |
| 48517-7 | Are you bothered by thoughts you cannot get out of your head [GDS] |
| 48518-5 | Are you in good spirits most of the time [GDS] |
| 48519-3 | Are you afraid that something bad is going to happen to you [GDS] |
| 48520-1 | Do you feel happy most of the time [GDS] |
| 48521-9 | Do you often feel helpless [GDS] |
| 48522-7 | Do you often get restless and fidgety [GDS] |
| 48523-5 | Do you prefer to stay at home, rather than going out and doing new things [GDS] |
| 48524-3 | Do you frequently worry about the future [GDS] |
| 48525-0 | Do you feel you have more problems with memory than most [GDS] |
| 48526-8 | Do you think it is wonderful to be alive now [GDS] |
| 48528-4 | Do you feel pretty worthless the way you are now [GDS] |
| 48529-2 | Do you worry a lot about the past [GDS] |
| 48530-0 | Do you find life very exciting [GDS] |
| 48531-8 | Is it hard for you to get started on new projects [GDS] |
| 48532-6 | Do you feel full of energy [GDS] |
| 48533-4 | Do you feel that your situation is hopeless [GDS] |
| 48534-2 | Do you think that most people are better off than you are [GDS] |
| 48535-9 | Do you frequently get upset over little things [GDS] |
| 48536-7 | Do you frequently feel like crying [GDS] |
| 48537-5 | Do you have trouble concentrating [GDS] |
| 48538-3 | Do you enjoy getting up in the morning [GDS] |
| 48539-1 | Do you prefer to avoid social gatherings [GDS] |
| 48540-9 | Is it easy for you to make decisions [GDS] |
| 48541-7 | Is your mind as clear as it used to be [GDS] |
| 48542-5 | Geriatric depression scale (GDS) panel |
| 48543-3 | Geriatric depression scale (GDS).short version panel |
| 48544-1 | Geriatric depression scale (GDS) total |
| 48545-8 | Geriatric depression scale (GDS) short version total |
| 48546-6 | Clinical Care Classification (CCC) v2.5 panel |
| 48547-4 | Omaha System 2005 panel |
| 48548-2 | Living with HIV (LIV-HIV) panel |
| 48549-0 | HIV-Signs and Symptoms Checklist (SSC) panel |
| 48550-8 | Quality Audit Marker (QAM) panel |
| 50786-3 | Date of entry |
| 50787-1 | Primary reason for assessment [Minimum Data Set (MDS) full] |
| 50943-0 | Reasons for assessment (full) Set |
| 52451-2 | Continuity Assessment Record and Evaluation (CARE) tool - Master Document - Core and Supplemental Items |
| 52454-6 | Reason for assessment |
| 52458-7 | Name Provider |
| 52459-5 | CMS certification number (CCN) Provider |
| 52469-4 | Major treatments admitted/discharged with panel |
| 52471-0 | Medications |
| 52473-6 | Allergy or cause of reaction |
| 52477-7 | Largest Ulcer Measurements |
| 52490-0 | Temporal orientation - CARE |
| 52491-8 | Brief interview for mental status [BIMS] |
| 52493-4 | Recall [BIMS] |
| 52501-4 | Pain Effect on Function during last 2 days |
| 52510-5 | Respiratory status |
| 52540-2 | ZIP Code unknown |
| 52543-6 | Structural barriers in prior residence that could interfere with the patient's discharge |
| 52552-7 | Falls in the past year |
| 52553-5 | Language.primary is English |
| 52556-8 | Payment sources |
| 52564-2 | Major treatments admitted/discharged with [CARE] |
| 52565-9 | Reason for continuous cardiac monitoring |
| 52567-5 | Reason for one on one 24 hour supervision |
| 52587-3 | Trauma-related wound # |
| 52588-1 | Diabetic foot ulcer(s) # |
| 52608-7 | Impairments with bladder or bowel management |
| 52617-8 | Any impairments with swallowing [CARE] |
| 52621-0 | Any impairments with hearing, vision, or communication |
| 52626-9 | Any impairments with weight-bearing |
| 52631-9 | Any impairments with grip strength |
| 52634-3 | Any impairments with respiratory status |
| 52637-6 | Any impairments with endurance |
| 52642-6 | Eating during 2 day assessment period [CARE] |
| 52644-2 | Oral hygiene during 2 day assessment period [CARE] |
| 52645-9 | Toilet hygiene during 2 day assessment period [CARE] |
| 52646-7 | Upper body dressing during 2 day assessment period [CARE] |
| 52647-5 | Lower body dressing during 2 day assessment period [CARE] |
| 52648-3 | Lying to sitting on side of bed during 2 day assessment period [CARE] |
| 52649-1 | Sit to stand during 2 day assessment period [CARE] |
| 52650-9 | Chair-bed to chair transfer during 2 day assessment period [CARE] |
| 52651-7 | Toilet transfer during 2 day assessment period [CARE] |
| 52653-3 | Walk 150 ft (45 m) during 2 day assessment period [CARE] |
| 52654-1 | Walk 100 ft (30 m) during 2 day assessment period [CARE] |
| 52656-6 | Walk 10 ft (3 m) during 2 day assessment period [CARE] |
| 52657-4 | Wheel 150 ft (45 m) during 2 day assessment period [CARE] |
| 52658-2 | Wheel 100 ft (30 m) during 2 day assessment period [CARE] |
| 52659-0 | Wheel 50 ft (15 m) during 2 day assessment period [CARE] |
| 52660-8 | Wheel 10 ft (3 m) during 2 day assessment period [CARE] |
| 52662-4 | Shower/bathe self during 2 day assessment period [CARE] |
| 52663-2 | Roll left and right during 2 day assessment period [CARE] |
| 52664-0 | Sit to lying during 2 day assessment period [CARE] |
| 52665-7 | Picking up objects during 2 day assessment period [CARE] |
| 52666-5 | Putting on/taking off footwear during 2 day assessment period [CARE] |
| 52667-3 | One step (curb) during two day assessment period [CARE] |
| 52668-1 | Walk 50 feet with two turns during two day assessment period [CARE] |
| 52669-9 | 12 steps-interior during two day assessment period [CARE] |
| 52670-7 | Four steps-exterior during two day assessment period [CARE] |
| 52671-5 | Walking 10 feet on uneven surfaces during two day assessment period [CARE] |
| 52672-3 | Car transfer during two day assessment period [CARE] |
| 52685-5 | Care goals documented |
| 52692-1 | Types of caregiver |
| 52716-8 | Discharge delayed at least 24 hours |
| 52717-6 | Reason for discharge delay |
| 52727-5 | Lives outside U.S. |
| 52728-3 | Diameter.any.max Pressure injury.largest stage 3 or 4 [CMS Assessment] |
| 52729-1 | Diameter transverse Pressure injury.largest stage 3 or 4 [CMS Assessment] |
| 52731-7 | Repetition of three words # [BIMS] |
| 52732-5 | Temporal orientation - current year [BIMS] |
| 52733-3 | Temporal orientation - current month [BIMS] |
| 52735-8 | Recall - sock [BIMS] |
| 52736-6 | Recall - blue [BIMS] |
| 52737-4 | Recall - bed [BIMS] |
| 52738-2 | Inattention during 2 day assessment period |
| 52739-0 | Disorganized thinking during 2 day assessment period |
| 52740-8 | Altered level of consciousness/alertness during 2 day assessment period |
| 52741-6 | Psychomotor retardation during 2 day assessment period |
| 52742-4 | Pain severity during last 2 days [Reported] |
| 52799-4 | Major treatments used on or 1 day prior to day of death panel |
| 52801-8 | Major treatments admitted with panel |
| 52826-5 | Nursing Management Minimum Data Set panel [NMMDS] |
| 52827-3 | Facility unique identifier panel [NMMDS] |
| 52828-1 | Federal provider name Facility |
| 52829-9 | Place of service |
| 52830-7 | State, district or territory federal abbreviation Facility |
| 52832-3 | Survey reporting period start date Facility |
| 52833-1 | Survey reporting period end date Facility |
| 52834-9 | Nursing delivery unit or service panel [NMMDS] |
| 52835-6 | Nursing unit name |
| 52836-4 | Nursing unit cost center |
| 52837-2 | Type of nursing unit or service [NDNQI] |
| 52838-0 | Population distribution panel [NMMDS] |
| 52839-8 | Total patient population # |
| 52840-6 | Total population of fetal age Population |
| 52841-4 | Total population of age birth to 28 days Population |
| 52842-2 | Total population of age 29 days to 1 year Population |
| 52843-0 | Total population of age 1-4 years Population |
| 52844-8 | Total population of age 5-9 years Population |
| 52845-5 | Total population of age 10-14 years Population |
| 52846-3 | Total population of age 15-19 years Population |
| 52847-1 | Total population of age 20-24 years Population |
| 52848-9 | Total population of age 25-29 years Population |
| 52849-7 | Total population of age 30-34 years Population |
| 52850-5 | Total population of age 35-39 years Population |
| 52851-3 | Total population of age 40-44 years Population |
| 52852-1 | Total population of age 45-49 years Population |
| 52853-9 | Total population of age 50-54 years Population |
| 52854-7 | Total population of age 55-59 years Population |
| 52855-4 | Total population of age 60-64 years Population |
| 52856-2 | Total population of age 65-69 years Population |
| 52857-0 | Total population of age 70-74 years Population |
| 52858-8 | Total population of age 75-79 years Population |
| 52859-6 | Total population of age 80-84 years Population |
| 52860-4 | Total population of age GE 85 years Population |
| 52861-2 | Catchment area panel [NMMDS] Population |
| 52862-0 | Neighborhood catchment area Population [Estimated] |
| 52863-8 | City or town catchment area Population [Estimated] |
| 52864-6 | District catchment area Population [Estimated] |
| 52865-3 | County catchment area Population [Estimated] |
| 52866-1 | Parish catchment area Population [Estimated] |
| 52867-9 | State catchment area Population [Estimated] |
| 52868-7 | Region catchment area Population [Estimated] |
| 52869-5 | Nation catchment area Population [Estimated] |
| 52870-3 | World catchment area Population [Estimated] |
| 52871-1 | Aerospace catchment area Population [Estimated] |
| 52872-9 | Nautical catchment area Population [Estimated] |
| 54112-8 | Cause of death Family member [USSG-FHT] |
| 54113-6 | Age range at death Family member [USSG-FHT] |
| 54114-4 | Family member health history [USSG-FHT] Family member |
| 54115-1 | Age range at onset of disease Family member [USSG-FHT] |
| 54116-9 | History of diseases Family member [USSG-FHT] |
| 54117-7 | Diseases history panel [USSG-FHT] Family member |
| 54118-5 | Parents related Family member [USSG-FHT] |
| 54119-3 | Race Family member [USSG-FHT] |
| 54120-1 | Ethnicity Family member [USSG-FHT] |
| 54121-9 | Twin Family member |
| 54122-7 | Adopted Family member |
| 54124-3 | Birth date Family member |
| 54126-8 | My health history [USSG-FHT] |
| 54127-6 | US Surgeon General family health portrait [USSG-FHT] |
| 54128-4 | Adopted |
| 54130-0 | Age range at onset of disease [USSG-FHT] |
| 54131-8 | Sex [USSG-FHT] |
| 54132-6 | Twin |
| 54133-4 | Ethnicity [USSG-FHT] |
| 54134-2 | Race [USSG-FHT] |
| 54135-9 | Parents related [USSG-FHT] |
| 54137-5 | Diseases history panel [USSG-FHT] |
| 54138-3 | Name Family member |
| 54139-1 | Living Family member |
| 54140-9 | History of diseases [USSG-FHT] |
| 54141-7 | Current age Family member [USSG-FHT] |
| 54501-2 | Identification information |
| 54502-0 | Assessment/tracking type |
| 54503-8 | Legal name of patient |
| 54505-3 | Language |
| 54506-1 | Optional resident items |
| 54507-9 | Medicare stay during assessment period [CMS Assessment] |
| 54508-7 | Hearing, speech, and vision during assessment period [CMS Assessment] |
| 54509-5 | Cognitive patterns |
| 54510-3 | Temporal orientation (orientation to year, month, and day) [BIMS] |
| 54511-1 | Behavior |
| 54512-9 | Psychosis in last 7 days |
| 54513-7 | Behavioral symptoms |
| 54514-5 | Behavioral symptom - presence and frequency during assessment period [CMS Assessment] |
| 54515-2 | Impact on resident during assessment period [CMS Assessment] |
| 54516-0 | Impact on others during assessment period [CMS Assessment] |
| 54517-8 | Wandering - impact [CMS Assessment] |
| 54518-6 | Preferences for customary routine and activities |
| 54519-4 | Interview for daily preferences during assessment period [CMS Assessment] |
| 54520-2 | Interview for activity preferences during assessment period [CMS Assessment] |
| 54521-0 | Staff assessment of daily and activity preferences |
| 54522-8 | Functional status |
| 54523-6 | Activities of Daily Living (ADL) Assistance in last 7 days [CMS Assessment] |
| 54524-4 | Balance during transitions and walking during assessment period [CMS Assessment] |
| 54527-7 | Functional rehabilitation potential during assessment period [CMS Assessment] |
| 54528-5 | Bladder and bowel |
| 54529-3 | Appliances |
| 54530-1 | Urinary toileting program during assessment period [CMS Assessment] |
| 54531-9 | Active disease diagnosis |
| 54532-7 | Cancer |
| 54533-5 | Heart/circulation |
| 54534-3 | Gastrointestinal |
| 54535-0 | Genitourinary |
| 54536-8 | Infections |
| 54537-6 | Metabolic |
| 54538-4 | Musculoskeletal |
| 54539-2 | Neurological |
| 54540-0 | Nutritional |
| 54541-8 | Psychiatric/mood disorder |
| 54542-6 | Pulmonary |
| 54543-4 | Vision |
| 54544-2 | None of above active diagnoses |
| 54545-9 | Additional diagnoses |
| 54546-7 | Additional ICD diagnosis 1 in last 7 days |
| 54547-5 | Additional ICD diagnosis 2 in last 7 days |
| 54548-3 | Additional ICD diagnosis 3 in last 7 days |
| 54549-1 | Additional ICD diagnosis 4 in last 7 days |
| 54550-9 | Additional ICD diagnosis 5 in last 7 days |
| 54551-7 | Additional ICD diagnosis 6 in last 7 days |
| 54552-5 | Additional ICD diagnosis 7 in last 7 days |
| 54553-3 | Additional ICD diagnosis 8 in last 7 days |
| 54554-1 | Additional ICD diagnosis 9 in last 7 days |
| 54555-8 | Additional ICD diagnosis 10 in last 7 days |
| 54556-6 | Health conditions |
| 54557-4 | Pain management during assessment period [CMS Assessment] |
| 54558-2 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Pain assessment interview during assessment period [CMS Assessment] |
| 54559-0 | Pain effect on function during assessment period [CMS Assessment] |
| 54560-8 | Pain intensity during assessment period [CMS Assessment] |
| 54561-6 | Staff assessment for pain |
| 54562-4 | Indicators of pain or possible pain |
| 54563-2 | Other health conditions |
| 54564-0 | Shortness of breath |
| 54565-7 | Swallowing/nutritional status |
| 54566-5 | Swallowing disorder |
| 54567-3 | Height and weight |
| 54568-1 | Nutritional approaches panel during assessment period [CMS Assessment] |
| 54569-9 | Percent intake by artificial route |
| 54570-7 | Oral/dental status |
| 54571-5 | Dental |
| 54572-3 | Skin conditions |
| 54573-1 | Determination of pressure injury risk |
| 54574-9 | Presence of pressure injury |
| 54575-6 | Current number of unhealed (non-epithelialized) pressure injuries at each stage |
| 54576-4 | Pressure injuries - stage 2 |
| 54577-2 | Pressure injuries - stage 3 |
| 54578-0 | Pressure injuries - stage 4 |
| 54579-8 | Pressure injuries - unstageable due to non-removable dressing |
| 54582-2 | Provider type [MDSv3] |
| 54583-0 | Federal OBRA reason for assessment during assessment period [CMS Assessment] |
| 54584-8 | PPS Assessment during assessment period [CMS Assessment] |
| 54585-5 | PPS Other Medicare Required Assessment - OMRA during assessment period [CMS Assessment] |
| 54587-1 | First assessment since the most recent admission/reentry during assessment period [CMS Assessment] |
| 54589-7 | Preadmission Screening and Resident Review (PASRR) during assessment period [CMS Assessment] |
| 54590-5 | Entry type during assessment period [CMS Assessment] |
| 54592-1 | Previous assessment reference date for significant correction during assessment period [CMS Assessment] |
| 54593-9 | Assessment reference date - observation end date during assessment period [CMS Assessment] |
| 54594-7 | Medicare-covered stay since the most recent entry during assessment period [CMS Assessment] |
| 54595-4 | Start date of most recent Medicare stay during assessment period [CMS Assessment] |
| 54596-2 | End date of most recent Medicare stay during assessment period [CMS Assessment] |
| 54597-0 | Comatose during assessment period [CMS Assessment] |
| 54598-8 | Hearing.ability to hear in last 7 days [CMS Assessment] |
| 54599-6 | Hearing aid used during assessment period [CMS Assessment] |
| 54600-2 | Speech clarity.description of speech pattern during assessment period [CMS Assessment] |
| 54601-0 | Express ideas and wants in last 7 days [CMS Assessment] |
| 54602-8 | Understanding verbal content during assessment period [CMS Assessment] |
| 54603-6 | Vision.ability to see in adequate light in last 7 days [CMS Assessment] |
| 54604-4 | Corrective lenses used during assessment period [CMS Assessment] |
| 54605-1 | Brief Interview for Mental Status (BIMS) should be conducted during assessment period [CMS Assessment] |
| 54606-9 | Repetition of three words [MDSv3] |
| 54609-3 | Temporal orientation - current day of the week [BIMS] |
| 54610-1 | Recall [MDSv3] |
| 54614-3 | Brief Interview for Mental Status - summary score [BIMS] |
| 54615-0 | Should staff assessment for mental status be conducted during assessment period [CMS Assessment] |
| 54616-8 | Short-term memory OK during assessment period [CMS Assessment] |
| 54617-6 | Long-term memory OK during assessment period [CMS Assessment] |
| 54618-4 | Memory/recall ability [MDSv3] |
| 54619-2 | Can recall current season in last 7 days [MDSv3] |
| 54620-0 | Can recall location of own room in last 7 days [MDSv3] |
| 54621-8 | Can recall staff names and faces in last 7 days [MDSv3] |
| 54622-6 | Can recall that he or she is in a nursing home in last 7 days [MDSv3] |
| 54623-4 | None of the above were recalled in last 7 days [MDSv3] |
| 54624-2 | Cognitive skills for daily decision making during assessment period [CMS Assessment] |
| 54626-7 | Delirium [MDSv3] |
| 54627-5 | Signs and symptoms of delirium (from CAM) [CAM.MDSv3] |
| 54628-3 | Inattention in last 7 days [CAM.CMS] |
| 54629-1 | Disorganized thinking in last 7 days [CAM.CMS] |
| 54630-9 | Altered level of consciousness in last 7 days [CAM.CMS] |
| 54631-7 | Psychomotor retardation in last 7 days [CAM.MDSv3] |
| 54632-5 | Acute onset mental status change [CAM.CMS] |
| 54633-3 | Mood during assessment period [CMS Assessment] |
| 54634-1 | Should resident mood interview be conducted during assessment period [CMS Assessment] |
| 54635-8 | Resident mood interview (PHQ-9) [Reported PHQ-9 CMS] |
| 54636-6 | Little interest or pleasure in doing things in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54637-4 | Little interest or pleasure in doing things in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54638-2 | Feeling down, depressed or hopeless in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54639-0 | Feeling down, depressed or hopeless in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54640-8 | Trouble falling or staying asleep, or sleeping too much in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54641-6 | Trouble falling or staying asleep, or sleeping too much in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54642-4 | Feeling tired or having little energy in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54643-2 | Feeling tired or having little energy in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54644-0 | Poor appetite or overeating in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54645-7 | Poor appetite or overeating in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54646-5 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54647-3 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54648-1 | Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54649-9 | Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54650-7 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54651-5 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54652-3 | Thoughts that you would be better off dead, or of hurting yourself in some way in last 2 weeks.presence [Reported PHQ-9 CMS] |
| 54653-1 | Thoughts that you would be better off dead, or of hurting yourself in some way in last 2 weeks.frequency [Reported PHQ-9 CMS] |
| 54654-9 | Mood interview total severity score [Reported PHQ-9 CMS] |
| 54655-6 | Responsible staff or provider was informed of potential for resident self harm during assessment period [CMS Assessment] |
| 54657-2 | Staff assessment of resident mood (PHQ-9-OV) [Observed PHQ-9 CMS] |
| 54658-0 | Little interest or pleasure in doing things in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54659-8 | Little interest or pleasure in doing things in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54660-6 | Feeling or appearing down, depressed or hopeless in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54661-4 | Feeling or appearing down, depressed, or hopeless in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54662-2 | Trouble falling or staying asleep, or sleeping too much in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54663-0 | Trouble falling or staying asleep, or sleeping too much in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54664-8 | Feeling tired or having little energy in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54665-5 | Feeling tired or having little energy in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54666-3 | Poor appetite or overeating in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54667-1 | Poor appetite or overeating in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54668-9 | Indicating that (s)he feels bad about self, are a failure, or has let self or family down in last 2W.presence [Observed PHQ-9 CMS] |
| 54669-7 | Indicating that (s)he feels bad about self, are a failure, or has let self or family down in last 2W.frequency [Observed PHQ-9 CMS] |
| 54670-5 | Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54671-3 | Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54672-1 | Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that (s)he has been moving around a lot more than usual in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54673-9 | States that life isn't worth living, wishes for death, or attempts to harm self in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54674-7 | States that life isn't worth living, wishes for death, or attempts to harm self in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54675-4 | Being short-tempered, easily annoyed in last 2 weeks.presence [Observed PHQ-9 CMS] |
| 54676-2 | Being short-tempered, easily annoyed in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54677-0 | Staff assessment of resident mood total severity score [Observed PHQ-9 CMS] |
| 54678-8 | Hallucinations in last 7 days [MDSv3] |
| 54680-4 | Delusions in last 7 days [MDSv3] |
| 54681-2 | Psychoses - none of the above in last 7 days [MDSv3] |
| 54682-0 | Physical behavioral symptoms directed toward others during assessment period [CMS Assessment] |
| 54683-8 | Verbal behavioral symptoms directed toward others during assessment period [CMS Assessment] |
| 54684-6 | Other behavioral symptoms not directed toward others during assessment period [CMS Assessment] |
| 54685-3 | Overall presence of behavioral symptoms during assessment period [CMS Assessment] |
| 54686-1 | Put the resident at significant risk for physical illness or injury during assessment period [CMS Assessment] |
| 54687-9 | Significantly interfere with the resident's care during assessment period [CMS Assessment] |
| 54688-7 | Significantly interfere with the resident's participation in activities or social interactions during assessment period [CMS Assessment] |
| 54689-5 | Put others at significant risk for physical injury during assessment period [CMS Assessment] |
| 54690-3 | Significantly intrude on the privacy or activity of others during assessment period [CMS Assessment] |
| 54691-1 | Significantly disrupt care or living environment during assessment period [CMS Assessment] |
| 54692-9 | Rejection of care - presence and frequency in last 7 days [CMS Assessment] |
| 54693-7 | Wandering - presence and frequency in last 7 days [CMS Assessment] |
| 54694-5 | Wandering places resident at significant risk of getting to a potentially dangerous place in last 7 days [CMS Assessment] |
| 54695-2 | Wandering significantly intrudes on the privacy or activities of others in last 7 days [CMS Assessment] |
| 54696-0 | Change in behavioral or other symptoms in last 7 days [CMS Assessment] |
| 54697-8 | Interview for daily and activity preferences should be conducted during assessment period [CMS Assessment] |
| 54698-6 | How important it is to choose what clothes to wear while in this facility during assessment period [CMS Assessment] |
| 54699-4 | How important it is to take care of your personal belongings or things while in this facility during assessment period [CMS Assessment] |
| 54700-0 | How important it is to choose between a tub bath, shower, bed bath, or sponge bath while in this facility during assessment period [CMS Assessment] |
| 54701-8 | How important it is to have snacks available between meals while in this facility during assessment period [CMS Assessment] |
| 54702-6 | How important it is to choose your own bedtime while in this facility during assessment period [CMS Assessment] |
| 54703-4 | How important it is to have your family or a close friend involved in discussions about your care while in this facility during assessment period [CMS Assessment] |
| 54704-2 | How important it is to be able to use the phone in private while in this facility during assessment period [CMS Assessment] |
| 54705-9 | How important it is to have a place to lock your things to keep them safe while in this facility during assessment period [CMS Assessment] |
| 54706-7 | How important it is to have books, newspapers, and magazines to read while in this facility during assessment period [CMS Assessment] |
| 54707-5 | How important it is to listen to music you like while in this facility during assessment period [CMS Assessment] |
| 54708-3 | How important it is to be around animals such as pets while in this facility during assessment period [CMS Assessment] |
| 54709-1 | How important it is to keep up with the news while in this facility during assessment period [CMS Assessment] |
| 54710-9 | How important it is to do things with groups of people while in this facility during assessment period [CMS Assessment] |
| 54711-7 | How important it is to do your favorite activities while in this facility during assessment period [CMS Assessment] |
| 54712-5 | How important it is to go outside to get fresh air when the weather is good while in this facility during assessment period [CMS Assessment] |
| 54713-3 | How important it is to participate in religious services or practices while in this facility during assessment period [CMS Assessment] |
| 54714-1 | Primary respondent for daily and activity preferences during assessment period [CMS Assessment] |
| 54715-8 | Staff assessment of daily and activity preferences should be conducted during assessment period [CMS Assessment] |
| 54716-6 | Resident prefers choosing clothes to wear [MDSv3] |
| 54717-4 | Resident prefers caring for personal belongings [MDSv3] |
| 54718-2 | Resident prefers receiving tub bath [MDSv3] |
| 54719-0 | Resident prefers receiving shower [MDSv3] |
| 54720-8 | Resident prefers receiving bed bath [MDSv3] |
| 54721-6 | Resident prefers receiving sponge bath [MDSv3] |
| 54722-4 | Resident prefers snacks between meals [MDSv3] |
| 54723-2 | Resident prefers staying up past 8:00 p.m. [MDSv3] |
| 54724-0 | Resident prefers family or significant other involvement in care discussions [MDSv3] |
| 54725-7 | Resident prefers use of phone in private [MDSv3] |
| 54726-5 | Resident prefers place to lock personal belongings [MDSv3] |
| 54727-3 | Resident prefers reading books, newspapers, magazines [MDSv3] |
| 54728-1 | Resident prefers listening to music [MDSv3] |
| 54729-9 | Resident prefers being around animals such as pets [MDSv3] |
| 54730-7 | Resident prefers keeping up with the news [MDSv3] |
| 54731-5 | Resident prefers doing things with groups of people [MDSv3] |
| 54732-3 | Resident prefers participating in favorite activities [MDSv3] |
| 54733-1 | Resident prefers spending time away from the nursing home [MDSv3] |
| 54734-9 | Resident prefers spending time outdoors [MDSv3] |
| 54735-6 | Resident prefers participating in religious activities or practices [MDSv3] |
| 54736-4 | Resident prefers none of the above [MDSv3] |
| 54738-0 | Transfer in last 7 days [MDSv3] |
| 54744-8 | Dressing upper body in last 7 days [MDSv3] |
| 54748-9 | Bathing in last 7 days [MDSv3] |
| 54749-7 | Moving from seated to standing position during assessment period [CMS Assessment] |
| 54750-5 | Walking (with assistive device if used) during assessment period [CMS Assessment] |
| 54751-3 | Turning around and facing the opposite direction while walking during assessment period [CMS Assessment] |
| 54752-1 | Moving on and off toilet during assessment period [CMS Assessment] |
| 54753-9 | Surface-to-surface transfer during assessment period [CMS Assessment] |
| 54757-0 | Walker normally used in last 7 days [MDSv3] |
| 54761-2 | Bedfast [MDSv3] |
| 54762-0 | Indwelling catheter used in last 7 days [MDSv3] |
| 54763-8 | External catheter used in last 7 days [MDSv3] |
| 54764-6 | Ostomy (including suprapubic catheter, ileostomy, and colostomy) present in last 7 days [MDSv3] |
| 54765-3 | Intermittent catheterization used in last 7 days [MDSv3] |
| 54766-1 | Appliances - none of the above used in last 7 days [MDSv3] |
| 54767-9 | Trial of toileting program has been attempted on admission or reentry or since urinary incontinence was noted in this facility during assessment period [CMS Assessment] |
| 54768-7 | Response to toileting program during assessment period [CMS Assessment] |
| 54769-5 | Current toileting program or trial during assessment period [CMS Assessment] |
| 54770-3 | Urinary continence in last 7 days [CMS Assessment] |
| 54771-1 | Bowel continence in last 7 days [CMS Assessment] |
| 54772-9 | Bowel toileting program currently being used during assessment period [CMS Assessment] |
| 54773-7 | Constipation present during assessment period [CMS Assessment] |
| 54774-5 | Cancer in last 30 days [MDSv3] |
| 54775-2 | Anemia in last 7 days [MDSv3] |
| 54776-0 | Atrial fibrillation and other dysrhythmias in last 7 days [MDSv3] |
| 54777-8 | Coronary artery disease in last 7 days [MDSv3] |
| 54778-6 | Deep venous thrombosis/pulmonary embolus or pulmonary thrombo-embolism in last 7 days [MDSv3] |
| 54779-4 | Heart failure in last 7 days [MDSv3] |
| 54780-2 | Hypertension in last 7 days [MDSv3] |
| 54781-0 | Orthostatic hypotension in last 7 days [MDSv3] |
| 54782-8 | Peripheral vascular disease in last 7 days [MDSv3] |
| 54783-6 | Cirrhosis in last 7 days [MDSv3] |
| 54784-4 | Gastroesophageal reflux disease/ulcer in last 7 days [MDSv3] |
| 54785-1 | Ulcerative colitis/Crohn's disease/inflammatory bowel disease in last 7 days [MDSv3] |
| 54786-9 | Benign prostatic hyperplasia in last 7 days [MDSv3] |
| 54787-7 | Renal insufficiency or renal failure/end-stage renal disease in last 7 days [MDSv3] |
| 54790-1 | Pneumonia in last 7 days [MDSv3] |
| 54791-9 | Septicemia in last 7 days [MDSv3] |
| 54792-7 | Tuberculosis in last 7 days [MDSv3] |
| 54794-3 | Viral hepatitis in last 7 days [MDSv3] |
| 54795-0 | Diabetes mellitus in last 7 days [MDSv3] |
| 54796-8 | Hyponatremia in last 7 days [MDSv3] |
| 54797-6 | Hyperkalemia in last 7 days [MDSv3] |
| 54798-4 | Hyperlipidemia in last 7 days [MDSv3] |
| 54799-2 | Thyroid disorder in last 7 days [MDSv3] |
| 54800-8 | Arthritis in last 7 days [MDSv3] |
| 54801-6 | Osteoporosis in last 7 days [MDSv3] |
| 54802-4 | Hip fracture in last 7 days [MDSv3] |
| 54803-2 | Other fracture in last 7 days [MDSv3] |
| 54804-0 | Alzheimer's disease in last 7 days [MDSv3] |
| 54805-7 | Aphasia in last 7 days [MDSv3] |
| 54806-5 | Cerebral palsy in last 7 days [MDSv3] |
| 54807-3 | Cerebrovascular accident/transient ischemic attack/stroke in last 7 days [MDSv3] |
| 54808-1 | Non-Alzheimer's dementia in last 7 days [MDSv3] |
| 54809-9 | Hemiplegia/hemiparesis in last 7 days [MDSv3] |
| 54810-7 | Paraplegia in last 7 days [MDSv3] |
| 54811-5 | Quadriplegia in last 7 days [MDSv3] |
| 54812-3 | Multiple sclerosis in last 7 days [MDSv3] |
| 54813-1 | Parkinson's disease in last 7 days [MDSv3] |
| 54814-9 | Seizure disorder in last 7 days [MDSv3] |
| 54815-6 | Traumatic brain injury in last 7 days [MDSv3] |
| 54816-4 | Protein or calorie malnutrition or at risk for malnutrition in last 7 days [MDSv3] |
| 54817-2 | Anxiety disorder in last 7 days [MDSv3] |
| 54818-0 | Depression other than bipolar in last 7 days [MDSv3] |
| 54819-8 | Manic depression other than schizophrenia in last 7 days [MDSv3] |
| 54820-6 | Schizophrenia in last 7 days [MDSv3] |
| 54821-4 | Post-traumatic stress disorder in last 7 days [MDSv3] |
| 54822-2 | Asthma/chronic obstructive lung disease or chronic lung disease in last 7 days [MDSv3] |
| 54823-0 | Cataracts/glaucoma or macular degeneration in last 7 days [MDSv3] |
| 54824-8 | None of the above active diagnoses in last 7 days [MDSv3] |
| 54825-5 | On scheduled pain medication regimen in last 7 days [MDSv3] |
| 54826-3 | Received PRN pain medications in last 7 days [MDSv3] |
| 54827-1 | Received non-medication intervention for pain in last 7 days [MDSv3] |
| 54828-9 | Pain assessment interview should be conducted during assessment period [CMS Assessment] |
| 54829-7 | Pain presence during assessment period [CMS Assessment] |
| 54830-5 | Pain frequency during assessment period [CMS Assessment] |
| 54831-3 | Pain has made it hard to sleep during assessment period [CMS Assessment] |
| 54832-1 | Limited activities because of pain during assessment period [CMS Assessment] |
| 54833-9 | Pain severity during assessment period [CMS Assessment] |
| 54834-7 | Rate pain severity during assessment period using verbal descriptor scale |
| 54835-4 | Non-verbal sounds of pain in last 5 days [MDSv3] |
| 54836-2 | Vocal complaints of pain in last 5 days [MDSv3] |
| 54837-0 | Facial expressions of pain in last 5 days [MDSv3] |
| 54838-8 | Protective body movements or postures in last 5 days [MDSv3] |
| 54839-6 | None of these signs of pain observed or documented in last 5 days [MDSv3] |
| 54841-2 | Shortness of breath or trouble breathing with exertion in last 7 days [MDSv3] |
| 54842-0 | Shortness of breath or trouble breathing when sitting at rest in last 7 days [MDSv3] |
| 54843-8 | Shortness of breath or trouble breathing when lying flat in last 7 days [MDSv3] |
| 54844-6 | None of the above shortness of breath symptoms in last 7 days [MDSv3] |
| 54845-3 | Tobacco use during assessment period [CMS Assessment] |
| 54846-1 | Life expectancy of less than 6 months during assessment period [CMS Assessment] |
| 54847-9 | Problem conditions [MDSv3] |
| 54848-7 | Problem conditions - none of above [MDSv3] |
| 54849-5 | Fall history on admission during assessment period [CMS Assessment] |
| 54850-3 | Fall one or more times in the last month prior to admission [CMS Assessment] |
| 54851-1 | Fall one or more times in the last 2 to 6 months prior to admission [CMS Assessment] |
| 54852-9 | Any fracture related to a fall in the 6 months prior to admission [CMS Assessment] |
| 54853-7 | Has the patient had any falls since admission or prior assessment [CMS Assessment] |
| 54854-5 | Number of falls since admission or prior assessment [CMS Assessment] |
| 54855-2 | Number of falls since admission or prior assessment - no injury [CMS Assessment] |
| 54856-0 | Number of falls since admission or prior assessment - injury except major [CMS Assessment] |
| 54857-8 | Number of falls since admission or prior assessment - major injury [CMS Assessment] |
| 54858-6 | Loss of liquids/solids from mouth when eating or drinking in last 7 days [MDSv3] |
| 54859-4 | Holding food in mouth/cheeks or residual food in mouth after meals in last 7 days [MDSv3] |
| 54860-2 | Coughing or choking during meals or when swallowing medications in last 7 days [MDSv3] |
| 54861-0 | Complaints of difficulty or pain with swallowing in last 7 days [MDSv3] |
| 54862-8 | Signs or symptoms of possible swallowing disorder - none of the above [MDSv3] |
| 54863-6 | Weight loss of 5% or more in the last month or loss of 10% or more in last 6 months [CMS Assessment] |
| 54864-4 | Parenteral/IV feeding in last 7 days [MDSv3] |
| 54865-1 | Nasogastric or abdominal feeding tube in last 7 days [MDSv3] |
| 54866-9 | Mechanically altered diet - require change in texture of food or liquids in last 7 days [MDSv3] |
| 54867-7 | Therapeutic diet in last 7 days [MDSv3] |
| 54868-5 | Nutritional approaches in last 7 days - none of the above [MDSv3] |
| 54869-3 | Average fluid intake per day by parenteral or tube feedings in the 7 days [MDSv3] |
| 54871-9 | Broken or loosely fitting full or partial denture in last 7 days [MDSv3] |
| 54872-7 | No natural teeth or tooth fragments in last 7 days [MDSv3] |
| 54873-5 | Abnormal mouth tissue in last 7 days [MDSv3] |
| 54874-3 | Obvious or likely cavity or broken natural teeth in last 7 days [MDSv3] |
| 54875-0 | Inflamed or bleeding gums or loose natural teeth in last 7 days [MDSv3] |
| 54876-8 | Mouth or facial pain, discomfort or difficulty with chewing in last 7 days [MDSv3] |
| 54877-6 | Dental status - none of the above in last 7 days [MDSv3] |
| 54878-4 | Pressure injury risk by resident has a stage 1 or greater, a scar over bony prominence, or a non-removable dressing, device in last 7 days [MDSv3] |
| 54879-2 | Pressure injury risk by formal assessment [MDSv3] |
| 54880-0 | Pressure injury risk by clinical judgment [MDSv3] |
| 54881-8 | Pressure injury risk - none of the above [MDSv3] |
| 54884-2 | Number of pressure injuries - stage 1 during assessment period [CMS Assessment] |
| 54886-7 | Number of pressure injuries present upon admission/reentry - stage 2 during assessment period [CMS Assessment] |
| 54887-5 | Number of pressure injuries present upon admission/reentry - stage 3 during assessment period [CMS Assessment] |
| 54888-3 | Date of onset of pressure injuries onset in this facility - oldest or only stage 3 [MDSv3] |
| 54890-9 | Number of pressure injuries present upon admission/reentry - stage 4 during assessment period [CMS Assessment] |
| 54891-7 | Date of onset of pressure injuries onset in this facility - oldest or only stage 4 [MDSv3] |
| 54893-3 | Number of pressure injuries - unstageable due to non-removable dressing or device during assessment period [CMS Assessment] |
| 54894-1 | Number of pressure injuries present upon admission/reentry - unstageable due to non-removable dressing during assessment period [CMS Assessment] |
| 54895-8 | Staff assessment for mental status [MDSv3] |
| 54896-6 | Submission requirement [MDSv3] |
| 54897-4 | Proportion of total calories the resident received through parenteral or tube feedings in the last 7 days [MDSv3] |
| 54898-2 | Other disease diagnoses in last 7 days [MDSv3] |
| 54904-8 | Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that (s)he has been moving around a lot more than usual in last 2 weeks.frequency [Observed PHQ-9 CMS] |
| 54946-9 | Number of pressure injuries - unstageable due to coverage of wound bed by slough/eschar during assessment period [CMS Assessment] |
| 54947-7 | Number of pressure injuries present upon admission/reentry - unstageable due to coverage of wound bed by slough/eschar during assessment period [CMS Assessment] |
| 54950-1 | Number of pressure injuries - unstageable with suspected deep tissue injury in evolution during assessment period [CMS Assessment] |
| 54951-9 | Number of pressure injuries present upon admission/reentry - unstageable with suspected deep tissue injury in evolution during assessment period [CMS Assessment] |
| 54952-7 | Worsening in pressure injury status since last assessment (OBRA, PPS, or Discharge) |
| 54953-5 | Number of current pressure injuries not present or were at a lesser stage on prior assessment - stage 2 during assessment period [CMS Assessment] |
| 54954-3 | Number of current pressure injuries not present or were at a lesser stage on prior assessment - stage 3 during assessment period [CMS Assessment] |
| 54955-0 | Number of current pressure injuries not present or were at a lesser stage on prior assessment - stage 4 during assessment period [CMS Assessment] |
| 54956-8 | Healed pressure injuries during assessment period [CMS Assessment] |
| 54957-6 | Pressure injuries were present on the prior assessment during assessment period [CMS Assessment] |
| 54958-4 | Number of pressure injuries noted on prior assessment that have completely closed - stage 2 during assessment period [CMS Assessment] |
| 54959-2 | Number of pressure injuries noted on prior assessment that have completely closed - stage 3 during assessment period [CMS Assessment] |
| 54960-0 | Number of pressure injuries noted on prior assessment that have completely closed - stage 4 during assessment period [CMS Assessment] |
| 54961-8 | Other ulcers, wounds and skin problems |
| 54963-4 | Diabetic foot ulcer(s) in last 7 days [MDSv3] |
| 54966-7 | Surgical wound(s) in last 7 days [MDSv3] |
| 54967-5 | Open lesion(s) other than ulcers, rashes, cuts in last 7 days [MDSv3] |
| 54968-3 | Second or third degree burns in last 7 days [MDSv3] |
| 54969-1 | Other ulcers, wounds, and skin problems - none of above in last 7 days [MDSv3] |
| 54970-9 | Number of venous and arterial ulcers in last 7 days [CMS Assessment] |
| 54971-7 | Skin and ulcer treatments in last 7 days |
| 54972-5 | Pressure reducing device for chair provided in last 7 days [MDSv3] |
| 54973-3 | Pressure reducing device for bed provided in last 7 days [MDSv3] |
| 54974-1 | Turning/repositioning provided in last 7 days [MDSv3] |
| 54975-8 | Nutrition or hydration intervention to manage skin problems provided in last 7 days [MDSv3] |
| 54976-6 | Ulcer care provided in last 7 days [MDSv3] |
| 54977-4 | Surgical wound care provided in last 7 days [MDSv3] |
| 54978-2 | Application of nonsurgical dressings (with or without topical medications) other than to feet provided in last 7 days [MDSv3] |
| 54979-0 | Applications of ointments/medications other than to feet provided in last 7 days [MDSv3] |
| 54980-8 | Application of dressings to feet (with or without topical medications) provided in last 7 days [MDSv3] |
| 54981-6 | Skin and ulcer treatments - none of above provided in last 7 days [MDSv3] |
| 54982-4 | Number of days injectable substances received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 54984-0 | Antipsychotic received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 54985-7 | Antianxiety received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 54986-5 | Antidepressant received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 54987-3 | Hypnotic received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 54988-1 | Anticoagulant received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 54989-9 | Medications received - none of the above were received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 54990-7 | Special treatments and procedures |
| 54991-5 | Special treatments and programs in last 14 days |
| 54992-3 | Chemotherapy in last 14 days - while not a resident [MDSv3] |
| 54993-1 | Chemotherapy in last 14 days - while a resident [MDSv3] |
| 54994-9 | Radiation in last 14 days - while not a resident [MDSv3] |
| 54995-6 | Radiation in last 14 days - while a resident [MDSv3] |
| 54996-4 | Oxygen therapy in last 14 days - while not a resident [MDSv3] |
| 54997-2 | Oxygen therapy in last 14 days - while a resident [MDSv3] |
| 54998-0 | Suctioning in last 14 days - while not a resident [MDSv3] |
| 54999-8 | Suctioning in last 14 days - while a resident [MDSv3] |
| 55000-4 | Tracheostomy care in last 14 days - while not a resident [MDSv3] |
| 55001-2 | Tracheostomy care in last 14 days - while a resident [MDSv3] |
| 55002-0 | Ventilator or respirator in last 14 days - while not a resident [MDSv3] |
| 55003-8 | Ventilator or respirator in last 14 days - while a resident [MDSv3] |
| 55004-6 | BIPAP/CPAP machine in last 14 days - while not a resident [MDSv3] |
| 55005-3 | BIPAP/CPAP machine in last 14 days - while a resident [MDSv3] |
| 55006-1 | IV medications in last 14 days - while not a resident [MDSv3] |
| 55007-9 | IV medications in last 14 days - while a resident [MDSv3] |
| 55008-7 | Transfusions in last 14 days - while not a resident [MDSv3] |
| 55009-5 | Transfusions in last 14 days - while a resident [MDSv3] |
| 55010-3 | Dialysis in last 14 days - while not a resident [MDSv3] |
| 55011-1 | Dialysis in last 14 days - while a resident [MDSv3] |
| 55012-9 | Hospice care in last 14 days - while not a resident [MDSv3] |
| 55013-7 | Hospice care in last 14 days - while a resident [MDSv3] |
| 55014-5 | Respite care in last 14 days - while not a resident [MDSv3] |
| 55015-2 | Respite care in last 14 days - while a resident [MDSv3] |
| 55016-0 | Isolation or quarantine for active infectious disease in last 14 days - while not a resident [MDSv3] |
| 55017-8 | Isolation or quarantine for active infectious disease in last 14 days - while a resident [MDSv3] |
| 55018-6 | Influenza vaccine |
| 55019-4 | Influenza virus vaccine received in facility during assessment period [CMS Assessment] |
| 55020-2 | Reason influenza virus vaccine not received during assessment period [CMS Assessment] |
| 55021-0 | Pneumococcal vaccine |
| 55022-8 | Pneumococcal vaccination up to date during assessment period [CMS Assessment] |
| 55024-4 | Therapies in last 7 days |
| 55025-1 | Start date of speech language pathology and audiology services during assessment period [CMS Assessment] |
| 55026-9 | End date of speech language pathology and audiology services during assessment period [CMS Assessment] |
| 55027-7 | Start date of occupational therapy during assessment period [CMS Assessment] |
| 55028-5 | End date of occupational therapy during assessment period [CMS Assessment] |
| 55029-3 | Start date of physical therapy during assessment period [CMS Assessment] |
| 55030-1 | End date of physical therapy during assessment period [CMS Assessment] |
| 55031-9 | Start date of respiratory therapy [MDSv3] |
| 55032-7 | End date of respiratory therapy [MDSv3] |
| 55035-0 | Total minutes of recreational and music therapy in last 7 days [CMS Assessment] |
| 55036-8 | Number of days with at least 15 minutes of recreational and music therapy in last 7 days [CMS Assessment] |
| 55039-2 | Nursing rehabilitation/restorative care in last 7 days |
| 55040-0 | Number of days physician examined the patient in last 14 days [CMS Assessment] |
| 55041-8 | Number of days physician orders changed in last 14 days [CMS Assessment] |
| 55042-6 | Restraints |
| 55043-4 | Physical restraints |
| 55044-2 | Physical restraints used in bed - bed rail of any type [MDSv3] |
| 55045-9 | Physical restraints used in bed - trunk restraint [MDSv3] |
| 55046-7 | Physical restraints used in bed - limb restraint [MDSv3] |
| 55047-5 | Physical restraints used in bed - other [MDSv3] |
| 55048-3 | Physical restraints used in chair or out of bed - trunk restraint [MDSv3] |
| 55049-1 | Physical restraints used in chair or out of bed - limb restraint [MDSv3] |
| 55050-9 | Physical restraints used in chair or out of bed - chair prevents rising [MDSv3] |
| 55051-7 | Physical restraints used in chair or out of bed - other [MDSv3] |
| 55052-5 | Participation in assessment and goal setting |
| 55053-3 | Participation in assessment |
| 55054-1 | Participation in assessment during assessment period [CMS Assessment] |
| 55055-8 | Return to community [MDSv3] |
| 55056-6 | Resident's overall goals during assessment period [CMS Assessment] |
| 55057-4 | Goals established during assessment process during assessment period [CMS Assessment] |
| 55058-2 | Information source for resident's overall goal during assessment period [CMS Assessment] |
| 55063-2 | Assessment administration |
| 55064-0 | Medicare part A billing |
| 55065-7 | Medicare part A - HIPPS code for billing |
| 55066-5 | Medicare part A - RUG version code |
| 55067-3 | State Medicaid billing |
| 55068-1 | State case mix - RUG group |
| 55069-9 | State case mix - RUG version code |
| 55070-7 | Insurance billing |
| 55071-5 | Insurance case mix - RUG group |
| 55072-3 | Insurance case mix - RUG version code |
| 55073-1 | Tissue type during assessment period [CMS Assessment] Pressure injury.Largest at most advanced stage |
| 55074-9 | Participation in assessment during assessment period [CMS Assessment] Family or significant other |
| 55075-6 | Version code Specifications |
| 55076-4 | Production or test indicator Submission [MDSv3] |
| 55077-2 | State assigned facility submission ID |
| 55078-0 | Federal employer tax ID Software vendor |
| 55079-8 | Vendor company name Software |
| 55080-6 | Product name Software |
| 55081-4 | Product version code Software |
| 55082-2 | Transaction code Transaction [MDSv3] |
| 55083-0 | Item subset code |
| 55084-8 | Other special treatments and programs in last 14 days |
| 55085-5 | Respiratory treatments in last 14 days |
| 55086-3 | Cancer treatments in last 14 days |
| 55088-9 | Pressure injuries - unstageable with suspected deep tissue injury in evolution |
| 55089-7 | Pressure injuries - unstageable due to coverage of wound bed by slough/eschar |
| 55093-9 | Vendor email address Software |
| 55094-7 | Medications [MDSv3] |
| 55123-4 | Resident believes he or she is capable of increased independence in at least some ADLs during assessment period [CMS Assessment] |
| 55124-2 | Number of pressure injuries - stage 2 during assessment period [CMS Assessment] |
| 55125-9 | Number of pressure injuries - stage 3 during assessment period [CMS Assessment] |
| 55126-7 | Number of pressure injuries - stage 4 during assessment period [CMS Assessment] |
| 55128-3 | Discharge disposition |
| 55129-1 | Physical restraints used in bed |
| 55130-9 | Physical restraints used in chair or out of bed |
| 55131-7 | Number of days of rehabilitative or restorative techniques |
| 55132-5 | Number of days of rehabilitative or restorative training and skill practice |
| 55181-2 | Quality Reporting Document Architecture panel |
| 55182-0 | Quality Reporting Document Architecture incidence report Document |
| 55183-8 | Quality Reporting Document Architecture patient list report Population Document |
| 55184-6 | Quality Reporting Document Architecture calculated summary report Population Document |
| 55185-3 | Measure set Document |
| 55186-1 | Measure Document |
| 55187-9 | Reporting parameters Document |
| 55188-7 | Patient data Document |
| 55744-7 | howRu |
| 55745-4 | How are you today: pain or discomfort |
| 55746-2 | How are you today: feeling low or worried |
| 55747-0 | How are you today: limited in what I can do |
| 55748-8 | Require help from others |
| 55749-6 | howRu score [R-Outcomes] |
| 55757-9 | Patient Health Questionnaire 2 item (PHQ-2) [Reported] |
| 55758-7 | Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] |
| 57040-8 | Clinical Record Items during assessment period [CMS Assessment] |
| 57041-6 | Patient history and diagnoses |
| 57042-4 | Sensory status during assessment period [CMS Assessment] |
| 57043-2 | Living arrangements |
| 57044-0 | Integumentary status |
| 57045-7 | Cardiac status |
| 57046-5 | Elimination status |
| 57047-3 | Neuro and emotional and behavioral status - SOC or ROC |
| 57048-1 | ADL and IADLs |
| 57049-9 | Care management during assessment period [CMS Assessment] |
| 57050-7 | Therapy need and plan of care during assessment period [CMS Assessment] |
| 57051-5 | Data items collected at inpatient facility admission or agency discharge only |
| 57052-3 | Emergent care during assessment period [CMS Assessment] |
| 57120-8 | Type of nursing provider [NMMDS] |
| 57121-6 | Type of client [NMMDS] |
| 57122-4 | Type of encounter [NMMDS] |
| 57123-2 | Hours designated [Estimate] |
| 57124-0 | Care capacity # [Estimate] |
| 57125-7 | Care provided # |
| 57126-5 | Volume of nursing delivery unit or service panel [NMMDS] |
| 57127-3 | Method of care delivery [NMMDS] |
| 57183-6 | Inpatient procedure relevant to plan of care |
| 57185-1 | Current number of unhealed pressure ulcers |
| 57186-9 | Number of pressure injuries at each stage Set |
| 57187-7 | Number of pressure injuries present at admission Set |
| 57188-5 | Stage 3 or 4 pressure injury with largest surface dimensions |
| 57195-0 | Patient/caregiver drug education intervention during assessment period [CMS Assessment] |
| 57196-8 | Prior medication management during assessment period [CMS Assessment] |
| 57197-6 | Plan of care synopsis during assessment period [CMS Assessment] |
| 57198-4 | Intervention synopsis |
| 57199-2 | Current payment sources for home care during assessment period [CMS Assessment] |
| 57200-8 | Reason for assessment during assessment period [CMS Assessment] |
| 57201-6 | Date of Physician-ordered Start of Care (Resumption of Care) during assessment period [CMS Assessment] |
| 57202-4 | Date of Referral |
| 57203-2 | Episode Timing during assessment period [CMS Assessment] |
| 57204-0 | Inpatient discharge facility within the past 14 days [CMS Assessment] |
| 57205-7 | Inpatient stay within last 14 days - ICD code [OASIS-C] |
| 57206-5 | Overall status during assessment period [CMS Assessment] |
| 57207-3 | Risk factors affecting health status and or outcome during assessment period [CMS Assessment] |
| 57208-1 | Influenza vaccination received in Reporting Period [CMS Assessment] |
| 57210-7 | Pneumococcal vaccine [OASIS-C] |
| 57211-5 | Reason pneumococcal vaccine not given [OASIS-C] |
| 57212-3 | Patient lives alone during assessment period [CMS Assessment] |
| 57213-1 | Patient lives with other person during assessment period [CMS Assessment] |
| 57214-9 | Patient lives in congregated situtation during assessment period [CMS Assessment] |
| 57215-6 | Vision during assessment period [CMS Assessment] |
| 57216-4 | Ability to hear during assessment period [CMS Assessment] |
| 57217-2 | Understanding of verbal content during assessment period [CMS Assessment] |
| 57218-0 | Speech and oral expression of language during assessment period [CMS Assessment] |
| 57219-8 | Formal pain assessment using standardized tool during assessment period [CMS Assessment] |
| 57220-6 | Frequency of pain interfering with activity or movement during assessment period [CMS Assessment] |
| 57221-4 | Pressure injury assessment was conducted during assessment period [CMS Assessment] |
| 57222-2 | Oldest non-epithelialized stage 2 pressure injury present at discharge during assessment period [CMS Assessment] |
| 57226-3 | Longitudinal diameter Pressure injury.largest stage 3 or 4 [OASIS-C] |
| 57228-9 | Depth during assessment period [CMS Assessment] Pressure injury.largest stage 3 or 4 |
| 57229-7 | Status of most problematic pressure injury during assessment period [CMS Assessment] |
| 57231-3 | Stage of most problematic pressure injury during assessment period [CMS Assessment] |
| 57232-1 | Stasis ulcer [CMS Assessment] |
| 57233-9 | Number of stasis ulcers during assessment period [CMS Assessment] |
| 57234-7 | Status of most problematic stasis pressure injury during assessment period [CMS Assessment] |
| 57235-4 | Surgical wound during assessment period [CMS Assessment] |
| 57236-2 | Status of most problematic surgical wound during assessment period [CMS Assessment] |
| 57237-0 | Exertion level causing shortness of breath during assessment period [CMS Assessment] |
| 57238-8 | Respiratory treatments administered at home during assessment period [CMS Assessment] |
| 57239-6 | Symptoms in heart failure patients during assessment period [CMS Assessment] |
| 57240-4 | Heart failure follow-up during assessment period [CMS Assessment] |
| 57241-2 | When urinary incontinence occurs during assessment period [CMS Assessment] |
| 57242-0 | Standardized depression screening was conducted during assessment period [CMS Assessment] |
| 57243-8 | Bathing - functional ability during assessment period [CMS Assessment] |
| 57244-6 | Toilet transferring - functional ability during assessment period [CMS Assessment] |
| 57245-3 | Toileting hygiene - functional ability during assessment period [CMS Assessment] |
| 57246-1 | Transferring - functional ability during assessment period [CMS Assessment] |
| 57247-9 | Locomotion - functional ability during assessment period [CMS Assessment] |
| 57248-7 | Feeding - functional ability during assessment period [CMS Assessment] |
| 57249-5 | Prepare light meals - functional ability during assessment period [CMS Assessment] |
| 57250-3 | Self-care [OASIS-C] |
| 57251-1 | Ambulation [OASIS-C] |
| 57252-9 | Transfer [OASIS-C] |
| 57253-7 | Household tasks [OASIS-C] |
| 57254-5 | Standardized fall risk assessment was conducted during assessment period [CMS Assessment] |
| 57255-2 | Drug regimen review identified potential medication issues during assessment period [CMS Assessment] |
| 57256-0 | Medication intervention since admission/reentry during assessment period [CMS Assessment] |
| 57257-8 | Patient/caregiver received high risk drug education during assessment period [CMS Assessment] |
| 57258-6 | Oral medication management - prior ability during assessment period [CMS Assessment] |
| 57259-4 | Injectable medication management - prior ability during assessment period [CMS Assessment] |
| 57260-2 | Non-agency caregiver ability and willingness to assist with ADL during assessment period [CMS Assessment] |
| 57261-0 | Non-agency caregiver ability and willingness to assist with IADL during assessment period [CMS Assessment] |
| 57262-8 | Non-agency caregiver ability and willingness to assist with medication administration during assessment period [CMS Assessment] |
| 57263-6 | Non-agency caregiver ability and willingness to assist with medical procedures/treatments during assessment period [CMS Assessment] |
| 57264-4 | Non-agency caregiver ability and willingness to assist with management of equipment during assessment period [CMS Assessment] |
| 57265-1 | Non-agency caregiver ability and willingness to assist with supervision and safety during assessment period [CMS Assessment] |
| 57266-9 | Non-agency caregiver ability and willingness to assist with advocacy or facilitation of patient participation during assessment period [CMS Assessment] |
| 57267-7 | ADL or IADL assistance frequency from any caregiver during assessment period [CMS Assessment] |
| 57268-5 | Therapy need during assessment period [CMS Assessment] |
| 57269-3 | Plan of care includes patient-specific parameters for notifying physician of changes during assessment period [CMS Assessment] |
| 57270-1 | Plan of care includes diabetic foot care during assessment period [CMS Assessment] |
| 57271-9 | Plan of care includes fall prevention interventions during assessment period [CMS Assessment] |
| 57272-7 | Plan of care includes depression intervention during assessment period [CMS Assessment] |
| 57273-5 | Plan of care includes intervention to monitor and mitigate pain during assessment period [CMS Assessment] |
| 57274-3 | Plan of care includes intervention to prevent pressure injuries during assessment period [CMS Assessment] |
| 57275-0 | Plan of care includes pressure injury treatment - moist healing during assessment period [CMS Assessment] |
| 57276-8 | Emergent care utilized during assessment period [CMS Assessment] |
| 57277-6 | Reason for emergent care during assessment period [CMS Assessment] |
| 57279-2 | Reason for hospitalization during assessment period [CMS Assessment] |
| 57280-0 | Risk of developing pressure injuries during assessment period [CMS Assessment] |
| 57281-8 | Medication follow-up during assessment period [CMS Assessment] |
| 57282-6 | Patient/caregiver drug education intervention [OASIS-C] |
| 57284-2 | Management of injectable medications - ability during assessment period [CMS Assessment] |
| 57285-9 | Management of oral medications - ability during assessment period [CMS Assessment] |
| 57306-3 | Types and sources of assistance during assessment period [CMS Assessment] |
| 57307-1 | Unhealed pressure injury at stage 2 or higher or designated as unstageable [OASIS-C] |
| 57319-6 | Risk for hospitalization during assessment period [CMS Assessment] |
| 58050-6 | Inpatient procedure relevant to plan of care [OASIS-C] |
| 58051-4 | Payment diagnosis [OASIS-C] |
| 58052-2 | Date pressure injury.oldest non-epithelialized stage 2 first identified [CMS Assessment] |
| 58102-5 | Current number of unhealed (non-epithelialized) pressure injuries at each stage [OASIS-C] |
| 58104-1 | When confused within the last 14 days [CMS Assessment] |
| 58105-8 | Current payment sources for home care.other specified [OASIS-C] |
| 58106-6 | Inpatient discharge facility.other specified [OASIS-C] |
| 58107-4 | Swing bed clinical change assessment during assessment period [CMS Assessment] |
| 58108-2 | Entry/discharge reporting during assessment period [CMS Assessment] |
| 58109-0 | Multidrug-resistant organism (MDRO) in last 7 days [MDSv3] |
| 58110-8 | Wound infection (other than foot) in last 7 days [MDSv3] |
| 58111-6 | Neurogenic bladder in last 7 days [MDSv3] |
| 58112-4 | Obstructive uropathy in the last 7 days [MDSv3] |
| 58113-2 | Huntington's disease Multiple sclerosis in last 7 days [MDSv3] |
| 58114-0 | Tourette's syndrome in last 7 days [MDSv3] |
| 58115-7 | Psychotic disorder (other than schizophrenia) in last 7 days [MDSv3] |
| 58116-5 | Respiratory failure in last 7 days [MDSv3] |
| 58117-3 | Staff pain assessment interview should be conducted during assessment period [CMS Assessment] |
| 58118-1 | Frequency of indicator of pain or possible pain during assessment period [CMS Assessment] |
| 58119-9 | Unable to examine oral or dental status [MDSv3] |
| 58120-7 | Patient Health Questionnaire 2 item (PHQ-2) [PHQ.CMS] |
| 58121-5 | Prior Functioning ADL/IADL during assessment period [CMS Assessment] |
| 58122-3 | Resident has one or more unhealed pressure injuries at stage 1 or higher [MDSv3] |
| 58123-1 | Date of Pressure injury.oldest non-epithelialized stage 2 [CMS Assessment] |
| 58124-9 | Diabetic foot ulcers [MDSv3] |
| 58125-6 | Other open lesion(s) on the foot [MDSv3] |
| 58126-4 | Number of days injection of any type were received in last 5 days or since admission/reentry if less than 7 days [MDSv3] |
| 58127-2 | Number of days insulin injections were received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 58128-0 | Number of days the physician changed the resident's insulin orders in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 58129-8 | Antibiotic received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 58130-6 | Diuretic received in last 7 days or since admission/reentry if less than 7 days [MDSv3] |
| 58132-2 | Speech-language pathology and audiology services [MDSv3] |
| 58133-0 | Speech-language pathology and audiology services - concurrent minutes in the last 7 days [CMS Assessment] |
| 58134-8 | Speech-language pathology and audiology services - group minutes in the last 7 days [CMS Assessment] |
| 58135-5 | Occupational therapy [MDSv3] |
| 58136-3 | Occupational therapy - concurrent minutes in the last 7 days [CMS Assessment] |
| 58137-1 | Occupational therapy - group minutes in the last 7 days [CMS Assessment] |
| 58138-9 | Physical therapy [MDSv3] |
| 58139-7 | Physical therapy - concurrent minutes in the last 7 days [CMS Assessment] |
| 58140-5 | Physical therapy - group minutes in the last 7 days [CMS Assessment] |
| 58141-3 | Respiratory therapy during assessment period [CMS Assessment] |
| 58142-1 | Psychological therapy during assessment period [CMS Assessment] |
| 58143-9 | Recreational therapy during assessment period [CMS Assessment] |
| 58144-7 | Resident's overall goal established during assessment process [MDSv3] |
| 58145-4 | Information source for overall goal [MDSv3] |
| 58146-2 | Active discharge planning in place for resident return to community during assessment period [CMS Assessment] |
| 58147-0 | Determination made by resident and core planning team regarding discharge to community [MDSv3] |
| 58148-8 | Resident has been asked about returning to the community [MDSv3] |
| 58149-6 | Wants to talk to someone about the possibility of returning to the community during assessment period [CMS Assessment] |
| 58150-4 | Referral has been made to the local contact agency during assessment period [CMS Assessment] |
| 58151-2 | Prior assessment Brief Interview for Mental Status (BIMS) summary score [MDSv3] |
| 58152-0 | Prior assessment resident mood interview (PHQ-9) total severity score [MDSv3] |
| 58153-8 | Prior assessment staff assessment of resident mood interview (PHQ-9) total severity score [MDSv3] |
| 58154-6 | Care Area Assessment (CAA) Summary [MDSv3] |
| 58155-3 | Care Area Assessment (CAA) and care planning [MDSv3] |
| 58156-1 | Care Area Assessment (CAA) results [MDSv3] |
| 58157-9 | Delirium - care area triggered [MDSv3] |
| 58158-7 | Delirium - addressed in care plan [MDSv3] |
| 58159-5 | Cognitive loss/dementia - care area triggered [MDSv3] |
| 58160-3 | Cognitive loss/dementia - addressed in care plan [MDSv3] |
| 58161-1 | Communication - care area triggered [MDSv3] |
| 58162-9 | Communication - addressed in care plan [MDSv3] |
| 58163-7 | ADL functional/rehabilitation potential - care area triggered [MDSv3] |
| 58164-5 | ADL functional/rehabilitation potential - addressed in care plan [MDSv3] |
| 58165-2 | Urinary incontinence and indwelling catheter - care area triggered [MDSv3] |
| 58166-0 | Urinary incontinence and indwelling catheter - addressed in care plan [MDSv3] |
| 58167-8 | Psychosocial well-being - care area triggered [MDSv3] |
| 58168-6 | Psychosocial well-being - addressed in care plan [MDSv3] |
| 58169-4 | Mood state - care area triggered [MDSv3] |
| 58170-2 | Mood state - addressed in care plan [MDSv3] |
| 58171-0 | Behavioral symptoms - care area triggered [MDSv3] |
| 58172-8 | Behavioral symptoms - addressed in care plan [MDSv3] |
| 58173-6 | Activities - care area triggered [MDSv3] |
| 58174-4 | Activities - addressed in care plan [MDSv3] |
| 58175-1 | Falls - care area triggered [MDSv3] |
| 58176-9 | Falls - addressed in care plan [MDSv3] |
| 58177-7 | Nutritional status - care area triggered [MDSv3] |
| 58178-5 | Nutritional status - addressed in care plan [MDSv3] |
| 58179-3 | Feeding tube - care area triggered [MDSv3] |
| 58180-1 | Feeding tube - addressed in care plan [MDSv3] |
| 58181-9 | Dehydration/fluid maintenance - care area triggered [MDSv3] |
| 58182-7 | Dehydration/fluid maintenance - addressed in care plan [MDSv3] |
| 58183-5 | Dental care - care area triggered [MDSv3] |
| 58184-3 | Dental care - addressed in care plan [MDSv3] |
| 58185-0 | Pressure injury - care area triggered [MDSv3] |
| 58186-8 | Pressure injury - addressed in care plan [MDSv3] |
| 58187-6 | Psychotropic drug use - care area triggered [MDSv3] |
| 58188-4 | Psychotropic drug use - addressed in care plan [MDSv3] |
| 58189-2 | Physical restraints - care area triggered [MDSv3] |
| 58190-0 | Physical restraints - addressed in care plan [MDSv3] |
| 58191-8 | Pain - care area triggered [MDSv3] |
| 58192-6 | Pain - addressed in care plan [MDSv3] |
| 58193-4 | Return to community referral - care area triggered [MDSv3] |
| 58194-2 | Return to community referral - addressed in care plan [MDSv3] |
| 58195-9 | Date of Care Area Assessment (CAA) information [MDSv3] |
| 58196-7 | Location of Care Area Assessment (CAA) information [MDSv3] |
| 58197-5 | Correction request [MDSv3] |
| 58198-3 | Type of record during assessment period [CMS Assessment] |
| 58199-1 | Reasons for modification [MDSv3] |
| 58200-7 | Correction number during assessment period [CMS Assessment] |
| 58201-5 | Transcription error [MDSv3] |
| 58202-3 | Data entry error [MDSv3] |
| 58203-1 | Item coding error [MDSv3] |
| 58204-9 | Other error requiring modification [MDSv3] |
| 58205-6 | Other error requiring modification.other specified [MDSv3] |
| 58206-4 | Reasons for inactivation [MDSv3] |
| 58207-2 | Reasons for inactivation - event did not occur [MDSv3] |
| 58208-0 | Other error requiring error requiring inactivation [MDSv3] |
| 58209-8 | Other error requiring error requiring inactivation.other specified [MDSv3] |
| 58210-6 | Medicare non-therapy Part A HIPPS code during assessment period [CMS Assessment] |
| 58211-4 | Medicare non-therapy Part A - RUG version code during assessment period [CMS Assessment] |
| 58212-2 | Alternate state Medicaid billing - RUG group during assessment period [CMS Assessment] |
| 58213-0 | Alternate state Medicaid billing - RUG version code during assessment period [CMS Assessment] |
| 58214-8 | One or more unhealed pressure injuries stage 1 or higher during assessment period [CMS Assessment] |
| 58215-5 | Stage 1 [MDSv3] |
| 58217-1 | Insulin during assessment period [CMS Assessment] |
| 58218-9 | Speech-language pathology and audiology services - individual minutes in the last 7 days [CMS Assessment] |
| 58219-7 | Occupational therapy - individual minutes in the last 7 days [CMS Assessment] |
| 58220-5 | Physical therapy - individual minutes in the last 7 days [CMS Assessment] |
| 58221-3 | Participation in assessment during assessment period [CMS Assessment] Guardian or legally authorized representative |
| 58222-1 | Discharge plan |
| 58223-9 | Return to community |
| 58224-7 | Items from most recent prior OBRA or scheduled PPS assessment |
| 58225-4 | Visual function - addressed in care plan [MDSv3] |
| 58226-2 | Visual function - care area triggered [MDSv3] |
| 58227-0 | Software product error [MDSv3] |
| 58228-8 | Infection of the foot [MDSv3] |
| 58421-9 | Medicare short stay assessment during assessment period [CMS Assessment] |
| 58422-7 | Alternate state Medicaid billing |
| 59373-1 | Special treatments andor programs - none of above - while a resident [MDSv3] |
| 59374-9 | Special treatments andor programs - none of above - while NOT a resident [MDSv3] |
| 59375-6 | Medicare non-therapy Part A billing during assessment period [CMS Assessment] |
| 59453-1 | Morse Fall Scale panel |
| 59454-9 | History of falling; immediate or within 3 months [Morse Fall Scale] |
| 59455-6 | Secondary diagnosis is present |
| 59456-4 | Ambulatory aid [Morse Fall Scale] |
| 59457-2 | Intravenous apparatus [Morse Fall Scale] |
| 59458-0 | Gait [Morse Fall Scale] |
| 59459-8 | Mental status [Morse Fall Scale] |
| 59460-6 | Fall risk total [Morse Fall Scale] |
| 59461-4 | Fall risk level [Morse Fall Scale] |
| 60687-1 | Test of Infant Motor Performance Version 5.1 |
| 60688-9 | TIMP cover |
| 60689-7 | Observed items [TIMP] |
| 60690-5 | Elicited items [TIMP] |
| 60691-3 | Head in midline [TIMP] |
| 60692-1 | Individual right finger movement [TIMP] |
| 60693-9 | Individual left finger movement [TIMP] |
| 60694-7 | Fingers objects or surfaces on right [TIMP] |
| 60695-4 | Fingers objects or surfaces on left [TIMP] |
| 60696-2 | Bilateral hip and knee flexion [TIMP] |
| 60697-0 | Isolated right ankle movement [TIMP] |
| 60698-8 | Isolated left ankle movement [TIMP] |
| 60699-6 | Fidgety movements [TIMP] |
| 60700-2 | Ballistic movements of the arms or legs (swipes or swats) [TIMP] |
| 60701-0 | Oscillation of arm or leg during movement [TIMP] |
| 60702-8 | Reaches for person or object [TIMP] |
| 60703-6 | Total observed item score [TIMP] |
| 60704-4 | Head rotation side to side [TIMP] |
| 60705-1 | Head control - supported sitting [TIMP] |
| 60706-9 | Head control - posterior neck muscles [TIMP] |
| 60707-7 | Head control - anterior neck muscles [TIMP] |
| 60708-5 | Head control - lowered from sitting [TIMP] |
| 60709-3 | Inhibition of neonatal neck righting (right side) [TIMP] |
| 60710-1 | Inhibition of neonatal neck righting (left side) [TIMP] |
| 60711-9 | Head in midline without visual stimulation [TIMP] |
| 60712-7 | Head held in midline with visual stimulation [TIMP] |
| 60713-5 | Supine neck rotation (right) [TIMP] |
| 60714-3 | Supine neck rotation (left) [TIMP] |
| 60715-0 | Defensive Reaction - Head and Neck Response [TIMP] |
| 60716-8 | Defensive reaction - arm movements [TIMP] |
| 60717-6 | Hip and knee flexion [TIMP] |
| 60718-4 | Rolling - elicited from the legs (right) [TIMP] |
| 60719-2 | Rolling - elicited from the legs (left) [TIMP] |
| 60720-0 | Rolling - elicited from the arms (right) [TIMP] |
| 60721-8 | Rolling - elicited from the arms (left) [TIMP] |
| 60722-6 | Pull to sit [TIMP] |
| 60723-4 | Lateral straightening of the head and body with arm support [TIMP] |
| 60724-2 | Lateral hip abduction reaction [TIMP] |
| 60725-9 | Prone suspension [TIMP] |
| 60726-7 | Head lift in prone [TIMP] |
| 60727-5 | Crawling [TIMP] |
| 60728-3 | Head turn in prone to sound (right) [TIMP] |
| 60729-1 | Head turn in prone to sound (left) [TIMP] |
| 60730-9 | Standing [TIMP] |
| 60731-7 | Lateral head righting (right) [TIMP] |
| 60732-5 | Lateral head righting (left) [TIMP] |
| 60733-3 | Notes [TIMP] |
| 60734-1 | Total elicited items score [TIMP] |
| 60735-8 | Total score [TIMP] |
| 60736-6 | Reciprocal kicking [TIMP] |
| 61131-9 | Preterm time |
| 61132-7 | Gestation adjusted age |
| 61133-5 | Clinical impression [TIMP] |
| 61134-3 | Environment [TIMP] |
| 61135-0 | Environment.other specified [TIMP] |
| 61136-8 | Start time Study |
| 61137-6 | End time Study |
| 61138-4 | Principal result interpreter Study |
| 61576-5 | PROMIS short form - global - version 1.1 |
| 61577-3 | In general, would you say your health is |
| 61578-1 | In general, would you say your quality of life is [PROMIS] |
| 61579-9 | In general, how would you rate your physical health [PROMIS] |
| 61580-7 | In general, how would you rate your mental health, including your mood and your ability to think [PROMIS] |
| 61581-5 | In general, how would you rate your satisfaction with you social activities and relationships [PROMIS] |
| 61582-3 | To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair [PROMIS] |
| 61583-1 | How would you rate your pain on average in past 7 days [PROMIS] |
| 61584-9 | How would you rate your fatigue on average in past 7 days [PROMIS] |
| 61585-6 | In general, please rate how well you carry out your usual social activities and roles [PROMIS] |
| 61586-4 | How often have you been bothered by emotional problems such as feeling anxious, depressed or irritable in past 7 days [PROMIS] |
| 61587-2 | PROMIS item bank - physical function - version 1.0 |
| 61588-0 | Does your health now limit you in doing vigorous activities, such as running, lifting heavy objects, participating in strenuous sports [PROMIS] |
| 61589-8 | Does your health now limit you in bending, kneeling, or stooping [PROMIS] |
| 61590-6 | Does your health now limit you in doing heavy work around the house like scrubbing floors, or lifting or moving heavy furniture [PROMIS] |
| 61591-4 | Does your health now limit you in lifting or carrying groceries [PROMIS] |
| 61592-2 | Does your health now limit you in bathing or dressing yourself [PROMIS] |
| 61593-0 | How much do physical health problems now limit your usual physical activities (such as walking or climbing stairs) [PROMIS] |
| 61594-8 | Are you able to move a chair from one room to another [PROMIS] |
| 61595-5 | Are you able to bend down and pick up clothing from the floor [PROMIS] |
| 61596-3 | Are you able to stand for one hour [PROMIS] |
| 61597-1 | Are you able to do chores such as vacuuming or yard work [PROMIS] |
| 61598-9 | Are you able to push open a heavy door [PROMIS] |
| 61599-7 | Are you able to exercise for an hour [PROMIS] |
| 61601-1 | Are you able to stand up from an armless straight chair [PROMIS] |
| 61602-9 | Are you able to dress yourself, including tying shoelaces and doing buttons [PROMIS] |
| 61603-7 | Are you able to reach into a high cupboard [PROMIS] |
| 61604-5 | Are you able to use a hammer to pound a nail [PROMIS] |
| 61605-2 | Are you able to run or jog for two miles [PROMIS] |
| 61606-0 | Are you able to cut your food using eating utensils [PROMIS] |
| 61607-8 | Are you able to go up and down stairs at a normal pace [PROMIS] |
| 61608-6 | Are you able to open previously opened jars [PROMIS] |
| 61609-4 | Are you able to go for a walk of at least 15 minutes [PROMIS] |
| 61610-2 | Are you able to do yard work like raking leaves, weeding, or pushing a lawn mower [PROMIS] |
| 61611-0 | Are you able to open a can with a hand can opener [PROMIS] |
| 61612-8 | Are you able to pull heavy objects (10 pounds) towards yourself [PROMIS] |
| 61613-6 | Are you able to step up and down curbs [PROMIS] |
| 61614-4 | Are you able to get up off the floor from lying on your back without help [PROMIS] |
| 61615-1 | Are you able to stand with your knees straight [PROMIS] |
| 61616-9 | Are you able to exercise hard for half an hour [PROMIS] |
| 61617-7 | Are you able to wash your back [PROMIS] |
| 61618-5 | Are you able to open and close a zipper [PROMIS] |
| 61619-3 | Are you able to put on and take off a coat or jacket [PROMIS] |
| 61620-1 | Are you able to stand for short periods of time [PROMIS] |
| 61621-9 | Are you able to dry your back with a towel [PROMIS] |
| 61622-7 | Are you able to run at a fast pace for two miles [PROMIS] |
| 61623-5 | Are you able to turn a key in a lock [PROMIS] |
| 61624-3 | Are you able to squat and get up [PROMIS] |
| 61625-0 | Are you able to carry a laundry basket up a flight of stairs [PROMIS] |
| 61626-8 | Are you able to write with a pen or pencil [PROMIS] |
| 61627-6 | Are you able to put on a shirt or blouse [PROMIS] |
| 61628-4 | Are you able to get out of bed into a chair [PROMIS] |
| 61629-2 | Are you able to pull on trousers [PROMIS] |
| 61630-0 | Are you able to peel fruit [PROMIS] |
| 61631-8 | Are you able to bend or twist your back [PROMIS] |
| 61632-6 | Are you able to brush your teeth [PROMIS] |
| 61633-4 | Are you able to sit on the edge of a bed [PROMIS] |
| 61634-2 | Are you able to tie your shoelaces [PROMIS] |
| 61635-9 | Are you able to run errands and shop [PROMIS] |
| 61636-7 | Are you able to button your shirt [PROMIS] |
| 61637-5 | Are you able to wash and dry your body [PROMIS] |
| 61638-3 | Are you able to get in and out of a car [PROMIS] |
| 61639-1 | Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries [PROMIS] |
| 61640-9 | Does your health now limit you in putting a trash bag outside [PROMIS] |
| 61641-7 | Does your health now limit you in hiking a couple of miles on uneven surfaces, including hills [PROMIS] |
| 61642-5 | Does your health now limit you in doing strenuous activities such as backpacking, skiing, playing tennis, bicycling or jogging [PROMIS] |
| 61643-3 | Are you able to carry two bags filled with groceries 100 yards [PROMIS] |
| 61644-1 | Are you able to jump up and down [PROMIS] |
| 61645-8 | Are you able to climb up five steps [PROMIS] |
| 61646-6 | Are you able to wash dishes, pots, and utensils by hand while standing at a sink [PROMIS] |
| 61647-4 | Are you able to make a bed, including spreading and tucking in bed sheets [PROMIS] |
| 61648-2 | Are you able to carry a shopping bag or briefcase [PROMIS] |
| 61649-0 | Are you able to take a tub bath [PROMIS] |
| 61650-8 | Are you able to change the bulb in a table lamp [PROMIS] |
| 61651-6 | Are you able to press with your index finger (for example ringing a doorbell) [PROMIS] |
| 61652-4 | Are you able to put on and take off your socks [PROMIS] |
| 61653-2 | Are you able to shave your face or apply makeup [PROMIS] |
| 61654-0 | Are you able to squeeze a new tube of toothpaste [PROMIS] |
| 61655-7 | Are you able to cut a piece of paper with scissors [PROMIS] |
| 61656-5 | Are you able to pick up coins from a table top [PROMIS] |
| 61657-3 | Are you able to hold a plate full of food [PROMIS] |
| 61658-1 | Are you able to pour liquid from a bottle into a glass [PROMIS] |
| 61659-9 | Are you able to run a short distance, such as to catch a bus [PROMIS] |
| 61660-7 | Are you able to push open a door after turning the knob [PROMIS] |
| 61661-5 | Are you able to shampoo your hair [PROMIS] |
| 61662-3 | Are you able to tie a knot or a bow [PROMIS] |
| 61663-1 | Are you able to lift 10 pounds above your shoulder [PROMIS] |
| 61664-9 | Are you able to lift a full cup or glass to your mouth [PROMIS] |
| 61665-6 | Are you able to open a new milk carton [PROMIS] |
| 61666-4 | Are you able to open car doors [PROMIS] |
| 61667-2 | Are you able to stand unsupported for 10 minutes [PROMIS] |
| 61668-0 | Are you able to remove something from your back pocket [PROMIS] |
| 61669-8 | Are you able to change a light bulb overhead [PROMIS] |
| 61670-6 | Are you able to put on a pullover sweater [PROMIS] |
| 61671-4 | Are you able to turn faucets on and off [PROMIS] |
| 61672-2 | Are you able to reach and get down a 5 pound object from above your head [PROMIS] |
| 61673-0 | Are you able to stand up on tiptoes [PROMIS] |
| 61674-8 | Are you able to trim your fingernails [PROMIS] |
| 61675-5 | Are you able to stand unsupported for 30 minutes [PROMIS] |
| 61676-3 | Does your health now limit you in taking care of your personal needs (dress, comb hair, toilet, eat, bathe) [PROMIS] |
| 61677-1 | Does your health now limit you in doing moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf [PROMIS] |
| 61678-9 | Does your health now limit you in taking a shower [PROMIS] |
| 61679-7 | Does your health now limit you in going for a short walk (less than 15 minutes) [PROMIS] |
| 61680-5 | How much difficulty do you have doing your daily physical activities, because of your health [PROMIS] |
| 61681-3 | Does your health now limit you in participating in active sports such as swimming, tennis, or basketball [PROMIS] |
| 61682-1 | Does your health now limit you in going outside the home, for example to shop or visit a doctor's office [PROMIS] |
| 61683-9 | Are you able to lift one pound (a full pint container) to shoulder level without bending your elbow [PROMIS] |
| 61685-4 | Are you able to walk a block on flat ground [PROMIS] |
| 61686-2 | Are you able to run five miles [PROMIS] |
| 61687-0 | Does your health now limit you in climbing several flights of stairs [PROMIS] |
| 61688-8 | Does your health now limit you in doing two hours of physical labor [PROMIS] |
| 61689-6 | Are you able to run 100 yards [PROMIS] |
| 61690-4 | Does your health now limit you in walking one hundred yards [PROMIS] |
| 61691-2 | Are you able to walk up and down two steps [PROMIS] |
| 61692-0 | Are you able to reach into a low cupboard [PROMIS] |
| 61693-8 | Are you able to climb up 5 flights of stairs [PROMIS] |
| 61694-6 | Are you able to run ten miles [PROMIS] |
| 61695-3 | Does your health now limit you in walking several hundred yards [PROMIS] |
| 61696-1 | Does your health now limit you in doing eight hours of physical labor [PROMIS] |
| 61697-9 | Does your health now limit you in walking more than a mile [PROMIS] |
| 61698-7 | Does your health now limit you in climbing one flight of stairs [PROMIS] |
| 61699-5 | Are you able to walk at a normal speed [PROMIS] |
| 61700-1 | Are you able to stand without losing your balance for several minutes [PROMIS] |
| 61701-9 | Are you able to kneel on the floor [PROMIS] |
| 61702-7 | Are you able to sit down in and stand up from a low, soft couch [PROMIS] |
| 61703-5 | Are you able to use your hands, such as for turning faucets, using kitchen gadgets, or sewing [PROMIS] |
| 61704-3 | Are you able to get on and off the toilet [PROMIS] |
| 61705-0 | Are you able to transfer from a bed to a chair and back [PROMIS] |
| 61706-8 | Are you able to be out of bed most of the day [PROMIS] |
| 61707-6 | Are you able to water a house plant [PROMIS] |
| 61708-4 | Are you able to wipe yourself after using the toilet [PROMIS] |
| 61709-2 | Are you able to turn from side to side in bed [PROMIS] |
| 61710-0 | Are you able to get in and out of bed [PROMIS] |
| 61711-8 | Does your health now limit you in getting in and out of the bathtub [PROMIS] |
| 61712-6 | Does your health now limit you in walking about the house [PROMIS] |
| 61714-2 | When I was in pain I became irritable in past 7 days [PROMIS] |
| 61715-9 | When I was in pain I grimaced in past 7 days [PROMIS] |
| 61716-7 | When I was in pain I would lie down in past 7 days [PROMIS] |
| 61717-5 | When I was in pain I moved extremely slowly in past 7 days [PROMIS] |
| 61718-3 | When I was in pain I became angry in past 7 days [PROMIS] |
| 61719-1 | When I was in pain I clenched my teeth in past 7 days [PROMIS] |
| 61720-9 | When I was in pain I tried to stay very still in past 7 days [PROMIS] |
| 61721-7 | When I was in pain I appeared upset or sad in past 7 days [PROMIS] |
| 61722-5 | When I was in pain I gasped in past 7 days [PROMIS] |
| 61723-3 | When I was in pain I asked for help doing things that needed to be done in past 7 days [PROMIS] |
| 61724-1 | When I was in pain it showed on my face (squinching eyes, opening eyes wide, frowning) in past 7 days [PROMIS] |
| 61725-8 | Pain caused me to bend over while walking in past 7 days [PROMIS] |
| 61726-6 | When I was in pain I asked one or more people to leave me alone in past 7 days [PROMIS] |
| 61727-4 | When I was in pain I moved stiffly in the past 7 days [PROMIS] |
| 61728-2 | When I was in pain I called out for someone to help me in past 7 days [PROMIS] |
| 61729-0 | Pain caused me to curl up in a ball in past 7 days [PROMIS] |
| 61730-8 | I had pain so bad it made me cry in past 7 days [PROMIS] |
| 61731-6 | When I was in pain I squirmed in past 7 days [PROMIS] |
| 61732-4 | When I was in pain I used a cane or something else for support in past 7 days [PROMIS] |
| 61733-2 | I limped because of pain in past 7 days [PROMIS] |
| 61734-0 | When I was in pain I became quiet and withdrawn in past 7 days [PROMIS] |
| 61735-7 | When I was in pain I frowned in past 7 days [PROMIS] |
| 61736-5 | When I was in pain I asked for help when walking or changing positions in past 7 days [PROMIS] |
| 61737-3 | When I was in pain I groaned in the past 7 days [PROMIS] |
| 61738-1 | When I was in pain I isolated myself from others in past 7 days [PROMIS] |
| 61739-9 | When I was in pain I drew my knees up in past 7 days [PROMIS] |
| 61740-7 | When I was in pain I moaned, whined or whimpered in past 7 days [PROMIS] |
| 61741-5 | When I was in pain I flung my arms or limbs around in past 7 days [PROMIS] |
| 61742-3 | When I was in pain I screamed in past 7 days [PROMIS] |
| 61743-1 | When I was in pain my upper body would tense up in past 7 days [PROMIS] |
| 61744-9 | When I was in pain I walked carefully in past 7 days [PROMIS] |
| 61745-6 | When I was in pain I bit or pursed my lips in past 7 days [PROMIS] |
| 61746-4 | When I was in pain I thrashed in past 7 days [PROMIS] |
| 61747-2 | When I was in pain I protected the part of my body that hurt in past 7 days [PROMIS] |
| 61748-0 | When I was in pain my body became stiff in past 7 days [PROMIS] |
| 61749-8 | When I was in pain I clenched my jaw or gritted my teeth in past 7 days [PROMIS] |
| 61750-6 | When I was in pain I winced in past 7 days [PROMIS] |
| 61751-4 | When I was in pain I moved my limbs protectively in past 7 days [PROMIS] |
| 61752-2 | When I was in pain I avoided physical contact with others in past 7 days [PROMIS] |
| 61753-0 | PROMIS item bank - pain interference - version 1.0 |
| 61754-8 | How difficult was it for you to take in new information because of pain in past 7 days [PROMIS] |
| 61755-5 | How much did pain interfere with your ability to participate in leisure activities in past 7 days [PROMIS] |
| 61756-3 | How much did pain interfere with your close personal relationships in past 7 days [PROMIS] |
| 61757-1 | How much did pain interfere with your ability to concentrate in past 7 days [PROMIS] |
| 61758-9 | How much did pain interfere with your day to day activities in past 7 days [PROMIS] |
| 61759-7 | How much did pain interfere with your enjoyment of recreational activities in past 7 days [PROMIS] |
| 61760-5 | How often did you feel emotionally tense because of your pain in past 7 days [PROMIS] |
| 61761-3 | How much did pain interfere with the things you usually do for fun in past 7 days [PROMIS] |
| 61762-1 | How much did pain interfere with your family life in past 7 days [PROMIS] |
| 61763-9 | How much did pain interfere with doing your tasks away from home (e.g., getting groceries, running errands) in past 7 days [PROMIS] |
| 61764-7 | How often did pain make you feel depressed in past 7 days [PROMIS] |
| 61765-4 | How much did pain interfere with your relationships with other people in past 7 days [PROMIS] |
| 61766-2 | How much did pain interfere with your ability to work (include work at home) in past 7 days [PROMIS] |
| 61767-0 | How much did pain make it difficult to fall asleep in past 7 days [PROMIS] |
| 61768-8 | How much did pain feel like a burden to you in past 7 days [PROMIS] |
| 61769-6 | How much did pain interfere with work around the home in past 7 days [PROMIS] |
| 61770-4 | How often was pain distressing to you in past 7 days [PROMIS] |
| 61771-2 | How often did pain keep you from socializing with others in past 7 days [PROMIS] |
| 61772-0 | How often was your pain so severe you could think of nothing else in past 7 days [PROMIS] |
| 61773-8 | How much did pain interfere with your ability to participate in social activities in past 7 days [PROMIS] |
| 61774-6 | How often did pain make you feel discouraged in past 7 days [PROMIS] |
| 61775-3 | How much did pain interfere with your household chores in past 7 days [PROMIS] |
| 61776-1 | How much did pain interfere with your ability to make trips from home that kept you gone for more than 2 hours in past 7 days [PROMIS] |
| 61777-9 | How much did pain interfere with your enjoyment of social activities in past 7 days [PROMIS] |
| 61778-7 | How often did pain make you feel anxious in past 7 days [PROMIS] |
| 61779-5 | How often did you avoid social activities because it might make you hurt more in past 7 days [PROMIS] |
| 61780-3 | How often did pain make simple tasks hard to complete in past 7 days [PROMIS] |
| 61781-1 | How often did pain prevent you from walking more than 1 mile in past 7 days [PROMIS] |
| 61782-9 | How often did pain prevent you from standing for more than one hour in past 7 days [PROMIS] |
| 61783-7 | How often did pain make it difficult for you to plan social activities in past 7 days [PROMIS] |
| 61784-5 | How often did pain prevent you from standing for more than 30 minutes in past 7 days [PROMIS] |
| 61785-2 | How much did pain interfere with your ability to do household chores in past 7 days [PROMIS] |
| 61786-0 | How much did pain interfere with your ability to remember things in past 7 days [PROMIS] |
| 61787-8 | How often did pain prevent you from sitting for more than 30 minutes in past 7 days [PROMIS] |
| 61788-6 | How often did pain prevent you from sitting for more than 10 minutes in past 7 days [PROMIS] |
| 61789-4 | How often was it hard to plan social activities because you didn't know if you would be in pain in past 7 days [PROMIS] |
| 61790-2 | How often did pain restrict your social life to your home in past 7 days [PROMIS] |
| 61791-0 | How often did pain keep you from getting into a standing position in past 7 days [PROMIS] |
| 61792-8 | How often did pain prevent you from sitting for more than one hour in past 7 days [PROMIS] |
| 61793-6 | How irritable did you feel because of pain in past 7 days [PROMIS] |
| 61794-4 | How much did pain interfere with your enjoyment of life in past 7 days [PROMIS] |
| 61795-1 | PROMIS item bank - fatigue - version 1.0 |
| 61796-9 | To what degree did you have to push yourself to get things done because of your fatigue in past 7 days [PROMIS] |
| 61797-7 | To what degree did your fatigue make you feel slowed down in your thinking in past 7 days [PROMIS] |
| 61798-5 | How often did you have to push yourself to get things done because of your fatigue in past 7 days [PROMIS] |
| 61799-3 | How often did your fatigue interfere with your social activities in past 7 days [PROMIS] |
| 61800-9 | How often are you less effective at work due to your fatigue (include work at home) in past 7 days [PROMIS] |
| 61801-7 | How often did your fatigue make you feel slowed down in your thinking in past 7 days [PROMIS] |
| 61802-5 | How often were you too tired to watch television in past 7 days [PROMIS] |
| 61803-3 | How often did your fatigue make it difficult to plan activities ahead of time in past 7 days [PROMIS] |
| 61804-1 | How often did your fatigue make it difficult to start anything new in past 7 days [PROMIS] |
| 61805-8 | How often did your fatigue make you more forgetful in past 7 days [PROMIS] |
| 61806-6 | How often were you too tired to do errands in past 7 days [PROMIS] |
| 61807-4 | How often did your fatigue make it difficult to organize your thoughts when doing things at work (include work at home) in past 7 days [PROMIS] |
| 61808-2 | How often did your fatigue interfere with your ability to engage in recreational activities in past 7 days [PROMIS] |
| 61809-0 | How often did you have trouble finishing things because of your fatigue in past 7 days [PROMIS] |
| 61810-8 | How often did your fatigue make it difficult to make decisions in past 7 days [PROMIS] |
| 61811-6 | How often did you have to limit your social activities because of your fatigue in past 7 days [PROMIS] |
| 61812-4 | How often were you too tired to do your household chores in past 7 days [PROMIS] |
| 61813-2 | How often did your fatigue make you feel less alert in past 7 days [PROMIS] |
| 61814-0 | How often were you too tired to take a bath or shower in past 7 days [PROMIS] |
| 61815-7 | How often did your fatigue make it difficult to organize your thoughts when doing things at home in past 7 days [PROMIS] |
| 61816-5 | How often did you have trouble starting things because of your fatigue in past 7 days [PROMIS] |
| 61817-3 | How often was it an effort to carry on a conversation because of your fatigue in past 7 days [PROMIS] |
| 61818-1 | How often were you too tired to socialize with your family in past 7 days [PROMIS] |
| 61819-9 | To what degree did you have trouble starting things because of your fatigue in past 7 days [PROMIS] |
| 61820-7 | How hard was it for you to carry on a conversation because of your fatigue in past 7 days [PROMIS] |
| 61821-5 | How often were you too tired to leave the house in past 7 days [PROMIS] |
| 61822-3 | How often were you too tired to think clearly in past 7 days [PROMIS] |
| 61823-1 | How often did your fatigue limit you at work (include work at home) in past 7 days [PROMIS] |
| 61824-9 | To what degree did you have to limit your social activities because of your fatigue in past 7 days [PROMIS] |
| 61825-6 | To what degree did your fatigue make it difficult to organize your thoughts when doing things at home in past 7 days [PROMIS] |
| 61826-4 | To what degree did your fatigue make it difficult to start anything new in past 7 days [PROMIS] |
| 61827-2 | Due to your fatigue were you less effective at work (include work at home) in past 7 days [PROMIS] |
| 61828-0 | To what degree did your fatigue make it difficult to make decisions in past 7 days [PROMIS] |
| 61829-8 | How often did you have enough energy to exercise strenuously in past 7 days [PROMIS] |
| 61830-6 | How often were you less effective at home due to your fatigue in past 7 days [PROMIS] |
| 61831-4 | To what degree did your fatigue make it difficult to organize your thoughts when doing things at work (include work at home) in past 7 days [PROMIS] |
| 61832-2 | To what degree did your fatigue make you more forgetful in past 7 days [PROMIS] |
| 61833-0 | To what degree did your fatigue interfere with your ability to engage in recreational activities in past 7 days [PROMIS] |
| 61834-8 | To what degree did you have to force yourself to get up and do things because of your fatigue in past 7 days [PROMIS] |
| 61835-5 | To what degree did your fatigue interfere with your social activities in past 7 days [PROMIS] |
| 61836-3 | To what degree did your fatigue interfere with your physical functioning in past 7 days [PROMIS] |
| 61837-1 | Did fatigue make you less effective at home in past 7 days [PROMIS] |
| 61838-9 | To what degree did you have trouble finishing things because of your fatigue in past 7 days [PROMIS] |
| 61839-7 | To what degree did your fatigue make you feel less alert in past 7 days [PROMIS] |
| 61840-5 | How often were you too tired to take a short walk in past 7 days [PROMIS] |
| 61841-3 | How often did you have to force yourself to get up and do things because of your fatigue in past 7 days [PROMIS] |
| 61842-1 | How often were you too tired to socialize with your friends in past 7 days [PROMIS] |
| 61843-9 | How often did you feel run-down in past 7 days [PROMIS] |
| 61844-7 | How often did you experience extreme exhaustion in past 7 days [PROMIS] |
| 61845-4 | How often did you feel tired even when you hadn't done anything in past 7 days [PROMIS] |
| 61846-2 | How often did you feel your fatigue was beyond your control in past 7 days [PROMIS] |
| 61847-0 | To what degree did you feel tired even when you hadn't done anything in past 7 days [PROMIS] |
| 61848-8 | How bushed were you on average in past 7 days [PROMIS] |
| 61849-6 | How often were you sluggish in past 7 days [PROMIS] |
| 61850-4 | How often did you run out of energy in past 7 days [PROMIS] |
| 61851-2 | How often were you physically drained in past 7 days [PROMIS] |
| 61852-0 | How often did you feel tired in past 7 days [PROMIS] |
| 61853-8 | How fatigued were you when your fatigue was at its worst in past 7 days [PROMIS] |
| 61854-6 | How often were you bothered by your fatigue in past 7 days [PROMIS] |
| 61855-3 | How often did you have enough energy to enjoy the things you do for fun in past 7 days [PROMIS] |
| 61856-1 | How often were you too tired to enjoy life in past 7 days [PROMIS] |
| 61857-9 | How often were you too tired to feel happy in past 7 days [PROMIS] |
| 61858-7 | How often did you feel totally drained in past 7 days [PROMIS] |
| 61859-5 | How often were you energetic in past 7 days [PROMIS] |
| 61860-3 | How tired did you feel on average in past 7 days [PROMIS] |
| 61861-1 | How much were you bothered by your fatigue on average in past 7 days [PROMIS] |
| 61862-9 | How exhausted were you on average in past 7 days [PROMIS] |
| 61863-7 | How fatigued were you on the day you felt most fatigued in past 7 days [PROMIS] |
| 61864-5 | How fatigued were you on average in past 7 days [PROMIS] |
| 61865-2 | How run-down did you feel on average in past 7 days [PROMIS] |
| 61866-0 | How much mental energy did you have on average in past 7 days [PROMIS] |
| 61867-8 | How physically drained were you on average in past 7 days [PROMIS] |
| 61868-6 | How energetic were you on average in past 7 days [PROMIS] |
| 61869-4 | How sluggish were you on average in past 7 days [PROMIS] |
| 61870-2 | On how many days was your fatigue worse in the morning in past 7 days [PROMIS] |
| 61871-0 | How often did you find yourself getting tired easily in past 7 days [PROMIS] |
| 61872-8 | How often did you think about your fatigue in past 7 days [PROMIS] |
| 61873-6 | How fatigued were you on the day you felt least fatigued in past 7 days [PROMIS] |
| 61874-4 | How easily did you find yourself getting tired on average in past 7 days [PROMIS] |
| 61875-1 | How wiped out were you on average in past 7 days [PROMIS] |
| 61876-9 | How often did you have physical energy in past 7 days [PROMIS] |
| 61877-7 | What was the level of your fatigue on most days in past 7 days [PROMIS] |
| 61878-5 | I feel fatigued during the past 7 days [PROMIS] |
| 61879-3 | I felt weak all over in past 7 days [PROMIS] |
| 61880-1 | I felt listless (washed out) in past 7 days [PROMIS] |
| 61881-9 | I felt tired in past 7 days [PROMIS] |
| 61882-7 | I had trouble starting things because I was tired in past 7 days [PROMIS] |
| 61883-5 | I had trouble finishing things because I was tired in past 7 days [PROMIS] |
| 61884-3 | I needed to sleep during the day in past 7 days [PROMIS] |
| 61885-0 | I was too tired to eat in past 7 days [PROMIS] |
| 61886-8 | I needed help doing my usual activities in past 7 days [PROMIS] |
| 61887-6 | I was frustrated by being too tired to do the things I want to do in past 7 days [PROMIS] |
| 61888-4 | I had to limit my social activity because I was tired in past 7 days [PROMIS] |
| 61889-2 | I had energy in past 7 days [PROMIS] |
| 61890-0 | I am able to do my usual activities in past 7 days [PROMIS] |
| 61892-6 | PROMIS item bank - emotional distress - anger - version 1.0 |
| 61893-4 | When I was frustrated, I let it show in past 7 days [PROMIS] |
| 61894-2 | I was irritated more than people knew in past 7 days [PROMIS] |
| 61895-9 | I felt envious of others in past 7 days [PROMIS] |
| 61896-7 | I disagreed with people in past 7 days [PROMIS] |
| 61897-5 | I made myself angry about something just by thinking about it in past 7 days [PROMIS] |
| 61898-3 | I tried to get even when I was angry with someone in past 7 days [PROMIS] |
| 61899-1 | I felt angry in past 7 days [PROMIS] |
| 61900-7 | When I was mad at someone, I gave them the silent treatment in past 7 days [PROMIS] |
| 61901-5 | I felt like breaking things in past 7 days [PROMIS] |
| 61902-3 | I felt like I was ready to explode in past 7 days [PROMIS] |
| 61903-1 | When I was angry, I sulked in past 7 days [PROMIS] |
| 61904-9 | I felt resentful when I didn't get my way in past 7 days [PROMIS] |
| 61905-6 | I felt guilty about my anger in past 7 days [PROMIS] |
| 61906-4 | I felt bitter about things in past 7 days [PROMIS] |
| 61907-2 | I felt people are trying to anger me in past 7 days [PROMIS] |
| 61908-0 | I stayed angry for hours in past 7 days [PROMIS] |
| 61909-8 | I held grudges towards others in past 7 days [PROMIS] |
| 61910-6 | I felt angrier than I thought I should in past 7 days [PROMIS] |
| 61911-4 | I was grouchy in past 7 days [PROMIS] |
| 61912-2 | I was stubborn with others in past 7 days [PROMIS] |
| 61913-0 | I felt annoyed in past 7 days [PROMIS] |
| 61914-8 | I had a bad temper in past 7 days [PROMIS] |
| 61915-5 | I had trouble controlling my temper in past 7 days [PROMIS] |
| 61916-3 | I was angry when I was delayed in past 7 days [PROMIS] |
| 61917-1 | Even when I expressed my anger, I had trouble forgetting about it in past 7 days [PROMIS] |
| 61918-9 | I felt like I needed help for my anger in past 7 days [PROMIS] |
| 61919-7 | I was angry when something blocked my plans in past 7 days [PROMIS] |
| 61920-5 | I felt like yelling at someone in past 7 days [PROMIS] |
| 61921-3 | Just being around people irritated me in past 7 days [PROMIS] |
| 61922-1 | PROMIS item bank - emotional distress - anxiety - version 1.0 |
| 61923-9 | I felt fearful in past 7 days [PROMIS] |
| 61924-7 | I felt frightened in past 7 days [PROMIS] |
| 61925-4 | It scared me when I felt nervous in past 7 days [PROMIS] |
| 61926-2 | I felt anxious in past 7 days [PROMIS] |
| 61927-0 | I felt like I needed help for my anxiety in past 7 days [PROMIS] |
| 61928-8 | I was concerned about my mental health in past 7 days [PROMIS] |
| 61929-6 | I felt upset in past 7 days [PROMIS] |
| 61930-4 | I had a racing or pounding heart in past 7 days [PROMIS] |
| 61931-2 | I was anxious if my normal routine was disturbed in past 7 days [PROMIS] |
| 61932-0 | I had sudden feelings of panic in past 7 days [PROMIS] |
| 61933-8 | Easily startled in past 7 days |
| 61934-6 | I had trouble paying attention in past 7 days [PROMIS] |
| 61935-3 | I avoided public places or activities in past 7 days [PROMIS] |
| 61936-1 | I felt fidgety in past 7 days [PROMIS] |
| 61937-9 | I felt something awful would happen in past 7 days [PROMIS] |
| 61938-7 | I felt worried in past 7 days [PROMIS] |
| 61939-5 | I felt terrified in past 7 days [PROMIS] |
| 61940-3 | I worried about other people's reactions to me in past 7 days [PROMIS] |
| 61941-1 | I found it hard to focus on anything other than my anxiety in past 7 days [PROMIS] |
| 61942-9 | My worries overwhelmed me in past 7 days [PROMIS] |
| 61943-7 | I had twitching or trembling muscles in past 7 days [PROMIS] |
| 61944-5 | I felt nervous in past 7 days [PROMIS] |
| 61945-2 | I felt indecisive in past 7 days [PROMIS] |
| 61946-0 | Many situations made me worry in past 7 days [PROMIS] |
| 61947-8 | I had difficulty sleeping in past 7 days [PROMIS] |
| 61948-6 | I had trouble relaxing in past 7 days [PROMIS] |
| 61949-4 | I felt uneasy in past 7 days [PROMIS] |
| 61950-2 | I felt tense in past 7 days [PROMIS] |
| 61951-0 | I had difficulty calming down in past 7 days [PROMIS] |
| 61952-8 | PROMIS item bank - emotional distress - depression - version 1.0 |
| 61953-6 | I felt worthless in past 7 days [PROMIS] |
| 61954-4 | I felt that I had nothing to look forward to in past 7 days [PROMIS] |
| 61955-1 | I felt helpless in past 7 days [PROMIS] |
| 61956-9 | I withdrew from other people in past 7 days [PROMIS] |
| 61957-7 | I felt that nothing could cheer me up in past 7 days [PROMIS] |
| 61958-5 | I felt that I was not as good as other people in past 7 days [PROMIS] |
| 61959-3 | I felt sad in past 7 days [PROMIS] |
| 61960-1 | I felt that I wanted to give up on everything in past 7 days [PROMIS] |
| 61961-9 | I felt that I was to blame for things in past 7 days [PROMIS] |
| 61962-7 | I felt like a failure in past 7 days [PROMIS] |
| 61963-5 | I had trouble feeling close to people in past 7 days [PROMIS] |
| 61964-3 | I felt disappointed in myself in past 7 days [PROMIS] |
| 61965-0 | I felt that I was not needed in past 7 days [PROMIS] |
| 61966-8 | I felt lonely in past 7 days [PROMIS] |
| 61967-6 | I felt depressed in past 7 days [PROMIS] |
| 61968-4 | I had trouble making decisions in past 7 days [PROMIS] |
| 61969-2 | I felt discouraged about the future in past 7 days [PROMIS] |
| 61970-0 | I found that things in my life were overwhelming in past 7 days [PROMIS] |
| 61971-8 | I felt unhappy in past 7 days [PROMIS] |
| 61972-6 | I felt I had no reason for living in past 7 days [PROMIS] |
| 61973-4 | I felt hopeless in past 7 days [PROMIS] |
| 61974-2 | I felt ignored by people in past 7 days [PROMIS] |
| 61975-9 | I felt upset for no reason in past 7 days [PROMIS] |
| 61976-7 | I felt that nothing was interesting in past 7 days [PROMIS] |
| 61977-5 | I felt pessimistic in past 7 days [PROMIS] |
| 61978-3 | I felt that my life was empty in past 7 days [PROMIS] |
| 61979-1 | I felt guilty in past 7 days [PROMIS] |
| 61980-9 | I felt emotionally exhausted in past 7 days [PROMIS] |
| 61982-5 | PROMIS item bank - sleep disturbance - version 1.0 |
| 61983-3 | My sleep was restful in past 7 days [PROMIS] |
| 61984-1 | My sleep was deep in past 7 days [PROMIS] |
| 61985-8 | I was satisfied with my sleep in past 7 days [PROMIS] |
| 61986-6 | My sleep was refreshing in past 7 days [PROMIS] |
| 61987-4 | My sleep quality was...in past 7 days [PROMIS] |
| 61988-2 | I got enough sleep in past 7 days [PROMIS] |
| 61989-0 | It was easy for me to fall asleep in past 7 days [PROMIS] |
| 61990-8 | I laid in bed for hours waiting to fall asleep in past 7 days [PROMIS] |
| 61991-6 | I woke up too early and could not fall back asleep in past 7 days [PROMIS] |
| 61993-2 | I had trouble sleeping in past 7 days [PROMIS] |
| 61994-0 | I woke up and had trouble falling back to sleep in past 7 days [PROMIS] |
| 61995-7 | My sleep was light in past 7 days [PROMIS] |
| 61996-5 | My sleep was restless in past 7 days [PROMIS] |
| 61997-3 | I felt lousy when I woke up in past 7 days [PROMIS] |
| 61998-1 | I had a problem with my sleep 7 days [PROMIS] |
| 61999-9 | I had difficulty falling asleep in past 7 days [PROMIS] |
| 62000-5 | I felt physically tense at bedtime in past 7 days [PROMIS] |
| 62001-3 | I worried about not being able to fall asleep in past 7 days [PROMIS] |
| 62002-1 | I felt worried at bedtime in past 7 days [PROMIS] |
| 62003-9 | I had trouble stopping my thoughts at bedtime in past 7 days [PROMIS] |
| 62004-7 | I felt sad at bedtime in past 7 days [PROMIS] |
| 62005-4 | I had trouble getting into a comfortable position to sleep in past 7 days [PROMIS] |
| 62006-2 | I tried hard to get to sleep in past 7 days [PROMIS] |
| 62007-0 | Stress disturbed my sleep in past 7 days [PROMIS] |
| 62008-8 | I tossed and turned at night in past 7 days [PROMIS] |
| 62009-6 | I was afraid I would not get back to sleep after waking up in past 7 days [PROMIS] |
| 62010-4 | PROMIS item bank - sleep related impairment - version 1.0 |
| 62011-2 | I tried to sleep whenever I could in past 7 days [PROMIS] |
| 62012-0 | My daytime activities are disturbed by poor sleep in past 7 days [PROMIS] |
| 62013-8 | I was sleepy during the daytime in past 7 days [PROMIS] |
| 62014-6 | I had trouble staying awake during the day in past 7 days [PROMIS] |
| 62015-3 | I had a hard time getting things done because I was sleepy in past 7 days [PROMIS] |
| 62016-1 | I had a hard time concentrating because I was sleepy in past 7 days [PROMIS] |
| 62017-9 | I had problems during the day because of poor sleep in past 7 days [PROMIS] |
| 62018-7 | I had a hard time concentrating because of poor sleep in past 7 days [PROMIS] |
| 62019-5 | I felt irritable because of poor sleep in past 7 days [PROMIS] |
| 62020-3 | I had a hard time controlling my emotions because of poor sleep in past 7 days [PROMIS] |
| 62021-1 | I had difficulty waking up in past 7 days [PROMIS] |
| 62022-9 | I still felt sleepy when I woke up in past 7 days [PROMIS] |
| 62023-7 | I had enough energy in past 7 days [PROMIS] |
| 62024-5 | I felt alert when I woke up in past 7 days [PROMIS] |
| 62025-2 | When I woke up I felt ready to start the day in past 7 days [PROMIS] |
| 62026-0 | PROMIS item bank - satisfaction with participation in DSA - version 1.0 |
| 62027-8 | I was satisfied with the amount of time I spend doing leisure activities in past 7 days [PROMIS] |
| 62028-6 | I was satisfied with my current level of social activity in past 7 days [PROMIS] |
| 62029-4 | I was satisfied with my ability to do all of the community activities that are really important to me in past 7 days [PROMIS] |
| 62030-2 | I was satisfied with my ability to do things for my friends in past 7 days [PROMIS] |
| 62031-0 | I was satisfied with my ability to do leisure activities in past 7 days [PROMIS] |
| 62032-8 | I was satisfied with my current level of activities with my friends in past 7 days [PROMIS] |
| 62033-6 | I was satisfied with my ability to do things for fun outside my home in past 7 days [PROMIS] |
| 62034-4 | I felt good about my ability to do things for my friends in past 7 days [PROMIS] |
| 62035-1 | I was happy with how much I do for my friends in past 7 days [PROMIS] |
| 62036-9 | I was satisfied with the amount of time I spend visiting friends in past 7 days [PROMIS] |
| 62037-7 | I was satisfied with my ability to do things for fun at home (like reading, listening to music, etc.) in past 7 days [PROMIS] |
| 62038-5 | I was satisfied with my ability to do all of the leisure activities that Are really important to me in past 7 days [PROMIS] |
| 62039-3 | PROMIS item bank - satisfaction with participation in roles - version 1.0 |
| 62040-1 | I was satisfied with my ability to do things for my family in past 7 days [PROMIS] |
| 62041-9 | I was satisfied with how much work I can do (include work at home) in past 7 days [PROMIS] |
| 62042-7 | I feel good about my ability to do things for my family in past 7 days [PROMIS] |
| 62043-5 | I was satisfied with my ability to do the work that is really important to me (include work at home) in past 7 days [PROMIS] |
| 62044-3 | I was satisfied with the amount of time I spend doing work (include work at home) in past 7 days [PROMIS] |
| 62045-0 | I was happy with how much I do for my family in past 7 days [PROMIS] |
| 62046-8 | I was satisfied with my ability to work (include work at home) in past 7 days [PROMIS] |
| 62047-6 | The quality of my work is as good as I want it to be (include work at home) in past 7 days [PROMIS] |
| 62048-4 | I was satisfied with the amount of time I spend performing my daily routines in past 7 days [PROMIS] |
| 62049-2 | I was satisfied with my ability to do household chores and tasks in past 7 days [PROMIS] |
| 62050-0 | I was satisfied with my ability to do regular personal and household responsibilities in past 7 days [PROMIS] |
| 62051-8 | I was satisfied with my ability to perform my daily routines in past 7 days [PROMIS] |
| 62052-6 | I was satisfied with my ability to meet the needs of those who depend on me in past 7 days [PROMIS] |
| 62053-4 | I was satisfied with my ability to run errands in past 7 days [PROMIS] |
| 62054-2 | PROMIS pediatric item bank - emotional distress - anxiety - version 1.0 |
| 62055-9 | I felt like something awful might happen in past 7 days [PROMIS] |
| 62056-7 | I got scared really easy in past 7 days [PROMIS] |
| 62057-5 | I felt scared in past 7 days [PROMIS] |
| 62058-3 | I worried about what could happen to me in past 7 days [PROMIS] |
| 62059-1 | I was worried I might die in past 7 days [PROMIS] |
| 62060-9 | I woke up at night scared in past 7 days [PROMIS] |
| 62061-7 | I worried when I went to bed at night in past 7 days [PROMIS] |
| 62062-5 | I worried when I was away from home in past 7 days [PROMIS] |
| 62063-3 | I worried when I was at home in past 7 days [PROMIS] |
| 62064-1 | I thought about scary things in past 7 days [PROMIS] |
| 62065-8 | I was afraid that I would make mistakes in past 7 days [PROMIS] |
| 62066-6 | I was afraid of going to school in past 7 days [PROMIS] |
| 62067-4 | It was hard for me to relax in past 7 days [PROMIS] |
| 62068-2 | PROMIS pediatric item bank - asthma - version 1.0 |
| 62069-0 | I felt scared that I might have trouble breathing because of my asthma in past 7 days [PROMIS] |
| 62070-8 | My chest felt tight because of my asthma in past 7 days [PROMIS] |
| 62071-6 | I felt wheezy because of my asthma in past 7 days [PROMIS] |
| 62072-4 | I had trouble sleeping at night because of my asthma in past 7 days [PROMIS] |
| 62073-2 | It was hard for me to play sports or exercise because of my asthma in past 7 days [PROMIS] |
| 62074-0 | It was hard to take a deep breath because of my asthma in past 7 days [PROMIS] |
| 62075-7 | My asthma bothered me in past 7 days [PROMIS] |
| 62076-5 | I coughed because of my asthma in past 7 days [PROMIS] |
| 62077-3 | I got tired easily because of my asthma in past 7 days [PROMIS] |
| 62078-1 | I had asthma attacks in past 7 days [PROMIS] |
| 62079-9 | I had trouble walking because of my asthma in past 7 days [PROMIS] |
| 62080-7 | I missed school because of asthma in past 7 days [PROMIS] |
| 62081-5 | I was bothered by the amount of time I spent wheezing in past 7 days [PROMIS] |
| 62082-3 | It was hard for me to play with pets because of my asthma in past 7 days [PROMIS] |
| 62083-1 | My asthma bothered me when I was with my friends in past 7 days [PROMIS] |
| 62084-9 | My body felt bad when I was out of breath in past 7 days [PROMIS] |
| 62085-6 | PROMIS pediatric short form - depressive symptoms - version 1.0 |
| 62086-4 | I felt too sad to eat in past 7 days [PROMIS] |
| 62087-2 | I didn't care about anything in past 7 days [PROMIS] |
| 62088-0 | I wanted to be by myself in past 7 days [PROMIS] |
| 62089-8 | I thought that my life was bad in past 7 days [PROMIS] |
| 62090-6 | It was hard for me to have fun in past 7 days [PROMIS] |
| 62091-4 | I felt alone in past 7 days [PROMIS] |
| 62092-2 | I could not stop feeling sad in past 7 days [PROMIS] |
| 62093-0 | I felt like I couldn't do anything right in past 7 days [PROMIS] |
| 62094-8 | I felt everything in my life went wrong in past 7 days [PROMIS] |
| 62095-5 | I felt stressed in past 7 days [PROMIS] |
| 62096-3 | Being sad made it hard for me to do things with my friends in past 7 days [PROMIS] |
| 62097-1 | PROMIS pediatric item bank - fatigue - version 1.0 |
| 62098-9 | Being tired kept me from having fun in past 7 days [PROMIS] |
| 62099-7 | Being tired made it hard for me to keep up with my schoolwork in past 7 days [PROMIS] |
| 62100-3 | Being tired made it hard for me to play or go out with my friends as much as I'd like in past 7 days [PROMIS] |
| 62101-1 | I felt more tired than usual when I woke up in the morning in past 7 days [PROMIS] |
| 62102-9 | I felt too tired to spend time with my friends in past 7 days [PROMIS] |
| 62103-7 | I felt weak in past 7 days [PROMIS] |
| 62104-5 | I got tired easily in past 7 days [PROMIS] |
| 62105-2 | I had trouble finishing things because I was too tired in past 7 days [PROMIS] |
| 62106-0 | I had trouble starting things because I was too tired in past 7 days [PROMIS] |
| 62107-8 | I was so tired it was hard for me to focus on my work in past 7 days [PROMIS] |
| 62108-6 | I was so tired it was hard for me to pay attention in past 7 days [PROMIS] |
| 62109-4 | I was too tired to do sports or exercise in past 7 days [PROMIS] |
| 62110-2 | I was too tired to do things outside in past 7 days [PROMIS] |
| 62111-0 | I was too tired to enjoy the things I like to do in past 7 days [PROMIS] |
| 62112-8 | I was too tired to go out with my family in past 7 days [PROMIS] |
| 62113-6 | I was too tired to go up and down a lot of stairs in past 7 days [PROMIS] |
| 62114-4 | I was too tired to read in past 7 days [PROMIS] |
| 62115-1 | I was too tired to take a bath or shower in past 7 days [PROMIS] |
| 62116-9 | I was too tired to watch television in past 7 days [PROMIS] |
| 62117-7 | PROMIS pediatric item bank - physical function - mobility - version 1.0 |
| 62118-5 | I could ride a bike in past 7 days [PROMIS] |
| 62119-3 | I could get in and out of a car in past 7 days [PROMIS] |
| 62120-1 | I could walk more than one block in past 7 days [PROMIS] |
| 62121-9 | I could do sports and exercise that other kids my age could do in past 7 days [PROMIS] |
| 62122-7 | I could keep up when I played with other kids in past 7 days [PROMIS] |
| 62123-5 | I could get out of bed by myself in past 7 days [PROMIS] |
| 62124-3 | I could get into bed by myself in past 7 days [PROMIS] |
| 62125-0 | I could stand up by myself in past 7 days [PROMIS] |
| 62126-8 | I could get down on my knees without holding on to something in past 7 days [PROMIS] |
| 62127-6 | I could walk up stairs without holding on to anything in past 7 days [PROMIS] |
| 62128-4 | I used a wheelchair to get around in past 7 days [PROMIS] |
| 62129-2 | I used a walker, cane or crutches to get around in past 7 days [PROMIS] |
| 62130-0 | I could carry my books in my backpack in past 7 days [PROMIS] |
| 62131-8 | I could move my legs in past 7 days [PROMIS] |
| 62132-6 | I could get up from a regular toilet in past 7 days [PROMIS] |
| 62133-4 | I could get up from the floor in past 7 days [PROMIS] |
| 62134-2 | I could go up one step in past 7 days [PROMIS] |
| 62135-9 | I could stand up on my tiptoes in past 7 days [PROMIS] |
| 62136-7 | I could turn my head all the way to the side in past 7 days [PROMIS] |
| 62137-5 | I have been physically able to do the activities I enjoy most in past 7 days [PROMIS] |
| 62138-3 | I could run a mile in past 7 days [PROMIS] |
| 62139-1 | I could bend over to pick something up in past 7 days [PROMIS] |
| 62140-9 | I could walk across the room in past 7 days [PROMIS] |
| 62141-7 | PROMIS pediatric item bank - pain interference - version 1.0 |
| 62142-5 | I felt angry when I had pain in past 7 days [PROMIS] |
| 62143-3 | I had trouble doing schoolwork when I had pain in past 7 days [PROMIS] |
| 62144-1 | I had trouble sleeping when I had pain in past 7 days [PROMIS] |
| 62145-8 | I hurt a lot in past 7 days [PROMIS] |
| 62146-6 | It was hard for me to remember things when I had pain in past 7 days [PROMIS] |
| 62147-4 | I hurt all over my body in past 7 days [PROMIS] |
| 62148-2 | It was hard for me to run when I had pain in past 7 days [PROMIS] |
| 62149-0 | It was hard for me to walk one block when I had pain in past 7 days [PROMIS] |
| 62150-8 | I missed school when I had pain in past 7 days [PROMIS] |
| 62151-6 | It was hard to get along with other people when I had pain in past 7 days [PROMIS] |
| 62152-4 | It was hard to have fun when I had pain in past 7 days [PROMIS] |
| 62153-2 | It was hard to stay standing when I had pain in past 7 days [PROMIS] |
| 62154-0 | It was hard for me to pay attention when I had pain in past 7 days [PROMIS] |
| 62155-7 | PROMIS pediatric item bank - peer relationships - version 1.0 |
| 62156-5 | I felt accepted by other kids my age in past 7 days [PROMIS] |
| 62157-3 | I felt good about my friendships in past 7 days [PROMIS] |
| 62158-1 | I liked being around other kids my age in past 7 days [PROMIS] |
| 62159-9 | I played alone and kept to myself in past 7 days [PROMIS] |
| 62160-7 | I shared with other kids (food, games, pens, etc) in past 7 days [PROMIS] |
| 62161-5 | I spent time with my friends in past 7 days [PROMIS] |
| 62162-3 | I was a good friend in past 7 days [PROMIS] |
| 62163-1 | I was able to count on my friends in past 7 days [PROMIS] |
| 62164-9 | I was able to have fun with my friends in past 7 days [PROMIS] |
| 62165-6 | I was able to talk about everything with my friends in past 7 days [PROMIS] |
| 62166-4 | I was good at making friends in past 7 days [PROMIS] |
| 62167-2 | My friends and I helped each other out in past 7 days [PROMIS] |
| 62168-0 | Other kids wanted to be my friend in past 7 days [PROMIS] |
| 62169-8 | Other kids wanted to be with me in past 7 days [PROMIS] |
| 62170-6 | Other kids wanted to talk to me in past 7 days [PROMIS] |
| 62171-4 | PROMIS pediatric item bank - physical function - upper extremity - version 1.0 |
| 62172-2 | I could button my shirt or pants in past 7 days [PROMIS] |
| 62173-0 | I could open a jar by myself in past 7 days [PROMIS] |
| 62174-8 | I could open the rings in school binders in past 7 days [PROMIS] |
| 62175-5 | I could pour a drink from a full pitcher in past 7 days [PROMIS] |
| 62176-3 | I could pull a shirt on over my head by myself in past 7 days [PROMIS] |
| 62177-1 | I could pull open heavy doors in past 7 days [PROMIS] |
| 62178-9 | I could put on my shoes by myself in past 7 days [PROMIS] |
| 62179-7 | I could use a key to unlock a door in past 7 days [PROMIS] |
| 62180-5 | PROMIS pediatric short form - emotional distress - anger - version 1.0 |
| 62181-3 | I felt fed up in past 7 days [PROMIS] |
| 62182-1 | I felt mad in past 7 days [PROMIS] |
| 62183-9 | I was so angry I felt like throwing something in past 7 days [PROMIS] |
| 62184-7 | I was so angry I felt like yelling at somebody in past 7 days [PROMIS] |
| 62185-4 | When I got mad, I stayed mad in past 7 days [PROMIS] |
| 62186-2 | PROMIS pediatric short form - emotional distress - anxiety - 8a - version 1.0 |
| 62189-6 | PROMIS short form - emotional distress - anger 8a - version 1.0 |
| 62190-4 | PROMIS short form - emotional distress - anxiety 7a - version 1.0 |
| 62191-2 | PROMIS short form - emotional distress - depression 8b - version 1.0 |
| 62192-0 | PROMIS short form - fatigue 7a - version 1.0 |
| 62193-8 | PROMIS short form - pain interference 6b - version 1.0 |
| 62194-6 | PROMIS short form - pain behavior 7a - version 1.0 |
| 62195-3 | PROMIS short form - satisfaction with participation in DSA 7a - version 1.0 |
| 62196-1 | PROMIS short form - satisfaction with participation in social roles 7a - version 1.0 |
| 62197-9 | PROMIS short form - sleep disturbance 8b - version 1.0 |
| 62198-7 | PROMIS short form - sleep impairment 8a - version 1.0 |
| 62199-5 | PROMIS short form - physical function 10a - version 1.0 |
| 62204-3 | It was hard for me to get out of bed in the morning because I was too tired in past 7 days [PROMIS] |
| 62205-0 | I needed help with a bath in past 7 days [PROMIS] |
| 62206-8 | PROMIS pediatric short form - physical function - mobility 8a - version 1.0 |
| 62207-6 | PROMIS pediatric short form - physical function - upper extremity 8a - version 1.0 |
| 62208-4 | PROMIS pediatric short form - asthma 8a - version 1.0 |
| 62209-2 | PROMIS pediatric short form - peer relationships 8a - version 1.0 |
| 62210-0 | PROMIS pediatric short form - fatigue 10a - version 1.0 |
| 62211-8 | PROMIS pediatric short form - pain interference 8a - version 1.0 |
| 62212-6 | PROMIS item bank - pain behavior - version 1.0 |
| 62213-4 | I had trouble breathing because of my asthma in past 7 days [PROMIS] |
| 62214-2 | I could put on my socks by myself in past 7 days [PROMIS] |
| 62215-9 | I could write with a pen or pencil in past 7 days [PROMIS] |
| 62216-7 | I could put toothpaste on my toothbrush by myself in past 7 days [PROMIS] |
| 62217-5 | I could lift a cup to drink in past 7 days [PROMIS] |
| 62218-3 | I could zip up my clothes in past 7 days [PROMIS] |
| 62219-1 | I could pull on and fasten my seatbelt in past 7 days [PROMIS] |
| 62220-9 | I could open my clothing drawers in past 7 days [PROMIS] |
| 62221-7 | I could dial a phone in past 7 days [PROMIS] |
| 62222-5 | I could cut paper with scissors in past 7 days [PROMIS] |
| 62223-3 | I could dry my back with a towel in past 7 days [PROMIS] |
| 62224-1 | I could wash my face with a cloth in past 7 days [PROMIS] |
| 62225-8 | I used a pencil with a special grip to write in past 7 days [PROMIS] |
| 62226-6 | I could move my hands or fingers in past 7 days [PROMIS] |
| 62227-4 | I could tie shoelaces by myself in past 7 days [PROMIS] |
| 62228-2 | I could put on my clothes by myself in past 7 days [PROMIS] |
| 62229-0 | I could turn door handles by myself in past 7 days [PROMIS] |
| 62230-8 | I could use a mouse or touch pad for the computer in past 7 days [PROMIS] |
| 62231-6 | I could hold a full cup in past 7 days [PROMIS] |
| 62232-4 | I could hold an empty cup in past 7 days [PROMIS] |
| 62233-2 | I could brush my teeth by myself in past 7 days [PROMIS] |
| 62336-3 | PROMIS item bank - 43 profile |
| 62337-1 | PROMIS item bank - 29 profile |
| 62338-9 | PROMIS item bank - 57 profile |
| 62339-7 | I felt sad in the past 7 days [PROMIS.PEDS] |
| 62340-5 | I felt tired in the past 7 days [PROMIS.PEDS] |
| 64301-5 | Full time dietitian staff positions filled at end of period Population # |
| 64302-3 | Full time social worker staff positions filled at end of period Population # |
| 64303-1 | Part time registered nurse staff positions filled at end of period Population # |
| 64304-9 | Part time licensed practical nurse and licensed vocational nurse staff positions filled at end of period Population # |
| 64305-6 | Part time patient care technician staff positions filled at end of period Population # |
| 64306-4 | Part time advance practice nurse staff positions filled at end of period Population # |
| 64307-2 | Part time dietitian staff positions filled at end of period Population # |
| 64308-0 | Part time social worker staff positions filled at end of period Population # |
| 64309-8 | Full time registered nurse staff positions vacant at end of period Population # |
| 64310-6 | Full time licensed practical nurse and licensed vocational nurse staff positions vacant at end of period Population # |
| 64311-4 | Full time patient care technician staff positions vacant at end of period Population # |
| 64312-2 | Full time advance practiced nurse staff positions vacant at end of period Population # |
| 64313-0 | Full time dietitian staff positions vacant at end of period Population # |
| 64314-8 | Full time social worker staff positions vacant at end of period Population # |
| 64315-5 | Part time registered nurse staff positions vacant at end of period Population # |
| 64316-3 | Part time licensed practical nurse and licensed vocational nurse staff positions vacant at end of period Population # |
| 64317-1 | Part time patient care technician staff positions vacant at end of period Population # |
| 64318-9 | Part time advance practice nurse staff positions vacant at end of period Population # |
| 64319-7 | Part time dietitian staff positions vacant at end of period Population # |
| 64320-5 | Part time social worker staff positions vacant at end of period Population # |
| 64321-3 | Kidney transplant center patients who received at least one kidney transplant Population # |
| 64322-1 | Kidney transplant center patients who received at least one kidney transplant and enrolled in Medicare Population # |
| 64323-9 | End Stage Renal Disease (ESRD) Facility Survey - OMB CMS form 2744 |
| 64324-7 | Dialysis stations Facility # |
| 64325-4 | Incenter dialysis patients at beginning of reporting period Population # |
| 64326-2 | Home dialysis patients at beginning of reporting period Population # |
| 64327-0 | Total dialysis patients at beginning of reporting period Population # |
| 64328-8 | Incenter patients starting dialysis for first time ever Population # |
| 64329-6 | Home patients starting dialysis for first time ever Population # |
| 64330-4 | Incenter patients restarting dialysis Population # |
| 64331-2 | Home patients restarting dialysis Population # |
| 64332-0 | Incenter patients transferred from other dialysis unit Population # |
| 64333-8 | Home patients transferred from other dialysis unit Population # |
| 64334-6 | Incenter patients restarting dialysis after failed transplantation Population # |
| 64335-3 | Home patients restarting dialysis after failed transplantation Population # |
| 64336-1 | Incenter dialysis patients who died Population # |
| 64337-9 | Home dialysis patients who died Population # |
| 64338-7 | Incenter dialysis patients who recovered kidney function Population # |
| 64339-5 | Home dialysis patients who recovered kidney function Population # |
| 64340-3 | Incenter dialysis patients who received transplant Population # |
| 64341-1 | Home dialysis patients who received transplant Population # |
| 64342-9 | Incenter patients who transferred to other dialysis unit Population # |
| 64343-7 | Home patients who transferred to other dialysis unit Population # |
| 64344-5 | Incenter patients who discontinued dialysis Population # |
| 64345-2 | Home patients who discontinued dialysis Population # |
| 64346-0 | Incenter dialysis patients lost to follow up Population # |
| 64347-8 | Home dialysis patients lost to follow up Population # |
| 64348-6 | Incenter patients receiving hemodialysis at end of reporting period Population # |
| 64349-4 | Incenter patients receiving dialysis other than hemodialysis at end of reporting period Population # |
| 64350-2 | Incenter patients in self-dialysis hemodialysis training at end of reporting period Population # |
| 64351-0 | Incenter patients in self-dialysis Continuous Ambulatory Peritoneal Dialysis (CAPD) training at end of reporting period Population # |
| 64352-8 | Incenter patients in self-dialysis Continuous Cyclic Peritoneal Dialysis (CCPD) training at end of reporting period Population # |
| 64353-6 | Incenter patients in self-dialysis training other than hemodialysis, CAPD or CCPD at end of reporting period Population # |
| 64354-4 | Total incenter dialysis patients at end of reporting period Population # |
| 64355-1 | Home patients hemodialyzing at end of reporting period Population # |
| 64356-9 | Home patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) at end of reporting period Population # |
| 64357-7 | Home patients on Continuous Cyclic Peritoneal Dialysis (CCPD) at end of reporting period Population # |
| 64358-5 | Home patients who received dialysis other than hemodialysis, CAPD or CCPD at end of reporting period Population # |
| 64359-3 | Total home dialysis patients at end of reporting period Population # |
| 64360-1 | Total dialysis patients receiving services at end of reporting period Population # |
| 64361-9 | Dialysis patients enrolled in Medicare at end of reporting period Population # |
| 64362-7 | Dialysis patients who have pending enrollment in Medicare at end of reporting period Population # |
| 64363-5 | Dialysis patients not enrolled or pending enrollment in Medicare at end of reporting period Population # |
| 64364-3 | Incenter patients dialyzing during the day and more than 4 times per week at end of reporting period Population # |
| 64365-0 | Home patients dialyzing during the day and more than 4 times per week at end of reporting period Population # |
| 64366-8 | Incenter patients dialyzing nocturnally and more than 4 times per week at end of reporting period Population # |
| 64367-6 | Home patients dialyzing nocturnally and more than 4 times per week at end of reporting period Population # |
| 64368-4 | Total patients age 18-54 years dialysing at facility at end of reporting period Population # |
| 64369-2 | Dialysis patients who have received or are receiving vocational rehabilitation services Population # |
| 64370-0 | Dialysis patients age 18 to 54 years employed full-time or part-time at end of reporting period Population # |
| 64371-8 | Dialysis patients age 18 to 54 years attending school full-time or part-time at end of reporting period Population # |
| 64372-6 | Incenter hemodialysis patients receiving treatments including training treatments Population # |
| 64373-4 | Incenter dialysis patients receiving treatments other than hemodialysis including training treatments Population # [Reported] |
| 64374-2 | Full time registered nurse staff positions filled at end of period Population # |
| 64375-9 | Full time licensed practical nurse and licensed vocational nurse staff positions filled at end of period Population # |
| 64376-7 | Full time patient care technician staff positions filled at end of period Population # |
| 64377-5 | Full time advanced practice nurse staff positions filled at end of period Population # |
| 64378-3 | Kidney transplant center patients who received at least one kidney transplant with pending enrollment in Medicare at end of period Population # |
| 64379-1 | Kidney transplant center patients who received at least one kidney transplant, who is US citizen or a foreign national US resident, and not eligible for enrollment in Medicare at end of period Population # |
| 64380-9 | Kidney transplant center patients who received at least one kidney transplant who is neither a US citizen nor a foreign national US resident and not eligible for enrollment in Medicare at end of period Population # |
| 64381-7 | Kidney transplant center patients who received at least one kidney transplant from a living related donor Population # |
| 64382-5 | Kidney transplant center patients who received at least one kidney transplant from a living unrelated donor Population # |
| 64383-3 | Kidney transplant center patients who received at least one kidney transplant from a deceased donor Population # |
| 64384-1 | Total kidney transplant center patients who received at least one kidney transplant Population # |
| 64385-8 | Kidney transplant center dialysis patients who are awaiting a kidney transplant at end of period Population # |
| 64386-6 | Kidney transplant center non-dialysis patients who are awaiting a kidney transplant at end of period Population # |
| 65191-9 | During the past 30 days, about how often did you feel restless or fidgety [Kessler 6 Distress] |
| 65833-6 | Facility Address |
| 65834-4 | Facility ownership |
| 65835-1 | Facility affiliation information |
| 65836-9 | Dialysis services offered Facility |
| 65837-7 | Facility offers dialysis shift starting at 5:00 pm |
| 65838-5 | Date submitted |
| 65839-3 | Principal result interpreter title Study |
| 65840-1 | Principal result interpreter phone number |
| 65841-9 | Form status |
| 65842-7 | Acceptance status |
| 65843-5 | Responsible observer |
| 67868-0 | End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728 |
| 67869-8 | Reason for medicare entitlement |
| 67870-6 | Patient information - end stage renal disease form 2728 |
| 67871-4 | Patient demographics - end stage renal disease form 2728 |
| 67872-2 | Medicare end stage renal disease coverage requested |
| 67873-0 | Cause of renal failure.primary [Reported] |
| 67874-8 | Employment status - 6 months prior to renal failure [Reported] |
| 67876-3 | End stage renal disease (ESRD) co-morbidities ICD code |
| 67877-1 | End stage renal disease (ESRD) patients in dialysis treatment - end stage renal disease form 2728 |
| 67878-9 | Facility name Dialysis facility |
| 67879-7 | Dialysis facility NPI Dialysis facility |
| 67880-5 | Transplant facility NPI |
| 67881-3 | Self-dialysis training facility NPI Dialysis facility |
| 67882-1 | Functional status of transplant Transplant |
| 67883-9 | Transplant information - end stage renal disease form 2728 |
| 67885-4 | Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy |
| 67886-2 | Care by nephrologist prior to end stage renal disease therapy |
| 67887-0 | Care by kidney dietitian prior to end stage renal disease therapy |
| 67888-8 | Vascular access for first outpatient dialysis |
| 67889-6 | Neuro-Qol item bank - anxiety - version 1.0 |
| 67890-4 | Neuro-Qol item bank - depression - version 1.0 |
| 67891-2 | Neuro-Qol item bank - fatigue - version 1.0 |
| 67892-0 | Neuro-Qol item bank - upper extremity - version 1.0 |
| 67893-8 | Neuro-Qol item bank - lower extremity - version 1.0 |
| 67894-6 | Neuro-Qol item bank - executive function - version 1.0 |
| 67895-3 | Neuro-Qol item bank - general concerns - version 1.0 |
| 67896-1 | Neuro-Qol item bank - emotional - behavioral dyscontrol - version 1.0 |
| 67897-9 | Neuro-Qol item bank - positive affect - version 1.0 |
| 67898-7 | Neuro-Qol item bank - sleep disturbance - version 1.0 |
| 67899-5 | Neuro-Qol item bank - participate in social roles - version 1.0 |
| 67900-1 | Neuro-Qol item bank - satisfaction with social roles - version 1.0 |
| 67901-9 | Neuro-Qol item bank - stigma - version 1.0 |
| 67902-7 | Neuro-Qol item scale - communication - version 1.0 |
| 67903-5 | Neuro-Qol short form - anxiety - version 1.0 |
| 67904-3 | Neuro-Qol short form - depression - version 1.0 |
| 67905-0 | Neuro-Qol short form - fatigue - version 1.0 |
| 67906-8 | Neuro-Qol short form - upper extremity - version 1.0 |
| 67907-6 | Neuro-Qol short form - lower extremity - version 1.0 |
| 67908-4 | Neuro-Qol short form - executive function - version 1.0 |
| 67909-2 | Neuro-Qol short form - general concerns - version 1.0 |
| 67910-0 | Neuro-Qol short form - emotional - behavioral - version 1.0 |
| 67911-8 | Neuro-Qol short form - positive affect - version 1.0 |
| 67912-6 | Neuro-Qol short form - participate in social roles - version 1.0 |
| 67913-4 | Neuro-Qol short form - satisfaction with social roles - version 1.0 |
| 67914-2 | Neuro-Qol short form - stigma - version 1.0 |
| 67915-9 | I felt nervous when my normal routine was disturbed in the past 7 days [NeuroQol] |
| 67916-7 | I felt fearful about my future in the past 7 days [NeuroQol] |
| 67917-5 | I felt exhausted in the past 7 days [NeuroQol] |
| 67918-3 | I felt that I had no energy in the past 7 days [NeuroQol] |
| 67919-1 | I felt fatigued in the past 7 days [NeuroQol] |
| 67920-9 | I was too tired to do my household chores in the past 7 days [NeuroQol] |
| 67921-7 | I was too tired to leave the house in the past 7 days [NeuroQol] |
| 67922-5 | I was frustrated by being too tired to do the things I wanted to do in the past 7 days [NeuroQol] |
| 67923-3 | I felt tired in the past 7 days [NeuroQol] |
| 67924-1 | I had to limit my social activity because I was tired in the past 7 days [NeuroQol] |
| 67925-8 | I needed help doing my usual activities because of my fatigue in the past 7 days [NeuroQol] |
| 67926-6 | I needed to sleep during the day in the past 7 days [NeuroQol] |
| 67927-4 | I had trouble starting things because I was too tired in the past 7 days [NeuroQol] |
| 67928-2 | I had trouble finishing things because I was too tired in the past 7 days [NeuroQol] |
| 67929-0 | I was too tired to take a short walk in the past 7 days [NeuroQol] |
| 67930-8 | I was too tired to eat in the past 7 days [NeuroQol] |
| 67931-6 | I was so tired that I needed to rest during the day in the past 7 days [NeuroQol] |
| 67932-4 | I felt weak all over in the past 7 days [NeuroQol] |
| 67933-2 | I needed help doing my usual activities because of weakness in the past 7 days [NeuroQol] |
| 67934-0 | I had to limit my social activity because I was physically weak in the past 7 days [NeuroQol] |
| 67935-7 | I had to force myself to get up and do things because I was physically too weak in the past 7 days [NeuroQol] |
| 67936-5 | Are you able to make a phone call using a touch tone key-pad [NeuroQol] |
| 67937-3 | How much difficulty do you currently have using a spoon to eat a meal [NeuroQol] |
| 67938-1 | How much difficulty do you currently have putting on a pullover shirt [NeuroQol] |
| 67939-9 | How much difficulty do you currently have taking off a pullover shirt [NeuroQol] |
| 67940-7 | How much difficulty do you currently have removing wrappings from small objects [NeuroQol] |
| 67941-5 | How much difficulty do you currently have opening medications or vitamin containers, like childproof containers, small bottles [NeuroQol] |
| 67942-3 | How much difficulty do you currently have standing up from an armless straight chair, like a dining room chair [NeuroQol] |
| 67943-1 | How much difficulty do you currently have sitting down on and standing up from a chair with arms [NeuroQol] |
| 67944-9 | How much difficulty do you currently have moving from sitting at the side of the bed to lying down on your back [NeuroQol] |
| 67945-6 | How much difficulty do you currently have standing up from a low, soft couch [NeuroQol] |
| 67946-4 | How much difficulty do you currently have going up and down a flight of stairs inside, using a handrail [NeuroQol] |
| 67947-2 | How much difficulty do you currently have walking on uneven surfaces, like grass, dirt road or sidewalk [NeuroQol] |
| 67948-0 | How much difficulty do you currently have walking around one floor of your home [NeuroQol] |
| 67949-8 | How much difficulty do you currently have taking a 20 minute brisk walk, without stopping to rest [NeuroQol] |
| 67950-6 | How much difficulty do you currently have walking on a slippery surface, outdoors [NeuroQol] |
| 67951-4 | How much difficulty do you currently have climbing stairs step over step without a handrail - alternating feet [NeuroQol] |
| 67952-2 | How much difficulty do you currently have walking in a dark room without falling [NeuroQol] |
| 67953-0 | How much difficulty do you currently have checking the accuracy of financial documents, like bills, checkbook, or bank statements [NeuroQol] |
| 67954-8 | How much difficulty do you currently have counting the correct amount of money when making purchases [NeuroQol] |
| 67955-5 | How much difficulty do you currently have reading and following complex instructions, like directions for a new medication [NeuroQol] |
| 67956-3 | How much difficulty do you currently have planning for and keeping appointments that are not part of your weekly routine, like a therapy or doctor appointment, or a social gathering with friends and family [NeuroQol] |
| 67957-1 | How much difficulty do you currently have managing your time to do most of your daily activities [NeuroQol] |
| 67958-9 | How much difficulty do you currently have taking care of complicated tasks like managing a checking account or getting appliances fixed [NeuroQol] |
| 67959-7 | How much difficulty do you currently have keeping important personal papers such as bills, insurance documents and tax forms organized [NeuroQol] |
| 67960-5 | How much difficulty do you currently have learning new tasks or instructions [NeuroQol] |
| 67961-3 | How much difficulty do you currently have planning an activity several days in advance, like a meal, trip, or visit to friends [NeuroQol] |
| 67962-1 | How much difficulty do you currently have getting things organized [NeuroQol] |
| 67963-9 | How much difficulty do you currently have remembering where things were placed or put away, like keys [NeuroQol] |
| 67964-7 | How much difficulty do you currently have remembering a list of 4 or 5 errands without writing it down [NeuroQol] |
| 67965-4 | How much difficulty do you currently have keeping track of time, like using a clock [NeuroQol] |
| 67966-2 | I had to read something several times to understand it in the past 7 days [NeuroQol] |
| 67967-0 | I had trouble keeping track of what I was doing if I was interrupted in the past 7 days [NeuroQol] |
| 67968-8 | I had difficulty doing more than one thing at a time in the past 7 days [NeuroQol] |
| 67969-6 | I had trouble remembering new information, like phone numbers or simple instructions in the past 7 days [NeuroQol] |
| 67970-4 | I had trouble thinking clearly in the past 7 days [NeuroQol] |
| 67971-2 | My thinking was slow in the past 7 days [NeuroQol] |
| 67972-0 | I had to work really hard to pay attention or I would make a mistake in the past 7 days [NeuroQol] |
| 67973-8 | I had trouble concentrating in the past 7 days [NeuroQol] |
| 67974-6 | I made simple mistakes more easily in the past 7 days [NeuroQol] |
| 67975-3 | Words I wanted to use seemed to be on the tip of my tongue in the past 7 days [NeuroQol] |
| 67976-1 | I had trouble remembering whether I did things I was supposed to do, like taking a medicine or buying something I needed in the past 7 days [NeuroQol] |
| 67977-9 | I walked into a room and forgot what I meant to get or do there in the past 7 days [NeuroQol] |
| 67978-7 | I had trouble remembering the name of a familiar person in the past 7 days [NeuroQol] |
| 67979-5 | I reacted slowly to things that were said or done in the past 7 days [NeuroQol] |
| 67980-3 | I had trouble forming thoughts in the past 7 days [NeuroQol] |
| 67981-1 | I had trouble getting started on very simple tasks in the past 7 days [NeuroQol] |
| 67982-9 | I had trouble making decisions in the past 7 days [NeuroQol] |
| 67983-7 | I had trouble planning out steps of a task in the past 7 day [NeuroQol] |
| 67984-5 | It was hard to control my behavior in the past 7 days [NeuroQol] |
| 67985-2 | I said or did things without thinking in the past 7 days [NeuroQol] |
| 67986-0 | I got impatient with other people in the past 7 days [NeuroQol] |
| 67987-8 | I was irritable around other people in the past 7 days [NeuroQol] |
| 67988-6 | I was bothered by little things in the past 7 days [NeuroQol] |
| 67989-4 | I became easily upset in the past 7 days [NeuroQol] |
| 67990-2 | I was in conflict with others in the past 7 days [NeuroQol] |
| 67991-0 | I felt impulsive in the past 7 days [NeuroQol] |
| 67992-8 | People told me that I talked in a loud or excessive manner in the past 7 days [NeuroQol] |
| 67993-6 | I said or did things that other people probably thought were inappropriate in the past 7 days [NeuroQol] |
| 67994-4 | I suddenly became emotional for no reason in the past 7 days [NeuroQol] |
| 67995-1 | I felt restless in the past 7 days [NeuroQol] |
| 67996-9 | It was hard to adjust to unexpected changes in the past 7 days [NeuroQol] |
| 67997-7 | I had a hard time accepting criticism from other people in the past 7 days [NeuroQol] |
| 67998-5 | I threatened violence toward people or property in the past 7 days [NeuroQol] |
| 67999-3 | Lately I had a sense of well-being [NeuroQol] |
| 68000-9 | Lately I felt hopeful [NeuroQol] |
| 68001-7 | Lately my life was satisfying [NeuroQol] |
| 68002-5 | Lately my life had purpose [NeuroQol] |
| 68003-3 | Lately my life had meaning [NeuroQol] |
| 68004-1 | Lately I felt cheerful [NeuroQol] |
| 68005-8 | Lately my life was worth living [NeuroQol] |
| 68006-6 | Lately I had a sense of balance in my life [NeuroQol] |
| 68007-4 | Lately, many areas of my life were interesting to me [NeuroQol] |
| 68008-2 | Lately I was able to enjoy life [NeuroQol] |
| 68009-0 | Lately I felt a sense of purpose in my life [NeuroQol] |
| 68010-8 | Lately I could laugh and see the humor in situations [NeuroQol] |
| 68011-6 | Lately I was able to be at ease and feel relaxed [NeuroQol] |
| 68012-4 | Lately I looked forward with enjoyment to upcoming events [NeuroQol] |
| 68013-2 | Lately I felt emotionally stable [NeuroQol] |
| 68014-0 | Lately I felt lovable [NeuroQol] |
| 68015-7 | Lately I felt confident [NeuroQol] |
| 68016-5 | Lately I had a good life [NeuroQol] |
| 68017-3 | Lately my life was peaceful [NeuroQol] |
| 68018-1 | Lately I was living life to the fullest [NeuroQol] |
| 68019-9 | Lately, in most ways, my life was close to my ideal [NeuroQol] |
| 68020-7 | Lately I had good control of my thoughts [NeuroQol] |
| 68021-5 | Lately, even when things were going badly, I still had hope [NeuroQol] |
| 68022-3 | I had to force myself to get up in the morning in the past 7 days [NeuroQol] |
| 68023-1 | I had trouble stopping my thoughts at bedtime in the past 7 days [NeuroQol] |
| 68024-9 | I was sleepy during the daytime in the past 7 days [NeuroQol] |
| 68025-6 | I had trouble sleeping because of bad dreams in the past 7 days [NeuroQol] |
| 68026-4 | I had difficulty falling asleep in the past 7 days [NeuroQol] |
| 68027-2 | Pain woke me up in the past 7 days [NeuroQol] |
| 68028-0 | I avoided or cancelled activities with my friends because I was tired from having a bad night's sleep [NeuroQol] |
| 68029-8 | I felt physically tense during the middle of the night or early morning hours [NeuroQol] |
| 68030-6 | I can keep up with my family responsibilities in the past 7 days [NeuroQol] |
| 68031-4 | I am able to do all of my regular family activities in the past 7 days [NeuroQol] |
| 68032-2 | I am able to socialize with my friends in the past 7 days [NeuroQol] |
| 68033-0 | I am able to do all of my regular activities with friends in the past 7 days [NeuroQol] |
| 68034-8 | I can keep up with my social commitments in the past 7 days [NeuroQol] |
| 68035-5 | I am able to participate in leisure activities in the past 7 days [NeuroQol] |
| 68036-3 | I am able to perform my daily routines in the past 7 days [NeuroQol] |
| 68037-1 | I can keep up with my work in the past 7 days [NeuroQol] |
| 68038-9 | I have trouble meeting the needs of my family in the past 7 days [NeuroQol] |
| 68039-7 | I have to limit my regular family activities in the past 7 days [NeuroQol] |
| 68040-5 | I am able to do all of the family activities that people expect me to do in the past 7 days [NeuroQol] |
| 68041-3 | I am able to do all of the family activities that I want to do in the past 7 days [NeuroQol] |
| 68042-1 | I am able to maintain my friendships as much as I would like in the past 7 days [NeuroQol] |
| 68043-9 | I can do everything for my friends that I want to do in the past 7 days [NeuroQol] |
| 68044-7 | I am able to do all of the activities with friends that people expect me to do in the past 7 days [NeuroQol] |
| 68045-4 | I feel limited in my ability to visit friends in the past 7 days [NeuroQol] |
| 68046-2 | I am able to do all of the activities with friends that I want to do in the past 7 days [NeuroQol] |
| 68047-0 | I feel limited in the amount of time I have to visit friends in the past 7 days [NeuroQol] |
| 68048-8 | I have to limit the things I do for fun at home, like reading, listening to music, etc in the past 7 days [NeuroQol] |
| 68049-6 | I am able to do all of my regular leisure activities in the past 7 days [NeuroQol] |
| 68050-4 | I have to limit my hobbies or leisure activities in the past 7 days [NeuroQol] |
| 68051-2 | I am able to do my hobbies or leisure activities in the past 7 days [NeuroQol] |
| 68052-0 | I am able to do all of the community activities that I want to do in the past 7 days [NeuroQol] |
| 68053-8 | I am able to do all of the leisure activities that people expect me to do in the past 7 days [NeuroQol] |
| 68054-6 | I have to do my hobbies or leisure activities for shorter periods of time than usual for me in the past 7 days [NeuroQol] |
| 68055-3 | I have to limit social activities outside my home in the past 7 days [NeuroQol] |
| 68056-1 | I have trouble keeping in touch with others in the past 7 days [NeuroQol] |
| 68057-9 | I can do all the leisure activities that I want to do in the past 7 days [NeuroQol] |
| 68058-7 | I am able to do all of the community activities that people expect me to do in the past 7 days [NeuroQol] |
| 68059-5 | I am able to go out for entertainment as much as I want in the past 7 days [NeuroQol] |
| 68060-3 | I have to limit the things I do for fun outside my home in the past 7 days [NeuroQol] |
| 68061-1 | I am doing fewer social activities with groups of people than usual for me in the past 7 days [NeuroQol] |
| 68062-9 | I am able to run errands without difficulty in the past 7 days [NeuroQol] |
| 68063-7 | I am able to do all of my usual work in the past 7 days [NeuroQol] |
| 68064-5 | I am accomplishing as much as usual at work for me in the past 7 days [NeuroQol] |
| 68065-2 | My ability to do my work is as good as it can be in the past 7 days [NeuroQol] |
| 68066-0 | I can do everything for work that I want to do in the past 7 days [NeuroQol] |
| 68067-8 | I have trouble doing my regular chores or tasks in the past 7 days [NeuroQol] |
| 68068-6 | I am able to do all of the work that people expect me to do in the past 7 days [NeuroQol] |
| 68069-4 | I am limited in doing my work in the past 7 days [NeuroQol] |
| 68070-2 | I have to do my work for shorter periods of time than usual for me in the past 7 days [NeuroQol] |
| 68071-0 | I am bothered by my limitations in regular family activities in the past 7 days [NeuroQol] |
| 68072-8 | I am disappointed in my ability to socialize with my family in the past 7 days [NeuroQol] |
| 68073-6 | I am bothered by limitations in my regular activities with friends in the past 7 days [NeuroQol] |
| 68074-4 | I am disappointed in my ability to meet the needs of my friends in the past 7 days [NeuroQol] |
| 68075-1 | I am satisfied with my ability to do household chores or tasks in the past 7 days [NeuroQol] |
| 68076-9 | I feel that my family is disappointed in my ability to socialize with them in the past 7 days [NeuroQol] |
| 68077-7 | I am disappointed in my ability to meet the needs of my family in the past 7 days [NeuroQol] |
| 68078-5 | I am satisfied with my current level of activity with family members in the past 7 days [NeuroQol] |
| 68079-3 | I feel that my friends are disappointed in my ability to socialize with them in the past 7 days [NeuroQol] |
| 68080-1 | I am disappointed in my ability to do things for my friends in the past 7 days [NeuroQol] |
| 68081-9 | I am disappointed in my ability to socialize with friends in the past 7 days [NeuroQol] |
| 68082-7 | I am disappointed in my ability to keep in touch with others in the past 7 days [NeuroQol] |
| 68083-5 | I feel that others are disappointed in my ability to do community activities in the past 7 days [NeuroQol] |
| 68084-3 | I am disappointed in my ability to do leisure activities in the past 7 days [NeuroQol] |
| 68085-0 | I am bothered by limitations in doing my hobbies or leisure activities in the past 7 days [NeuroQol] |
| 68086-8 | I feel that I am disappointing other people at work in the past 7 days [NeuroQol] |
| 68087-6 | I am disappointed in my ability to perform my daily routines in the past 7 days [NeuroQol] |
| 68088-4 | I am disappointed in my ability to work in the past 7 days [NeuroQol] |
| 68089-2 | I am bothered by limitations in performing my daily routines in the past 7 days [NeuroQol] |
| 68090-0 | I am disappointed in my ability to take care of personal and household responsibilities in the past 7 days [NeuroQol] |
| 68091-8 | I am bothered by limitations in performing my work in the past 7 days [NeuroQol] |
| 68092-6 | I am satisfied with my ability to take care of personal and household responsibilities in the past 7 days [NeuroQol] |
| 68093-4 | I am satisfied with my ability to work in the past 7 days [NeuroQol] |
| 68094-2 | Lately, because of my illness, some people avoided me [NeuroQol] |
| 68095-9 | Lately, because of my illness, I felt left out of things [NeuroQol] |
| 68096-7 | Lately, because of my illness, people avoided looking at me [NeuroQol] |
| 68097-5 | Lately, I felt embarrassed about my illness [NeuroQol] |
| 68098-3 | Lately, because of my illness, some people seemed uncomfortable with me [NeuroQol] |
| 68099-1 | Lately, I felt embarrassed because of my physical limitations [NeuroQol] |
| 68100-7 | Lately, because of my illness, people were unkind to me [NeuroQol] |
| 68101-5 | Lately, some people acted as though it was my fault I have this illness [NeuroQol] |
| 68102-3 | Lately, because of my illness, I felt emotionally distant from other people [NeuroQol] |
| 68103-1 | Lately, because of my illness, people made fun of me [NeuroQol] |
| 68104-9 | Lately, because of my illness, I felt embarrassed in social situations [NeuroQol] |
| 68105-6 | Lately, because of my illness, strangers tended to stare at me [NeuroQol] |
| 68106-4 | Lately, because of my illness, I worried about other people's attitudes towards me [NeuroQol] |
| 68107-2 | Lately, because of my illness, I was treated unfairly by others [NeuroQol] |
| 68108-0 | Lately, I was unhappy about how my illness affected my appearance [NeuroQol] |
| 68109-8 | Lately, because of my illness, it was hard for me to stay neat and clean [NeuroQol] |
| 68110-6 | Lately, because of my illness, people tended to ignore my good points [NeuroQol] |
| 68111-4 | Lately, because of my illness, I worried that I was a burden to others [NeuroQol] |
| 68112-2 | Lately, I felt embarrassed about my speech [NeuroQol] |
| 68113-0 | Lately, because of my illness, I felt different from others [NeuroQol] |
| 68114-8 | Lately, I tended to blame myself for my problems [NeuroQol] |
| 68115-5 | Lately, I avoided making new friends to avoid telling others about my illness [NeuroQol] |
| 68116-3 | Lately, people with my illness lost their jobs when their employers found out about it [NeuroQol] |
| 68117-1 | Lately, I lost friends by telling them that I have this illness [NeuroQol] |
| 68118-9 | How much difficulty do you currently have writing notes to yourself, such as appointments or to do lists [NeuroQol] |
| 68119-7 | How much difficulty do you currently have understanding family and friends on the phone [NeuroQol] |
| 68120-5 | How much difficulty do you currently have carrying on a conversation with a small group of familiar people, like family or a few friends [NeuroQol] |
| 68121-3 | How much difficulty do you currently have organizing what you want to say [NeuroQol] |
| 68122-1 | How much difficulty do you currently have speaking clearly enough to use the telephone [NeuroQol] |
| 68125-4 | Neuro-Qol pediatric item bank - stigma - version 1.0 [NeuroQol.Peds] |
| 68126-2 | Neuro-Qol pediatric item bank - depression - version 1.0 [NeuroQol.Peds] |
| 68127-0 | Neuro-Qol pediatric item bank - anxiety - version 1.0 [NeuroQol.Peds] |
| 68128-8 | Neuro-Qol pediatric item bank - anger - version 1.0 [NeuroQol.Peds] |
| 68129-6 | Neuro-Qol pediatric item bank - peer interaction - version 1.0 [NeuroQol.Peds] |
| 68130-4 | Neuro-Qol pediatric item bank - adult interaction - version 1.0 [NeuroQol.Peds] |
| 68131-2 | Neuro-Qol pediatric item bank - general concerns - version 1.0 [NeuroQol.Peds] |
| 68132-0 | Neuro-Qol pediatric item bank - fatigue - version 1.0 [NeuroQol.Peds] |
| 68133-8 | Neuro-Qol pediatric item bank - pain - version 1.0 [NeuroQol.Peds] |
| 68134-6 | Neuro-Qol pediatric item scale - lower extremity - version 1.0 [NeuroQol.Peds] |
| 68135-3 | Neuro-Qol pediatric item scale - upper extremity - version 1.0 [NeuroQol.Peds] |
| 68136-1 | Neuro-Qol pediatric short form - anxiety - version 1.0 [NeuroQol.Peds] |
| 68137-9 | Neuro-Qol pediatric short form - stigma - version 1.0 [NeuroQol.Peds] |
| 68138-7 | Neuro-Qol pediatric short form - depression - version 1.0 [NeuroQol.Peds] |
| 68139-5 | Neuro-Qol pediatric short form - peer interaction - version 1.0 [NeuroQol.Peds] |
| 68140-3 | Neuro-Qol pediatric short form - general concerns - version 1.0 [NeuroQol.Peds] |
| 68141-1 | Neuro-Qol pediatric short form - fatigue - version 1.0 [NeuroQol.Peds] |
| 68142-9 | Lately, because of my illness, others my age avoided me [NeuroQol.Peds] |
| 68143-7 | Lately, because of my illness, I felt left out of things [NeuroQol.Peds] |
| 68144-5 | Lately, because of my illness, others my age made fun of me [NeuroQol.Peds] |
| 68145-2 | Lately, because of my illness, I felt embarrassed when I was in front of others my age [NeuroQol.Peds] |
| 68146-0 | Lately, because of my illness, I was treated unfairly by others my age [NeuroQol.Peds] |
| 68147-8 | Lately, because of my illness, others my age tended to ignore my good points [NeuroQol.Peds] |
| 68148-6 | Lately, because of my illness, I felt different from others my age [NeuroQol.Peds] |
| 68149-4 | Lately I avoided making new friends to avoid talking about my illness [NeuroQol.Peds] |
| 68150-2 | Lately, because of my illness, others my age bullied me [NeuroQol.Peds] |
| 68151-0 | Lately, because of my illness, others my age seemed uncomfortable with me [NeuroQol.Peds] |
| 68152-8 | Lately, because of my illness, others my age were mean to me [NeuroQol.Peds] |
| 68153-6 | Lately, because of my illness, others my age tended to stare at me [NeuroQol.Peds] |
| 68154-4 | Lately, because of my illness, I worried about what others my age thought about me [NeuroQol.Peds] |
| 68155-1 | Lately I was unhappy about how my illness affected my appearance [NeuroQol.Peds] |
| 68156-9 | Lately, because of my illness, I worried that I made life harder for my parents or guardians [NeuroQol.Peds] |
| 68157-7 | Lately I felt embarrassed about my illness [NeuroQol.Peds] |
| 68158-5 | Lately I felt embarrassed about the way I talk [NeuroQol.Peds] |
| 68159-3 | Lately I lost friends by telling them that I have this illness [NeuroQol.Peds] |
| 68160-1 | I felt too sad to do things with friends in the past 7 days [NeuroQol.Peds] |
| 68161-9 | I was less interested in doing things I usually enjoy in the past 7 days [NeuroQol.Peds] |
| 68162-7 | It was hard for me to care about anything in the past 7 days [NeuroQol.Peds] |
| 68163-5 | I was bored in the past 7 days [NeuroQol.Peds] |
| 68164-3 | I felt frustrated in the past 7 days [NeuroQol.Peds] |
| 68165-0 | My mood swings from good feelings to bad feelings in the past 7 days [NeuroQol.Peds] |
| 68166-8 | I had trouble sleeping in the past 7 days [NeuroQol.Peds] |
| 68167-6 | I felt that no one loved me in the past 7 days [NeuroQol.Peds] |
| 68168-4 | I cried more often than usual in the past 7 days [NeuroQol.Peds] |
| 68169-2 | I felt too sad to do my schoolwork in the past 7 days [NeuroQol.Peds] |
| 68170-0 | I felt afraid to go out alone in the past 7 days [NeuroQol.Peds] |
| 68171-8 | Being worried made it hard for me to be with my friends in the past 7 days [NeuroQol.Peds] |
| 68172-6 | It was hard to do schoolwork because I was nervous or worried in the past 7 days [NeuroQol.Peds] |
| 68173-4 | I felt afraid in the past 7 days [NeuroQol.Peds] |
| 68174-2 | I worry that my health might get worse in the past 7 days [NeuroQol.Peds] |
| 68175-9 | I worry about doing well in school in the past 7 days [NeuroQol.Peds] |
| 68176-7 | I become anxious when I go back to the hospital or clinic in the past 7 days [NeuroQol.Peds] |
| 68177-5 | I worry about how my health will affect my future in the past 7 days [NeuroQol.Peds] |
| 68178-3 | Because of my health, I worry about having a boyfriend or girlfriend in the past 7 days [NeuroQol.Peds] |
| 68179-1 | I worry about getting a good job because of my medical condition in the past 7 days [NeuroQol.Peds] |
| 68180-9 | I get nervous more easily than other people in the past 7 days [NeuroQol.Peds] |
| 68181-7 | I worried when I was away from my family in the past 7 days [NeuroQol.Peds] |
| 68182-5 | I got scared easily in the past 7 days [NeuroQol.Peds] |
| 68183-3 | I was worried that I might die in the past 7 days [NeuroQol.Peds] |
| 68184-1 | Because of my health, I worry about being able to go to college in the past 7 days [NeuroQol.Peds] |
| 68185-8 | Because of my health, I worry about getting a job to support myself in the past 7 days [NeuroQol.Peds] |
| 68186-6 | Being angry made it hard for me to be with my friends in the past 7 days [NeuroQol.Peds] |
| 68187-4 | It was hard to do schoolwork because I was angry in the past 7 days [NeuroQol.Peds] |
| 68188-2 | I felt angry in the past 7 days [NeuroQol.Peds] |
| 68189-0 | I was so mad that I felt like throwing something in the past 7 days [NeuroQol.Peds] |
| 68190-8 | I was so mad that I felt like hitting something in the past 7 days [NeuroQol.Peds] |
| 68191-6 | I was so mad that I felt like yelling at someone in the past 7 days [NeuroQol.Peds] |
| 68192-4 | I was so mad that I felt like breaking things in the past 7 days [NeuroQol.Peds] |
| 68193-2 | I was so mad that I acted grouchy towards other people in the past 7 days [NeuroQol.Peds] |
| 68194-0 | I felt close to my friends in the past 7 days [NeuroQol.Peds] |
| 68195-7 | In the past 7 days I felt comfortable with others my age [NeuroQol.Peds] |
| 68196-5 | I was happy with the friends I had in the past 7 days [NeuroQol.Peds] |
| 68197-3 | I felt comfortable talking with my friends in the past 7 days [NeuroQol.Peds] |
| 68198-1 | I had fun with my friends in the past 7 days [NeuroQol.Peds] |
| 68199-9 | I was able to talk openly with my friends in the past 7 days [NeuroQol.Peds] |
| 68200-5 | In the past 7 days I was able to stand up for myselfI was able to stand up for myself in the past 7 days [NeuroQol.Peds] |
| 68201-3 | I think I have fewer friends than other people my age in the past 7 days [NeuroQol.Peds] |
| 68202-1 | My friends ignored me in the past 7 days [NeuroQol.Peds] |
| 68203-9 | I wanted to spend time with my friends in the past 7 days [NeuroQol.Peds] |
| 68204-7 | I did things with other kids my age in the past 7 days [NeuroQol.Peds] |
| 68205-4 | I got along with my parents or guardians in the past 7 days [NeuroQol.Peds] |
| 68206-2 | I felt loved by my parents or guardians in the past 7 days [NeuroQol.Peds] |
| 68207-0 | I was happy at home in the past 7 days [NeuroQol.Peds] |
| 68208-8 | My parents or guardians spent enough time with me in the past 7 days [NeuroQol.Peds] |
| 68209-6 | I got along well with my teachers in the past 7 days [NeuroQol.Peds] |
| 68210-4 | My teachers accepted me in the past 7 days [NeuroQol.Peds] |
| 68211-2 | My teachers respected me in the past 7 days [NeuroQol.Peds] |
| 68212-0 | My parents or guardians seem to know what's important to me in the past 7 days [NeuroQol.Peds] |
| 68213-8 | I felt comfortable talking with my parents or guardians in the past 7 days [NeuroQol.Peds] |
| 68214-6 | I forget schoolwork that I need to do [NeuroQol.Peds] |
| 68215-3 | I sometimes forget what I was going to say [NeuroQol.Peds] |
| 68216-1 | I react slower than most people my age when I play games [NeuroQol.Peds] |
| 68217-9 | I forget things easily [NeuroQol.Peds] |
| 68218-7 | I have trouble remembering to do things like school projects [NeuroQol.Peds] |
| 68219-5 | It is hard for me to concentrate in school [NeuroQol.Peds] |
| 68220-3 | I have trouble paying attention to the teacher [NeuroQol.Peds] |
| 68221-1 | I have to work really hard to pay attention or I will make a mistake [NeuroQol.Peds] |
| 68222-9 | I have a hard time keeping track of my homework [NeuroQol.Peds] |
| 68223-7 | I forget to bring books or worksheets home that I need for homework [NeuroQol.Peds] |
| 68224-5 | I have to read something several times to understand it [NeuroQol.Peds] |
| 68225-2 | It is hard for me to find the right words to say what I mean [NeuroQol.Peds] |
| 68226-0 | It takes me longer than other people to get my schoolwork done [NeuroQol.Peds] |
| 68227-8 | I have to use written lists more often than other people my age so I will not forget things [NeuroQol.Peds] |
| 68229-4 | I had trouble starting things because I was too tired in the past 7 days [NeuroQol.Peds] |
| 68230-2 | I had trouble finishing things because I was too tired in the past 7 days [NeuroQol.Peds] |
| 68231-0 | I needed to sleep during the day in the past 7 days [NeuroQol.Peds] |
| 68232-8 | Being tired made it hard to play or go out with my friends as much as I would like in the past 7 days [NeuroQol.Peds] |
| 68233-6 | I was too tired to eat in the past 7 days [NeuroQol.Peds] |
| 68234-4 | Being tired makes me sad in the past 7 days [NeuroQol.Peds] |
| 68235-1 | Being tired makes me mad in the past 7 days [NeuroQol.Peds] |
| 68236-9 | I had energy or strength in the past 7 days [NeuroQol.Peds] |
| 68237-7 | I could do my usual things at home in the past 7 days [NeuroQol.Peds] |
| 68238-5 | I got upset by being too tired to do things I wanted to do in the past 7 days [NeuroQol.Peds] |
| 68239-3 | I needed help doing my usual things at home in the past 7 days [NeuroQol.Peds] |
| 68240-1 | I felt weak in the past 7 days [NeuroQol.Peds] |
| 68241-9 | I had so much pain that I had to stop what I was doing in the past 7 days [NeuroQol.Peds] |
| 68242-7 | I had pain in the past 7 days [NeuroQol.Peds] |
| 68243-5 | When you had pain, how long did it last in the past 7 days [NeuroQol.Peds] |
| 68244-3 | I had trouble watching TV when I had pain in the past 7 days [NeuroQol.Peds] |
| 68245-0 | It was hard for me to play or hang out with my friends when I had pain in the past 7 days [NeuroQol.Peds] |
| 68246-8 | I could walk for 15 minutes in the past 7 days [NeuroQol.Peds] |
| 68247-6 | I could walk between rooms in the past 7 days [NeuroQol.Peds] |
| 68248-4 | I could get on and off the toilet without using my arms in the past 7 days [NeuroQol.Peds] |
| 68249-2 | I could get on and off a low chair in the past 7 days [NeuroQol.Peds] |
| 68250-0 | I could get up from the floor by myself in the past 7 days [NeuroQol.Peds] |
| 68251-8 | I could sit on a bench without support for 15 minutes in the past 7 days [NeuroQol.Peds] |
| 68252-6 | I could stand on my tiptoes to reach for something in the past 7 days [NeuroQol.Peds] |
| 68253-4 | I could stand on my tiptoes to put something, like a 5 lb bag of sugar, on a shelf in the past 7 days [NeuroQol.Peds] |
| 68254-2 | I fall down easily in the past 7 days [NeuroQol.Peds] |
| 68255-9 | I could walk on slightly uneven surfaces such as cracked pavement in the past 7 days [NeuroQol.Peds] |
| 68256-7 | I could walk on rough, uneven surfaces such as lawns, gravel driveway in the past 7 days [NeuroQol.Peds] |
| 68257-5 | I could walk up and down ramps or hills in the past 7 days [NeuroQol.Peds] |
| 68258-3 | I could walk up and down curbs in the past 7 days [NeuroQol.Peds] |
| 68259-1 | I could get in and out of a bus in the past 7 days [NeuroQol.Peds] |
| 68260-9 | I could walk while wearing a backpack full of books in the past 7 days [NeuroQol.Peds] |
| 68261-7 | I could do exercise that others my age can do in the past 7 days [NeuroQol.Peds] |
| 68262-5 | I could move up and down curbs using a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68263-3 | I could move up and down inclines or ramps using a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68264-1 | I could move on rough, uneven surfaces like lawns or gravel driveway using a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68265-8 | I could move between my wheelchair and another seat such as a chair or bed in the past 7 days [NeuroQol.Peds] |
| 68266-6 | I could move around within a room, including making turns in my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68267-4 | I could manage getting on and off the tub bench from a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68268-2 | I could manage getting on and off the toilet from a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68269-0 | I could stand up from an armless straight chair using my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68270-8 | I could move on slightly uneven surfaces, cracked pavement, using a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68271-6 | I could move for 30 minutes using a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68272-4 | I could park a wheelchair in a narrow space like in an elevator in the past 7 days [NeuroQol.Peds] |
| 68273-2 | I could back out of an elevator in a wheelchair if there was no room to turn around in the past 7 days [NeuroQol.Peds] |
| 68274-0 | I could do a wheelie, like popping front wheels off the floor and balancing on back wheels, using my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68275-7 | I could reach for a high object from my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68276-5 | I could reverse direction in my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68277-3 | I could open a door that faced away from my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68278-1 | I could open a door that was facing my wheelchair in the past 7 days [NeuroQol.Peds] |
| 68279-9 | I could lock and unlock my wheelchair brakes in the past 7 days [NeuroQol.Peds] |
| 68280-7 | I could manage the armrests on my wheelchair [NeuroQol.Peds] |
| 68281-5 | I could manage the footrests on my wheelchair [NeuroQol.Peds] |
| 68282-3 | I could move for 15 minutes using a wheelchair in the past 7 days [NeuroQol.Peds] |
| 68283-1 | With a walking aid, I could walk for 15 minutes in the past 7 days [NeuroQol.Peds] |
| 68284-9 | With a walking aid, I could walk for 30 minutes in the past 7 days [NeuroQol.Peds] |
| 68285-6 | With a walking aid, I could walk on slightly uneven surfaces, cracked pavement in the past 7 days [NeuroQol.Peds] |
| 68286-4 | With a walking aid, I could walk on rough, uneven surfaces like lawns or gravel driveway in the past 7 days [NeuroQol.Peds] |
| 68287-2 | With a walking aid, I could walk up and down inclines or ramps in the past 7 days [NeuroQol.Peds] |
| 68288-0 | With a walking aid, I could walk up and down curbs in the past 7 days [NeuroQol.Peds] |
| 68289-8 | With a walking aid, I could open and close inside or outside doors to walk between rooms in the past 7 days [NeuroQol.Peds] |
| 68290-6 | With a walking aid, I could walk within a room in the past 7 days [NeuroQol.Peds] |
| 68291-4 | With a walking aid, I could walk across the room in the past 7 days [NeuroQol.Peds] |
| 68292-2 | With a walking aid, I could walk up stairs without holding on to anything in the past 7 days [NeuroQol.Peds] |
| 68293-0 | With a walking aid I could get in and out of a car in the past 7 days [NeuroQol.Peds] |
| 68294-8 | I was able to use my fingers to point to something in the past 7 days [NeuroQol.Peds] |
| 68295-5 | I was able to take off my socks in the past 7 days [NeuroQol.Peds] |
| 68296-3 | I was able to put on and fasten my pants by myself in the past 7 days [NeuroQol.Peds] |
| 68297-1 | I was able to button and unbutton my shirt in the past 7 days [NeuroQol.Peds] |
| 68298-9 | I was able to use a spoon to bring food up to my mouth in the past 7 days [NeuroQol.Peds] |
| 68299-7 | I was able to wipe myself thoroughly after using the toilet in the past 7 days [NeuroQol.Peds] |
| 68300-3 | I was able to pull my pants back up after using the toilet in the past 7 days [NeuroQol.Peds] |
| 68301-1 | I was able to hold a plate full of food in the past 7 days [NeuroQol.Peds] |
| 68302-9 | I was able to cut a piece of paper in half with scissors in the past 7 days [NeuroQol.Peds] |
| 68303-7 | I was able to take a shower by myself in the past 7 days [NeuroQol.Peds] |
| 68304-5 | I was able to take a bath by myself in the past 7 days [NeuroQol.Peds] |
| 68305-2 | I was able to make a phone call using a touch tone key-pad in the past 7 days [NeuroQol.Peds] |
| 68306-0 | I was able to get out of bed by myself in the past 7 days [NeuroQol.Peds] |
| 68307-8 | I was able to put on my shoes by myself in the past 7 days [NeuroQol.Peds] |
| 68308-6 | I was able to open a jar by myself in the past 7 days [NeuroQol.Peds] |
| 68309-4 | I was able to put toothpaste on my toothbrush by myself in the past 7 days [NeuroQol.Peds] |
| 68310-2 | I was able to brush my teeth by myself in the past 7 days [NeuroQol.Peds] |
| 68311-0 | I was able to dry my back with a towel in the past 7 days [NeuroQol.Peds] |
| 68312-8 | I was able to put on my clothes by myself in the past 7 days [NeuroQol.Peds] |
| 68313-6 | I was able to zip up my clothes in the past 7 days [NeuroQol.Peds] |
| 68321-9 | I worried about dying in the past 7 days [NeuroQol] |
| 68322-7 | I had a lot of pain in the past 7 days [NeuroQol.Peds] |
| 68323-5 | My pain was so bad that I needed to take medicine for it in the past 7 days [NeuroQol.Peds] |
| 68329-2 | Country of origin |
| 68330-0 | CMS certification number - CCN Dialysis facility |
| 68332-6 | Donor |
| 68333-4 | Date return to dialysis after failed transplant |
| 68334-2 | Current dialysis treatment site |
| 68335-9 | Self-dialysis training facility name Dialysis facility |
| 68336-7 | Self-dialysis training |
| 68337-5 | Self-dialysis training location |
| 68338-3 | Is patient expected to complete training |
| 68339-1 | Date self-dialysis training completion |
| 68340-9 | Attending physician phone number Provider |
| 68341-7 | Dialysis at time of death |
| 68343-3 | Primary cause of death |
| 68344-1 | Were there secondary causes of death |
| 68345-8 | Secondary cause of death |
| 68346-6 | Other cause of death |
| 68347-4 | Renal replacement therapy discontinued prior to death |
| 68348-2 | Reason renal replacement therapy discontinued |
| 68349-0 | Date last dialysis treatment |
| 68350-8 | Discontinuation renal replacement therapy request of patient or family |
| 68351-6 | Date most recent transplant |
| 68352-4 | Graft functioning at death |
| 68353-2 | Did patient resume chronic maintenance dialysis prior to death |
| 68354-0 | Hospice prior to death |
| 68355-7 | Date signed |
| 68356-5 | Form version |
| 68357-3 | Self-dialysis training physician NPI Provider |
| 68358-1 | Date chronic dialysis began |
| 68359-9 | End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746 |
| 68360-7 | Transplant options given |
| 68361-5 | Reasons patient not informed of transplant option |
| 68362-3 | Date self-dialysis training began |
| 68442-3 | Primary dialysis setting |
| 68443-1 | Primary dialysis |
| 68444-9 | Date chronic dialysis began at current facility |
| 68445-6 | Date transplant |
| 68446-4 | Transplant facility name |
| 68447-2 | Date transplant admission |
| 68448-0 | Dialysis sessions per week |
| 68449-8 | Arteriovenous fistula maturity |
| 68450-6 | Graft maturity |
| 68451-4 | Self-dialysis training program - end stage renal disease form 2728 |
| 68456-3 | Transplant preparation facility NPI |
| 68462-1 | Physician information - end stage renal disease form 2728 Provider |
| 68468-8 | Attending physician NPI Provider |
| 68488-6 | State location of Facility |
| 68489-4 | Dialysis hours per session |
| 68490-2 | Transplant preparation facility name |
| 68491-0 | Self-dialysis training physician name Provider |
| 68492-8 | Date last prenatal visit |
| 68493-6 | Prenatal visits for this pregnancy # |
| 68494-4 | Body weight--at delivery |
| 68496-9 | Previous live births now dead # |
| 68497-7 | Previous cesarean deliveries # |
| 68499-3 | Date last live birth |
| 68500-8 | Date last other pregnancy outcome |
| 68503-2 | How well do you speak English [SAMHSA] |
| 68504-0 | What language do you feel most comfortable speaking with your doctor or nurse [SAMHSA] |
| 68505-7 | Current occupational status [SAMHSA] |
| 68506-5 | What is the highest grade or level of schooling you completed [SAMHSA] |
| 68507-3 | Did you ever serve on active duty in the armed forces of the U.S. [SAMHSA] |
| 68508-1 | How many children under the age of 18 live in your household # [SAMHSA] |
| 68509-9 | Not able to stop or control worrying in the last 2 weeks |
| 68510-7 | How many times a week did you eat fast food or snacks or pizza in past 7 days [SAMHSA] |
| 68511-5 | How many servings of fruits-vegetables did you eat each day in past 7 days [SAMHSA] |
| 68512-3 | How many soda and sweetened drinks, regular, not diet, did you drink each day in past 7 days [SAMHSA] |
| 68513-1 | How many day in the past week did you miss taking one or more of your medications [SAMHSA] |
| 68514-9 | Reason you fail to take doses of your medications [SAMHSA] |
| 68515-6 | How many days of moderate to strenuous exercise, like a brisk walk, did you do in the last 7 days [SAMHSA] |
| 68516-4 | On those days that you engage in moderate to strenuous exercise, how many minutes, on average, do you exercise |
| 68517-2 | How many times in the past year have you have X or more drinks in a day |
| 68521-4 | How much stress have you been experiencing in the past week, including today # [SAMHSA] |
| 68522-2 | To what extent did the following common sources contributed to your overall stress in the lastweek [SAMHSA] |
| 68523-0 | Sources of stress [SAMHSA] |
| 68525-5 | In the past year, have you used drugs other than those required for medical reasons [SAMHSA] |
| 68526-3 | Do you abuse more than one drug at a time [SAMHSA] |
| 68527-1 | Are you always able to stop using drugs when you want to [SAMHSA] |
| 68528-9 | Have you had blackouts or flashbacks as a result for drug use [SAMHSA] |
| 68529-7 | Do you ever feel bad or guilty about your drug use [SAMHSA] |
| 68530-5 | Does your spouse or parent ever complain about your involvement with drugs [SAMHSA] |
| 68531-3 | Have you neglected your family because of your use of drugs [SAMHSA] |
| 68532-1 | Have you engaged in illegal activities in order to obtain drugs [SAMHSA] |
| 68533-9 | Have you ever experienced withdrawal symptoms, felt sick, when you stopped taking drugs [SAMHSA] |
| 68534-7 | Have you had medical problems as a result of your drug use [SAMHSA] |
| 68535-4 | Have you used tobacco in the last 30 days [SAMHSA] |
| 68536-2 | Have you used smokeless tobacco product in the last 30 days [SAMHSA] |
| 68537-0 | Would you be interested in quitting tobacco use within the next few weeks [SAMHSA] |
| 68538-8 | Did you provide brief counseling-coaching to quit [SAMHSA] |
| 68539-6 | Did you prescribe or recommend that the patient use one of the 7 FDA - approved medications for tobacco cessation [SAMHSA] |
| 68540-4 | Did you refer the patient to your states tobacco quitline [SAMHSA] |
| 68899-4 | Core behavioral and psychosocial data elements for the electronic health record [SAMHSA] |
| 68900-0 | Albumin lab method |
| 68995-0 | Person completing form name Provider |
| 68996-8 | Laboratory - end stage renal disease form 2728 |
| 68997-6 | City |
| 68998-4 | U.S. standard certificate of live birth - 2003 revision |
| 69043-8 | Other pregnancy outcomes # |
| 69044-6 | Date first prenatal visit |
| 69045-3 | U.S. standard report of fetal death - 2003 revision |
| 69046-1 | Airway status |
| 69323-4 | Changed medical regimen diagnoses - OASIS - B1 [OASIS] |
| 69325-9 | Diagnosis and severity index - OASIS B1 [OASIS] |
| 69330-9 | Data items collected at inpatient facility admission or agency discharge only - OASIS-C - transfer to facility [OASIS-C] |
| 69331-7 | Data items collected at inpatient facility admission or agency discharge only - discharge from agency during assessment period [CMS Assessment] |
| 69332-5 | Neuro and emotional and behavioral status - discharge from agency [CMS Assessment] |
| 69333-3 | Neuro and emotional and behavioral status - resumption of care [OASIS-C] |
| 69334-1 | Neuro and emotional and behavioral status - start of care [OASIS-C] |
| 69336-6 | ADL and IADLs - follow-up [OASIS-C] |
| 69337-4 | ADL and IADLs - discharge during assessment period [CMS Assessment] |
| 69339-0 | Influenza vaccine during assessment period [CMS Assessment] |
| 69346-5 | Endotracheal tube activity |
| 69347-3 | Artificial airway |
| 69365-5 | Inpatient facility diagnoses - OASIS B1 [OASIS] |
| 69406-7 | Adult GFR method |
| 69407-5 | Pediatric GFR method |
| 69409-1 | U.S. standard certificate of death - 2003 revision |
| 69430-7 | Expected self-care dialysis |
| 69431-5 | Medicare enrollment status |
| 69432-3 | Dialysis time period |
| 69433-1 | Citizenship status |
| 69434-9 | Location of death name Facility |
| 69435-6 | Street address where death occurred if not facility |
| 69436-4 | Autopsy results available |
| 69437-2 | Death certifier [Type] |
| 69439-8 | Death certifier Address |
| 69440-6 | Disease onset to death interval |
| 69441-4 | Other significant causes or conditions of death |
| 69442-2 | Timing of recent pregnancy in relation to death |
| 69443-0 | Did tobacco use contribute to death |
| 69444-8 | Did death result from injury at work |
| 69445-5 | Injury date |
| 69446-3 | Injury date comment |
| 69447-1 | Injury location Narrative |
| 69448-9 | Injury leading to death associated with transportation event |
| 69449-7 | Manner of death |
| 69450-5 | Place of injury Facility |
| 69451-3 | Transportation role of decedent |
| 69452-1 | Coroner - medical examiner case number |
| 69453-9 | Cause of death [US Standard Certificate of Death] |
| 69454-7 | Death date comment |
| 69491-9 | Mobility aids [OPTIMAL] |
| 69492-7 | Outpatient physical therapy improvement in movement assessment log [OPTIMAL] |
| 69493-5 | OPTIMAL difficulty - baseline |
| 69494-3 | OPTIMAL confidence - baseline |
| 69495-0 | OPTIMAL difficulty - follow up |
| 69496-8 | OPTIMAL confidence - follow up |
| 69497-6 | Lying flat - difficulty [OPTIMAL] |
| 69498-4 | Rolling over - difficulty [OPTIMAL] |
| 69499-2 | Moving - lying to sitting - difficulty [OPTIMAL] |
| 69500-7 | Sitting - difficulty [OPTIMAL] |
| 69501-5 | Squatting - difficulty |
| 69502-3 | Bending - stooping - difficulty [OPTIMAL] |
| 69503-1 | Balancing - difficulty [OPTIMAL] |
| 69504-9 | Kneeling - difficulty [OPTIMAL] |
| 69505-6 | Walking - short distance - difficulty [OPTIMAL] |
| 69506-4 | Walking - long distance - difficulty [OPTIMAL] |
| 69507-2 | Walking - outdoors - difficulty [OPTIMAL] |
| 69508-0 | Climbing stairs - difficulty [OPTIMAL] |
| 69509-8 | Hopping - difficulty [OPTIMAL] |
| 69510-6 | Jumping - difficulty [OPTIMAL] |
| 69511-4 | Running - difficulty [OPTIMAL] |
| 69512-2 | Pushing - difficulty [OPTIMAL] |
| 69513-0 | Pulling - difficulty [OPTIMAL] |
| 69514-8 | Reaching - difficulty [OPTIMAL] |
| 69515-5 | Grasping - difficulty [OPTIMAL] |
| 69516-3 | Lifting - difficulty [OPTIMAL] |
| 69517-1 | Carrying - difficulty [OPTIMAL] |
| 69518-9 | Choose the number of the activity you would most like to be able to do without any difficulty [OPTIMAL] |
| 69519-7 | Overall level of difficulty with these activities today [OPTIMAL] |
| 69520-5 | Lying flat - confidence [OPTIMAL] |
| 69521-3 | Rolling over - confidence [OPTIMAL] |
| 69522-1 | Moving - lying to sitting - confidence [OPTIMAL] |
| 69523-9 | Sitting - confidence [OPTIMAL] |
| 69524-7 | Squatting - confidence [OPTIMAL] |
| 69525-4 | Bending - stooping - confidence [OPTIMAL] |
| 69526-2 | Balancing - confidence [OPTIMAL] |
| 69527-0 | Kneeling - confidence [OPTIMAL] |
| 69528-8 | Walking - short distance - confidence [OPTIMAL] |
| 69529-6 | Walking - long distance - confidence [OPTIMAL] |
| 69530-4 | Walking - outdoors - confidence [OPTIMAL] |
| 69531-2 | Climbing stairs - confidence [OPTIMAL] |
| 69532-0 | Hopping - confidence [OPTIMAL] |
| 69533-8 | Jumping - confidence [OPTIMAL] |
| 69534-6 | Running - confidence [OPTIMAL] |
| 69535-3 | Pushing - confidence [OPTIMAL] |
| 69536-1 | Pulling - confidence [OPTIMAL] |
| 69537-9 | Reaching - confidence [OPTIMAL] |
| 69538-7 | Grasping - confidence [OPTIMAL] |
| 69539-5 | Lifting - confidence [OPTIMAL] |
| 69540-3 | Carrying - confidence [OPTIMAL] |
| 69541-1 | Overall level of confidence with these activities today [OPTIMAL] |
| 69586-6 | Carrying - confidence - score change [OPTIMAL] |
| 69587-4 | Lifting - confidence - score change [OPTIMAL] |
| 69588-2 | Grasping - confidence - score change [OPTIMAL] |
| 69589-0 | Reaching - confidence - score change [OPTIMAL] |
| 69590-8 | Pulling - confidence - score change [OPTIMAL] |
| 69591-6 | Pushing - confidence - score change [OPTIMAL] |
| 69592-4 | Running - confidence - score change [OPTIMAL] |
| 69593-2 | Jumping - confidence - score change [OPTIMAL] |
| 69594-0 | Hopping - confidence - score change [OPTIMAL] |
| 69595-7 | Climbing stairs - confidence - score change [OPTIMAL] |
| 69596-5 | Walking - outdoors - confidence - score change [OPTIMAL] |
| 69597-3 | Walking - long distance - confidence - score change [OPTIMAL] |
| 69598-1 | Walking - short distance - confidence - score change [OPTIMAL] |
| 69599-9 | Kneeling - confidence - score change [OPTIMAL] |
| 69600-5 | Balancing - confidence - score change [OPTIMAL] |
| 69601-3 | Bending - stooping - confidence - score change [OPTIMAL] |
| 69602-1 | Squatting - confidence - score change [OPTIMAL] |
| 69603-9 | Sitting - confidence - score change [OPTIMAL] |
| 69604-7 | Moving - lying to sitting - confidence - score change [OPTIMAL] |
| 69605-4 | Rolling over - confidence - score change [OPTIMAL] |
| 69606-2 | Lying flat - confidence - score change [OPTIMAL] |
| 69607-0 | Carrying - difficulty - score change [OPTIMAL] |
| 69608-8 | Lifting - difficulty - score change [OPTIMAL] |
| 69609-6 | Grasping - difficulty - score change [OPTIMAL] |
| 69610-4 | Reaching - difficulty - score change [OPTIMAL] |
| 69611-2 | Pulling - difficulty - score change [OPTIMAL] |
| 69612-0 | Pushing - difficulty - score change [OPTIMAL] |
| 69613-8 | Running - difficulty - score change [OPTIMAL] |
| 69614-6 | Jumping - difficulty - score change [OPTIMAL] |
| 69615-3 | Hopping - difficulty - score change [OPTIMAL] |
| 69616-1 | Climbing stairs - difficulty - score change [OPTIMAL] |
| 69617-9 | Walking - outdoors - difficulty - score change [OPTIMAL] |
| 69618-7 | Walking - long distance - difficulty - score change [OPTIMAL] |
| 69619-5 | Walking - short distance - difficulty - score change [OPTIMAL] |
| 69620-3 | Kneeling - difficulty - score change [OPTIMAL] |
| 69621-1 | Balancing - difficulty - score change [OPTIMAL] |
| 69622-9 | Bending - stooping - difficulty - score change [OPTIMAL] |
| 69623-7 | Squatting - difficulty - score change [OPTIMAL] |
| 69624-5 | Sitting - difficulty - score change [OPTIMAL] |
| 69625-2 | Moving - lying to sitting - difficulty - score change [OPTIMAL] |
| 69626-0 | Rolling over - difficulty - score change [OPTIMAL] |
| 69627-8 | Lying flat - difficulty - score change [OPTIMAL] |
| 69631-0 | Total change score - difficulty [OPTIMAL] |
| 69632-8 | Total difficulty score - baseline [OPTIMAL] |
| 69633-6 | Total difficulty score - follow-up [OPTIMAL] |
| 69652-6 | Total change score - confidence [OPTIMAL] |
| 69653-4 | Total confidence score - baseline [OPTIMAL] |
| 69654-2 | Total confidence score - follow-up [OPTIMAL] |
| 69671-6 | Bothered by stomach pain in last 4 weeks [Reported.PHQ] |
| 69672-4 | Bothered by back pain in last 4 weeks [Reported.PHQ] |
| 69673-2 | Bothered by pain in your arms, legs, or joints - knees, hips, etc - in last 4 weeks [Reported.PHQ] |
| 69674-0 | Bothered by menstrual cramps or other problems with your period in last 4 weeks [Reported.PHQ] |
| 69675-7 | Bothered by headaches in last 4 weeks [Reported.PHQ] |
| 69676-5 | Bothered by chest pain in last 4 weeks [Reported.PHQ] |
| 69677-3 | Bothered by dizziness in last 4 weeks [Reported.PHQ] |
| 69678-1 | Bothered by fainting spells in last 4 weeks [Reported.PHQ] |
| 69679-9 | Bothered by feeling your heart pound or race in last 4 weeks [Reported.PHQ] |
| 69680-7 | Bothered by shortness of breath in last 4 weeks [Reported.PHQ] |
| 69681-5 | Bothered by constipation, loose stools, or diarrhea in last 4 weeks [Reported.PHQ] |
| 69682-3 | Bothered by nausea, gas, or indigestion in last 4 weeks [Reported.PHQ] |
| 69683-1 | Feeling nervous, anxious, on edge, or worrying a lot about different things in last 4 weeks [Reported.PHQ] |
| 69684-9 | Feeling restless so that it is hard to sit still in last 4 weeks [Reported.PHQ] |
| 69685-6 | Getting tired very easily in last 4 weeks [Reported.PHQ] |
| 69686-4 | Muscle tension, aches, or soreness in last 4 weeks [Reported.PHQ] |
| 69687-2 | Trouble falling asleep or staying asleep in last 4 weeks [Reported.PHQ] |
| 69688-0 | Trouble concentrating on things, such as reading a book or watching TV in last 4 weeks [Reported.PHQ] |
| 69689-8 | Becoming easily annoyed or irritable in last 4 weeks [Reported.PHQ] |
| 69690-6 | Do you often feel that you can't control what or how much you eat [Reported.PHQ] |
| 69691-4 | Do you often eat, within any 2 hour period, what most people would regard as an unusually large amount of food [Reported.PHQ] |
| 69692-2 | Has this been as often, on average, as twice a week for the last 3 months [Reported.PHQ] |
| 69693-0 | Made yourself vomit often in last 3 months in order to avoid gaining weight [Reported.PHQ] |
| 69694-8 | Took more than twice the recommended dose of laxatives often in last 3 months in order to avoid gaining weight [Reported.PHQ] |
| 69695-5 | Fasted - not eaten anything at all for at least 24 hours - often in last 3 months in order to avoid gaining weight [Reported.PHQ] |
| 69696-3 | Exercised for more than an hour specifically to avoid gaining weight after binge eating often in last 3 months in order to avoid gaining weight [Reported.PHQ] |
| 69697-1 | You drank alcohol, even though a doctor suggested that you stop drinking because of a problem with your health, more than once in last 6 months [Reported.PHQ] |
| 69698-9 | You drank alcohol, were high from alcohol, or hung over while you were working, going to school, or taking care of children or other responsibilities more than once in last 6 months [Reported.PHQ] |
| 69699-7 | You missed or were late for work, school, or other activities because you were drinking or hung over, more than once in last 6 months [Reported.PHQ] |
| 69700-3 | You had a problem getting along with other people while you were drinking more than once in last 6 months [Reported.PHQ] |
| 69701-1 | You drove a car after having several drinks or after drinking too much more than once in last 6 months [Reported.PHQ] |
| 69702-9 | Has this ever happened before [Reported.PHQ] |
| 69703-7 | Do some of these attacks come suddenly out of the blue - that is, in situations where you don't expect to be nervous or uncomfortable [Reported.PHQ] |
| 69704-5 | Do these attacks bother you a lot or are you worried about having another attack [Reported.PHQ] |
| 69705-2 | Were you short of breath [Reported.PHQ] |
| 69706-0 | Did your heart race, pound, or skip [Reported.PHQ] |
| 69707-8 | Did you have chest pain or pressure [Reported.PHQ] |
| 69708-6 | Did you sweat [Reported.PHQ] |
| 69709-4 | Did you feel as if you were choking [Reported.PHQ] |
| 69710-2 | Did you have hot flashes or chills [Reported.PHQ] |
| 69711-0 | Did you have nausea or an upset stomach, or the feeling that you were going to have diarrhea [Reported.PHQ] |
| 69712-8 | Did you feel dizzy, unsteady, or faint [Reported.PHQ] |
| 69713-6 | Did you have tingling or numbness in parts of your body [Reported.PHQ] |
| 69714-4 | Did you tremble or shake [Reported.PHQ] |
| 69715-1 | Were you afraid you were dying [Reported.PHQ] |
| 69716-9 | In the last 4 weeks, have you had an anxiety attack - suddenly feeling fear or panic [Reported.PHQ] |
| 69717-7 | Bothered by pain or problems during sexual intercourse [Reported.PHQ] |
| 69720-1 | If you checked yes to any of these ways of avoiding gaining weight, were any as often, on average, as twice a week [Reported.PHQ] |
| 69721-9 | Do you ever drink alcohol - including beer or wine [Reported.PHQ] |
| 69722-7 | How difficult have these made it for you to do your work, take care of things at home, or get along with other people [Reported.PHQ] |
| 69723-5 | Patient Health Questionnaire (PHQ) [Reported] |
| 69724-3 | Patient Health Questionnaire 4 item (PHQ-4) [Reported] |
| 69725-0 | Feeling nervous, anxious or on edge in last 2 weeks |
| 69728-4 | Patient Health Questionnaire 15 item (PHQ-15) [Reported] |
| 69729-2 | Patient Health Questionnaire - Somatic, Anxiety, and Depressive Symptoms (PHQ-SADS) [Reported] |
| 69731-8 | Feeling tired or having low energy level in past 4 weeks [Reported.PHQ] |
| 69732-6 | Trouble sleeping in past 4 weeks [Reported.PHQ] |
| 69733-4 | Worrying too much about different things in last 2 weeks [Reported.PHQ] |
| 69734-2 | Trouble relaxing in last 2 weeks [Reported.PHQ] |
| 69735-9 | Being so restless that it is hard to sit still in last 2 weeks [Reported.PHQ] |
| 69736-7 | Feeling afraid as if something awful might happen in last 2 weeks [Reported.PHQ] |
| 69737-5 | Generalized anxiety disorder 7 item (GAD-7) |
| 69751-6 | OPTIMAL change scores - difficulty |
| 69752-4 | OPTIMAL change scores - confidence |
| 69855-5 | Race [HHS.ACA Section 4302] |
| 69856-3 | Are you deaf, or do you have serious difficulty hearing |
| 69857-1 | Are you blind, or do you have serious difficulty seeing, even when wearing glasses |
| 69858-9 | Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions |
| 69859-7 | Do you have serious difficulty walking or climbing stairs |
| 69860-5 | Do you have difficulty dressing or bathing |
| 69861-3 | Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a physician's office or shopping |
| 69919-9 | Race, ethnicity, sex, primary language, disability - Health and Human Services (HHS) panel [HHS.ACA Section 4302] |
| 69967-8 | Procedure ICD code |
| 70127-6 | Signature verifying assessment completion |
| 70157-3 | Form sections completed Provider |
| 70158-1 | Date sections completed Provider |
| 70182-1 | NIH Stroke Scale |
| 70183-9 | NIH stroke scale interval [NIH Stroke Scale] |
| 70184-7 | Level of consciousness [NIH Stroke Scale] |
| 70185-4 | LOC questions [NIH Stroke Scale] |
| 70186-2 | LOC commands [NIH Stroke Scale] |
| 70187-0 | Best gaze [NIH Stroke Scale] |
| 70188-8 | Visual [NIH Stroke Scale] |
| 70189-6 | Facial palsy [NIH Stroke Scale] |
| 70190-4 | Motor arm Left arm [NIH Stroke Scale] |
| 70191-2 | Motor leg Leg - left [NIH Stroke Scale] |
| 70192-0 | Limb ataxia [NIH Stroke Scale] |
| 70193-8 | Sensory [NIH Stroke Scale] |
| 70194-6 | Best language [NIH Stroke Scale] |
| 70195-3 | Dysarthria [NIH Stroke Scale] |
| 70196-1 | Extinction and inattention [NIH Stroke Scale] |
| 70220-9 | Repeated disturbing memories, thoughts, or images of a stressful experience from the past in the last month [PCL-C] |
| 70221-7 | Post traumatic stress disorder (PTSD) checklist - civilian version [PCL-C] |
| 70222-5 | Repeated disturbing dreams of a stressful experience from the past in the last month [PCL-C] |
| 70223-3 | Suddenly acting or feeling as if a stressful experience were happening again - as if you were reliving it - in the last month [PCL-C] |
| 70224-1 | Feeling very upset when something reminded you of a stressful experience from the past in the last month [PCL-C] |
| 70225-8 | Having physical reactions, heart pounding, trouble breathing or sweating, when something reminded you of a stressful experience from the past in the last month [PCL-C] |
| 70226-6 | Avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it in the last month [PCL-C] |
| 70227-4 | [PCL-C] |
| 70228-2 | Trouble remembering important parts of a stressful experience from the past in the last month [PCL-C] |
| 70229-0 | Loss of interest in things that you used to enjoy in the last month [PCL-C] |
| 70230-8 | Feeling distant or cut off from other people in the last month [PCL-C] |
| 70231-6 | Feeling emotionally numb or being unable to have loving feelings for those close to you in the last month [PCL-C] |
| 70232-4 | Feeling as if your future will somehow be cut short in the last month [PCL-C] |
| 70233-2 | Trouble falling or staying asleep in the last month [PCL-C] |
| 70234-0 | Feeling irritable or having angry outbursts in the last month [PCL-C] |
| 70235-7 | Having difficulty concentrating in the last month [PCL-C] |
| 70236-5 | Being super alert or watchful on guard in the last month [PCL-C] |
| 70237-3 | Feeling jumpy or easily startled in the last month [PCL-C] |
| 70271-2 | Patient Health Questionnaire - Somatic, Anxiety, and Depressive Symptoms (PHQ-SADS) total score [Reported] |
| 70272-0 | Patient Health Questionnaire 4 item (PHQ-4) total score [Reported] |
| 70273-8 | Patient Health Questionnaire 15 item (PHQ-15) total score [Reported] |
| 70274-6 | Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ] |
| 70297-7 | ESRD patient information panel |
| 70298-5 | ESRD mineral metabolism panel |
| 70299-3 | ESRD anemia management panel |
| 70300-9 | ESRD dialysis adequacy panel |
| 70301-7 | I have pain in my stomach area in the past 7 days [FACIT] |
| 70302-5 | I get headaches in the past 7 days [FACIT] |
| 70303-3 | I need help doing my usual activities in the past 7 days [FACIT] |
| 70304-1 | I feel tired in the past 7 days [FACIT] |
| 70305-8 | I have been short of breath in the past 7 days |
| 70306-6 | I am self-conscious about the way I dress in the past 7 days [FACIT] |
| 70307-4 | One or more of my arms are swollen or tender in the past 7 days [FACIT] |
| 70308-2 | I feel sexually attractive in the past 7 days [FACIT] |
| 70309-0 | I am bothered by hair loss in the past 7 days [FACIT] |
| 70310-8 | I worry that other members of my family might someday get the same illness I have in the past 7 days [FACIT] |
| 70311-6 | I worry about the effect of stress on my illness in the past 7 days [FACIT] |
| 70312-4 | I am bothered by a change in weight in the past 7 days [FACIT] |
| 70313-2 | I am able to feel like a woman in the past 7 days [FACIT] |
| 70314-0 | I have trouble controlling my urine in the past 7 days [FACIT] |
| 70315-7 | I urinate more frequently than usual in the past 7 days [FACIT] |
| 70316-5 | It burns when I urinate in the past 7 days [FACIT] |
| 70317-3 | I am interested in sex in the past 7 days [FACIT] |
| 70318-1 | For men only - I am able to have and maintain an erection in the past 7 days [FACIT] |
| 70319-9 | I have emotional ups and downs in the past 7 days [FACIT] |
| 70320-7 | I am able to get around by myself in the past 7 days [FACIT] |
| 70321-5 | I have concerns about my ability to have children in the past 7 days [FACIT] |
| 70322-3 | I have bone pain in the past 7 days [FACIT] |
| 70323-1 | I am able to concentrate in the past 7 days [FACIT] |
| 70324-9 | I am bothered by the change in my personality in the past 7 days [FACIT] |
| 70325-6 | I am able to make decisions and take responsibility in the past 7 days [FACIT] |
| 70326-4 | I am bothered by the drop in my contribution to the family in the past 7 days [FACIT] |
| 70327-2 | I am able to put my thoughts together in the past 7 days [FACIT] |
| 70328-0 | I need help caring for myself - bathing, dressing, eating, etc in the past 7 days [FACIT] |
| 70329-8 | I am able to put my thoughts into action in the past 7 days [FACIT] |
| 70330-6 | I am able to read like I used to in the past 7 days [FACIT] |
| 70331-4 | I am able to write like I used to in the past 7 days [FACIT] |
| 70332-2 | I am able to drive a vehicle - my car, truck, etc - in the past 7 days [FACIT] |
| 70333-0 | I have trouble feeling sensation in my arms, hands or legs in the past 7 days [FACIT] |
| 70334-8 | I have had seizures - convulsions - in the past 7 days [FACIT] |
| 70335-5 | I have weakness in my arms or legs in the past 7 days [FACIT] |
| 70336-3 | I have trouble with coordination in the past 7 days [FACIT] |
| 70337-1 | I can remember new things in the past 7 days [FACIT] |
| 70338-9 | I get frustrated that I cannot do the things I used to in the past 7 days [FACIT] |
| 70339-7 | I am afraid of having a seizure - convulsion - in the past 7 days [FACIT] |
| 70340-5 | I have trouble with my eyesight in the past 7 days [FACIT] |
| 70341-3 | I feel independent in the past 7 days [FACIT] |
| 70342-1 | I am able to find the right words to say what I mean in the past 7 days [FACIT] |
| 70343-9 | I have difficulty expressing my thoughts in the past 7 days [FACIT] |
| 70344-7 | I am bothered by fevers - episodes of high body temperature - in the past 7 days [FACIT] |
| 70345-4 | I have swelling or cramps in my stomach area in the past 7 days [FACIT] |
| 70346-2 | I am losing weight in the past 7 days [FACIT] |
| 70347-0 | I have control of my bowels in the past 7 days [FACIT] |
| 70348-8 | I can digest my food well in the past 7 days [FACIT] |
| 70349-6 | I have diarrhea in the past 7 days [FACIT] |
| 70350-4 | I have a good appetite in the past 7 days [FACIT] |
| 70351-2 | I like the appearance of my body in the past 7 days [FACIT] |
| 70352-0 | I am embarrassed by my ostomy appliance in the past 7 days [FACIT] |
| 70353-8 | Caring for my ostomy appliance is difficult in the past 7 days [FACIT] |
| 70354-6 | I am able to maintain my balance in the past 7 days [FACIT] |
| 70355-3 | I am able to walk in the past 7 days [FACIT] |
| 70356-1 | I have strength in my arms in the past 7 days [FACIT] |
| 70357-9 | I have strength in my legs in the past 7 days [FACIT] |
| 70358-7 | I have numbness in my legs in the past 7 days [FACIT] |
| 70359-5 | I have pain in my back in the past 7 days [FACIT] |
| 70360-3 | I am bothered by discharge or bleeding from my vagina in the past 7 days [FACIT] |
| 70361-1 | I am bothered by odor coming from my vagina in the past 7 days [FACIT] |
| 70362-9 | I am afraid to have sex in the past 7 days [FACIT] |
| 70363-7 | My vagina feels too narrow or short in the past 7 days [FACIT] |
| 70364-5 | I am afraid the treatment will harm my body in the past 7 days [FACIT] |
| 70365-2 | I am bothered by constipation in the past 7 days [FACIT] |
| 70366-0 | I have discomfort when I urinate in the past 7 days [FACIT] |
| 70367-8 | I have difficulty swallowing solid foods in the past 7 days [FACIT] |
| 70368-6 | I have difficulty swallowing soft or mashed foods in the past 7 days [FACIT] |
| 70369-4 | I have difficulty swallowing liquids in the past 7 days [FACIT] |
| 70370-2 | I have a pain in my chest when I swallow in the past 7 days [FACIT] |
| 70371-0 | I choke when I swallow in the past 7 days [FACIT] |
| 70372-8 | I am able to enjoy meals with family or friends in the past 7 days [FACIT] |
| 70373-6 | I wake at night because of coughing in the past 7 days [FACIT] |
| 70374-4 | I have trouble digesting food in the past 7 days [FACIT] |
| 70375-1 | I have discomfort or pain in my pelvic area in the past 7 days [FACIT] |
| 70376-9 | I have hot flashes in the past 7 days [FACIT] |
| 70377-7 | I have gained weight in the past 7 days [FACIT] |
| 70378-5 | I have cold sweats in the past 7 days [FACIT] |
| 70379-3 | I have night sweats in the past 7 days [FACIT] |
| 70380-1 | I have vaginal discharge in the past 7 days [FACIT] |
| 70381-9 | I have vaginal bleeding or spotting in the past 7 days [FACIT] |
| 70382-7 | I have pain or discomfort with intercourse in the past 7 days [FACIT] |
| 70383-5 | I have a loss of appetite in the past 7 days [FACIT] |
| 70384-3 | My digestive problems interfere with my usual activities in the past 7 days [FACIT] |
| 70385-0 | I have trouble swallowing food in the past 7 days [FACIT] |
| 70386-8 | I am bothered by gas - flatulence - in the past 7 days [FACIT] |
| 70387-6 | I am bothered by reflux or heartburn in the past 7 days [FACIT] |
| 70388-4 | I am bothered by a change in my eating habits in the past 7 days [FACIT] |
| 70389-2 | I have discomfort or pain when I eat in the past 7 days [FACIT] |
| 70390-0 | I have stomach problems that worry me in the past 7 days [FACIT] |
| 70391-8 | I avoid going out to eat because of my illness in the past 7 days [FACIT] |
| 70392-6 | I feel sad in the past 7 days [FACIT] |
| 70393-4 | I am satisfied with how I am coping with my illness in the past 7 days [FACIT] |
| 70394-2 | I am losing hope in the fight against my illness in the past 7 days [FACIT] |
| 70395-9 | I feel nervous in the past 7 days [FACIT] |
| 70396-7 | I worry about dying in the past 7 days [FACIT] |
| 70397-5 | I worry that my condition will get worse in the past 7 days [FACIT] |
| 70398-3 | I am able to work - include work at home - in the past 7 days [FACIT] |
| 70399-1 | My work - include work at home - is fulfilling in the past 7 days [FACIT] |
| 70400-7 | I am able to enjoy life in the past 7 days [FACIT] |
| 70401-5 | I have accepted my illness in the past 7 days [FACIT] |
| 70402-3 | I am sleeping well in the past 7 days [FACIT] |
| 70403-1 | I am enjoying the things I usually do for fun in the past 7 days [FACIT] |
| 70404-9 | I am content with the quality of my life right now in the past 7 days [FACIT] |
| 70405-6 | I have a lack of energy in the past 7 days [FACIT] |
| 70406-4 | I have nausea in the past 7 days [FACIT] |
| 70407-2 | Because of my physical condition, I have trouble meeting the needs of my family in the past 7 days [FACIT] |
| 70408-0 | I have pain in the past 7 days [FACIT] |
| 70409-8 | I am bothered by side effects of treatment in the past 7 days [FACIT] |
| 70410-6 | I feel ill in the past 7 days [FACIT] |
| 70411-4 | I am forced to spend time in bed in the past 7 days [FACIT] |
| 70412-2 | I feel close to my friends in the past 7 days [FACIT] |
| 70413-0 | I get emotional support from my family in the past 7 days [FACIT] |
| 70414-8 | I get support from my friends in the past 7 days [FACIT] |
| 70415-5 | My family has accepted my illness in the past 7 days [FACIT] |
| 70416-3 | I am satisfied with family communication about my illness in the past 7 days [FACIT] |
| 70417-1 | I feel close to my partner, or the person who is my main support, in the past 7 days [FACIT] |
| 70418-9 | I am satisfied with my sex life in the past 7 days [FACIT] |
| 70419-7 | I am unhappy about a change in my appearance in the past 7 days [FACIT] |
| 70420-5 | I am bothered by jaundice or yellow color to my skin in the past 7 days [FACIT] |
| 70421-3 | I have had fevers - episodes of high body temperature - in the past 7 days [FACIT] |
| 70422-1 | I have had a change in the way food tastes in the past 7 days [FACIT] |
| 70423-9 | I have had chills in the past 7 days [FACIT] |
| 70424-7 | I have discomfort or pain in my stomach area in the past 7 days [FACIT] |
| 70425-4 | I feel weak all over in the past 7 days [FACIT] |
| 70426-2 | I feel fatigued in the past 7 days [FACIT] |
| 70427-0 | I am able to eat the foods that I like in the past 7 days [FACIT] |
| 70428-8 | I am able to communicate with others in the past 7 days [FACIT] |
| 70429-6 | I can eat solid foods in the past 7 days [FACIT] |
| 70430-4 | I have pain in my mouth, throat or neck in the past 7 days [FACIT] |
| 70431-2 | My mouth is dry in the past 7 days [FACIT] |
| 70432-0 | I have trouble breathing in the past 7 days [FACIT] |
| 70433-8 | My voice has its usual quality and strength in the past 7 days [FACIT] |
| 70434-6 | I am able to eat as much food as I want in the past 7 days [FACIT] |
| 70435-3 | I am unhappy with how my face and neck look in the past 7 days [FACIT] |
| 70436-1 | I can swallow naturally and easily in the past 7 days [FACIT] |
| 70437-9 | I smoke cigarettes or other tobacco products in the past 7 days [FACIT] |
| 70438-7 | I drink alcohol - beer, wine, etc - in the past 7 days [FACIT] |
| 70439-5 | I have to limit my social activity because of my condition in the past 7 days [FACIT] |
| 70440-3 | I have to limit my physical activity because of my condition in the past 7 days [FACIT] |
| 70441-1 | My thinking is clear in the past 7 days [FACIT] |
| 70442-9 | I have been coughing in the past 7 days [FACIT] |
| 70443-7 | I feel tightness in my chest in the past 7 days [FACIT] |
| 70444-5 | Breathing is easy for me in the past 7 days [FACIT] |
| 70445-2 | I regret my smoking in the past 7 days [FACIT] |
| 70446-0 | I am bothered by lumps or swelling in certain part of my body - neck, armpits, or groin - in the past 7 days [FACIT] |
| 70447-8 | Because of my illness, I have difficulty planning for the future in the past 7 days [FACIT] |
| 70448-6 | I feel uncertain about my future health in the past 7 days [FACIT] |
| 70449-4 | I worry that I might get new symptoms of my illness in the past 7 days [FACIT] |
| 70450-2 | I feel isolated from others because of my illness or treatment in the past 7 days [FACIT] |
| 70451-0 | I am bothered by itching in the past 7 days [FACIT] |
| 70452-8 | I have trouble sleeping at night in the past 7 days [FACIT] |
| 70453-6 | I have pain at my melanoma site or surgical site in the past 7 days [FACIT] |
| 70454-4 | I have swelling at my melanoma site in the past 7 days [FACIT] |
| 70455-1 | I have swelling as a result of surgery in the past 7 days [FACIT] |
| 70456-9 | I am bothered by the amount of swelling in the past 7 days [FACIT] |
| 70457-7 | Movement of my swollen area is painful in the past 7 days [FACIT] |
| 70458-5 | Swelling keeps me from doing the things I want to do in the past 7 days [FACIT] |
| 70459-3 | Swelling keeps me from wearing clothes or shoes I want to wear in the past 7 days [FACIT] |
| 70460-1 | I feel numbness at my surgical site in the past 7 days [FACIT] |
| 70461-9 | I have good range of movement in my arm or leg in the past 7 days [FACIT] |
| 70462-7 | I have noticed new changes in my skin - lumps, bumps, color in the past 7 days [FACIT] |
| 70463-5 | I worry about the appearance of surgical scars in the past 7 days [FACIT] |
| 70464-3 | I have aches and pains in my bones in the past 7 days [FACIT] |
| 70465-0 | I have noticed blood in my stool in the past 7 days [FACIT] |
| 70466-8 | I isolate myself from others because of my condition in the past 7 days [FACIT] |
| 70467-6 | I have difficulty thinking clearly - remembering, concentrating - in the past 7 days [FACIT] |
| 70468-4 | I have trouble walking because of the pain in the past 7 days [FACIT] |
| 70469-2 | I feel overwhelmed by my condition in the past 7 days [FACIT] |
| 70470-0 | I worry about getting infections in the past 7 days [FACIT] |
| 70471-8 | I have difficulty moving my neck and shoulders because of stiffness in the past 7 days [FACIT] |
| 70472-6 | I am bothered by ringing in my ears in the past 7 days [FACIT] |
| 70473-4 | I am bothered by worsening eyesight in the past 7 days [FACIT] |
| 70474-2 | I have trouble smelling the in past 7 days [FACIT] |
| 70475-9 | I can enjoy the taste of food in the past 7 days [FACIT] |
| 70476-7 | I am bothered by having a blocked nose in the past 7 days [FACIT] |
| 70477-5 | I have trouble hearing in the past 7 days [FACIT] |
| 70478-3 | I have swelling in my stomach area in the past 7 days [FACIT] |
| 70479-1 | I have been vomiting in the past 7 days [FACIT] |
| 70480-9 | I have cramps in my stomach area in the past 7 days [FACIT] |
| 70481-7 | I have certain parts of my body where I experience pain in the past 7 days [FACIT] |
| 70482-5 | Do you have an ostomy appliance [FACIT] |
| 70483-3 | Have you ever smoked [FACIT] |
| 70484-1 | I bleed easily in the past 7 days [FACIT] |
| 70485-8 | I bruise easily in the past 7 days [FACIT] |
| 70486-6 | I am bothered by discharge or bleeding from my vulva in the past 7 days [FACIT] |
| 70487-4 | I am bothered by odor coming from my vulva in the past 7 days [FACIT] |
| 70488-2 | I am bothered by swelling, fluid in my legs, in the past 7 days [FACIT] |
| 70489-0 | I am bothered by discomfort in my groin or legs in the past 7 days [FACIT] |
| 70490-8 | I am bothered by itching - burning in my vulva area in the past 7 days [FACIT] |
| 70491-6 | I am bothered by pain or numbness in my vulva area in the past 7 days [FACIT] |
| 70492-4 | I have trouble bending in the past 7 days [FACIT] |
| 70493-2 | I have discomfort when I'm sitting in the past 7 days [FACIT] |
| 70494-0 | I am bothered by wearing compression stockings in the past 7 days [FACIT] |
| 70495-7 | Functional Assessment of Cancer Therapy - General Questionnaire - version 4 (FACT-G) [FACIT] |
| 70496-5 | Functional Assessment of Cancer Therapy for patients with breast cancer questionnaire - version 4 (FACT-B) [FACIT] |
| 70497-3 | Functional Assessment of Cancer Therapy for patients with bladder cancer questionnaire - version 4 (FACT-Bl) [FACIT] |
| 70498-1 | Physical well-being [FACIT] |
| 70499-9 | Social - family well-being [FACIT] |
| 70500-4 | Emotional well being [FACIT] |
| 70501-2 | Functional well-being [FACIT] |
| 70502-0 | Additional concerns [FACIT] |
| 70503-8 | Functional Assessment of Cancer Therapy for patients with brain cancer questionnaire - version 4 (FACT-Br) [FACIT] |
| 70504-6 | Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel |
| 70505-3 | Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel |
| 70506-1 | Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel |
| 70507-9 | Functional Assessment of Cancer Therapy for patients with colorectal cancer questionnaire - version 4 (FACT-C) [FACIT] |
| 70508-7 | Functional Assessment of Cancer Therapy for patients with cancer in the central nervous system questionnaire - version 4 (FACT-CNS) [FACIT] |
| 70509-5 | Functional Assessment of Cancer Therapy for patients with cancer of the cervix questionnaire - version 4 (FACT-Cx) [FACIT] |
| 70510-3 | Functional Assessment of Cancer Therapy for patients with esophageal cancer questionnaire - version 4 (FACT-E) [FACIT] |
| 70511-1 | Functional Assessment of Cancer Therapy for patients with endometrial cancer questionnaire - version 4 (FACT-En) [FACIT] |
| 70512-9 | Functional Assessment of Cancer Therapy for patients with gastric cancer questionnaire - version 4 (FACT-Ga) [FACIT] |
| 70513-7 | Functional Assessment of Cancer Therapy for patients with head and neck cancer questionnaire - version 4 (FACT H and N) [FACIT] |
| 70514-5 | Functional Assessment of Cancer Therapy for patients with hepatobiliary cancer - version 4 (FACT-Hep) [FACIT] |
| 70515-2 | Functional Assessment of Cancer Therapy for patients with lung cancer questionnaire - version 4 (FACT-L) [FACIT] |
| 70516-0 | Functional Assessment of Cancer Therapy for patients with leukemia questionnaire - version 4 (FACT-Leu) [FACIT] |
| 70517-8 | Functional Assessment of Cancer Therapy for patients with non-Hodgkins lymphoma questionnaire - version 4 (FACT-Lym) [FACIT] |
| 70518-6 | Functional Assessment of Cancer Therapy for patients with melanoma questionnaire - version 4 (FACT-M) [FACIT] |
| 70519-4 | Functional Assessment of Cancer Therapy for patient with multiple myeloma questionnaire - version 4 (FACT-MM) [FACIT] |
| 70520-2 | Functional Assessment of Cancer Therapy for patients with nasopharyngeal cancer questionnaire - version 4 (FACT-NP) [FACIT] |
| 70521-0 | Functional Assessment of Cancer Therapy for patients with ovarian cancer questionnaire - version 4 (FACT-O) [FACIT] |
| 70522-8 | Functional Assessment of Cancer Therapy for patients with vulva cancer questionnaire - version 4 (FACT-V) [FACIT] |
| 70523-6 | Functional Assessment of Cancer Therapy - General Population Questionnaire - version 4 (FACT-GP) [FACIT] |
| 70524-4 | Functional Assessment of Non-Life Threatening Conditions Questionnaire - version 4 (FANLTC) [FACIT] |
| 70525-1 | I have a feeling of fullness or heaviness in my stomach area in the past 7 days [FACIT] |
| 70526-9 | I have had itching in the past 7 days [FACIT] |
| 70527-7 | I am bothered by the chills in the past 7 days [FACIT] |
| 70528-5 | I get tired easily in the past 7 days [FACIT] |
| 70530-1 | I have trouble concentrating in the past 7 days [FACIT] |
| 70531-9 | I feel discouraged about my illness in the past 7 days [FACIT] |
| 70532-7 | Functional Assessment of Cancer Therapy - Prostate Symptom Index Questionnaire - 8 items (FAPSI-8) [FACIT] |
| 70533-5 | Functional Assessment of Cancer Therapy - Bladder Symptom Index Questionnaire - 7 items (FBlSI) [FACIT] |
| 70534-3 | National Comprehensive Cancer Network - Bladder Symptom Index Questionnaire - 18 items (NCCN-FBlSI-18) [FACIT] |
| 70535-0 | Functional Assessment of Cancer Therapy - Brain Symptom Index Questionnaire - 15 items [FACIT] |
| 70536-8 | National comprehensive cancer network - Brain Symptom Index Questionnaire - 24 items (NCCN-FACT - FBrSI-24) [FACIT] |
| 70537-6 | Functional Assessment of Cancer Therapy - Breast Symptom Index Questionnaire - 8 items (FBSI-8) [FACIT] |
| 70538-4 | National Comprehensive Cancer Network - Breast Symptom Index Questionnaire - 16 items (NCCN-FBSI-16) [FACIT] |
| 70539-2 | Functional Assessment of Cancer Therapy - Colorectal Symptom Index Questionnaire - 9 items (FCSI-9) [FACIT] |
| 70540-0 | National Comprehensive Cancer Network - Colorectal Symptom Index Questionnaire - 19 items (NCCN - FCSI-19) [FACIT] |
| 70541-8 | Functional Assessment of Cancer Therapy - Head and Neck Symptom Index Questionnaire - 10 items (FACIT - FHNSI) [FACIT] |
| 70542-6 | National Comprehensive Cancer Network - Head and Neck Symptom Index Questionnaire - 22 items (NCCN-FACT - FHNSI-22) [FACIT] |
| 70543-4 | Functional Assessment of Cancer Therapy - Hepatibiliary Symptom Index Questionnaire - 8 items (FACIT - FHSI-8) [FACIT] |
| 70544-2 | National Comprehensive Cancer Network - Hepatibiliary Symptom Index Questionnaire - 18 items (NCCN-FACT - FHSI-18) [FACIT] |
| 70545-9 | Functional Assessment of Chronic Illness Therapy for patients with kidney cancer questionnaire -15 items (FACIT - FKSI-15) |
| 70546-7 | Functional Assessment of Chronic Illness Therapy for patients with kidney cancer questionnaire -10 items (FACIT - FKSI-10) |
| 70547-5 | Functional Assessment of Chronic Illness Therapy for patients with kidney cancer - Disease Related Symptoms Questionnaire - 9 items (FACIT - FKSI-DRS 9) |
| 70548-3 | National Comprehensive Cancer Network - Kidney Symptom Index Questionnaire - 19 items (NCCN-FACT - FKSI-19) [FACIT] |
| 70549-1 | Functional Assessment of Cancer Therapy - Lung Symptom Index Questionnaire - 6 items - version 4 (FACT - FLSI 6) [FACIT] |
| 70550-9 | Functional Assessment of Cancer Therapy - Lung Symptom Index Questionnaire - 12 items - version 4 (FACIT - FLSI-12) [FACIT] |
| 70551-7 | Functional Assessment of Cancer Therapy - Lung Symptom Index Questionnaire - 7 items - version 4 (FACIT - FACT-LCS) [FACIT] |
| 70552-5 | National Comprehensive Cancer Network - Lung Symptom Index Questionnaire - 17 items (NCCN-FACT - FLSI-17) [FACIT] |
| 70553-3 | National Comprehensive Cancer Network - Lymphoma Symptom Index Questionnaire - 18 items (NCCN-FACT - FLymSI-18) [FACIT] |
| 70554-1 | Functional Assessment of Cancer Therapy - Ovarian Symptom Index Questionnaire - 8 items (FACIT-FOSI 8) [FACIT] |
| 70555-8 | National Comprehensive Cancer Network - Ovarian Symptom Index Questionnaire - 18 items (NCCN_FACT - FOSI 18) [FACIT] |
| 70557-4 | National Comprehensive Cancer Network - Prostate Symptom Index Questionnaire - 17 items (NCCN-FACT-FPSI 17) [FACIT] |
| 70558-2 | My pain keeps me from doing things I want to do in the past 7 days [FACIT] |
| 70559-0 | My problems with urinating limit my activities in the past 7 days [FACIT] |
| 70560-8 | I feel light-headed, dizzy in the past 7 days [FACIT] |
| 70561-6 | I have mouth sores in the past 7 days [FACIT] |
| 70562-4 | I have numbness or tingling in my hands in the past 7 days [FACIT] |
| 70563-2 | I have pain in my hands or feet when I am exposed to cold temperatures in the past 7 days [FACIT] |
| 70564-0 | I have had blood in my urine in the past 7 days [FACIT] |
| 70565-7 | I am bothered by skin problems in the past 7 days [FACIT] |
| 70566-5 | I have difficulty urinating in the past 7 days [FACIT] |
| 70567-3 | I have trouble moving my bowels in the past 7 days [FACIT] |
| 70570-7 | I have weakness in my legs in the past 7 days [FACIT] |
| 70571-5 | Functional Assessment of Chronic Illness Therapy - Bone treatment convenience and satisfaction questionnaire - version 1 (FACIT-TS-BTCSQ) |
| 70572-3 | I believe that treatment for bone disease will take up my time [FACIT] |
| 70573-1 | I believe that my treatment for bone disease will take up my family's time [FACIT] |
| 70574-9 | I worry about side effects from treatment for bone disease [FACIT] |
| 70575-6 | I believe that my treatment for bone disease will cause me physical pain [FACIT] |
| 70576-4 | I believe that receiving treatment for bone disease will be inconvenient [FACIT] |
| 70577-2 | I worry that my treatment for bone disease will not be effective [FACIT] |
| 70578-0 | I believe that treatment for bone disease will be harmful to me [FACIT] |
| 70579-8 | I believe that my treatment schedule for bone disease will be stressful to me [FACIT] |
| 70580-6 | I believe that my treatment schedule for bone disease will be stressful to my family [FACIT] |
| 70581-4 | I believe that I will be bothered by side effects of treatment for bone disease [FACIT] |
| 70582-2 | I believe that waiting up to 60 minutes before eating breakfast in the morning will be inconvenient [FACIT] |
| 70583-0 | I believe that an infusion for my bone treatment will cause me physical pain [FACIT] |
| 70584-8 | I believe that having my blood drawn will be inconvenient [FACIT] |
| 70585-5 | Functional Assessment of Cancer Therapy for patients receiving enteral feeding questionnaire - version 1 (FACT-EF) [FACIT] |
| 70586-3 | I experience a pleasant feeling of fullness during or after my tube feeding in the past 7 days [FACIT] |
| 70587-1 | I feel uncomfortably full during or after my tube feeding in the past 7 days [FACIT] |
| 70588-9 | I have constipation during or after my tube feeding in the past 7 days [FACIT] |
| 70589-7 | I experience vomiting during or after my tube feeding in the past 7 days [FACIT] |
| 70590-5 | Tube feeding limits what I can do inside the house - for example housework, watching TV or reading - in the past 7 days [FACIT] |
| 70591-3 | Tube feeding limits what I can do outside of the house - for example shopping, driving or yard work - in the past 7 days [FACIT] |
| 70592-1 | Tube feeding limits my activities with my friends in the past 7 days [FACIT] |
| 70593-9 | During the use of tube feeding, I can eat and drink by mouth in the past 7 days [FACIT] |
| 70594-7 | I miss being able to take more food or drink by mouth now that I have a feeding tube in the past 7 days [FACIT] |
| 70595-4 | I have the desire to eat in the past 7 days [FACIT] |
| 70596-2 | I worry that having a feeding tube means my health is worse in the past 7 days [FACIT] |
| 70597-0 | I worry about the tube coming out by accident in the past 7 days [FACIT] |
| 70598-8 | I worry about the tube getting plugged or blocked in the past 7 days [FACIT] |
| 70599-6 | I worry about getting an infection from the feeding tube in the past 7 days [FACIT] |
| 70600-2 | I worry about losing weight because I have a feeding tube in the past 7 days [FACIT] |
| 70601-0 | I feel that I have lost control of my food choices because I have a feeding tube in the past 7 days [FACIT] |
| 70602-8 | I feel dependent on others because I have a feeding tube in the past 7 days [FACIT] |
| 70603-6 | I feel left out when others are eating in the past 7 days [FACIT] |
| 70604-4 | I am more confident about my nutrition because of my feeding tube in the past 7 days [FACIT] |
| 70605-1 | Getting a feeding tube was the right decision for me in the past 7 days [FACIT] |
| 70606-9 | Functional Assessment of Cancer Therapy for patients with EGFRI inhibitors questionnaire - 18 items (FACT-EGFRI-18) [FACIT] |
| 70607-7 | My skin or scalp feels irritated in the past 7 days [FACIT] |
| 70608-5 | My skin or scalp is dry or flaky in the past 7 days [FACIT] |
| 70609-3 | My skin or scalp itches in the past 7 days [FACIT] |
| 70610-1 | My skin bleeds easily in the past 7 days [FACIT] |
| 70611-9 | I am bothered by a change in my skins sensitivity to the sun in the past 7 days [FACIT] |
| 70612-7 | My skin condition interferes with my ability to sleep in the past 7 days [FACIT] |
| 70613-5 | My skin condition affects my mood in the past 7 days [FACIT] |
| 70614-3 | My skin condition interferes with my social life in the past 7 days [FACIT] |
| 70615-0 | I am embarrassed by my skin condition in the past 7 days [FACIT] |
| 70616-8 | I avoid going out in public because of how my skin looks in the past 7 days [FACIT] |
| 70617-6 | I feel unattractive because of how my skin looks in the past 7 days [FACIT] |
| 70618-4 | Changes in my skin condition make daily life difficult in the past 7 days [FACIT] |
| 70619-2 | The skin side effects from treatment have interfered with household tasks in the past 7 days [FACIT] |
| 70620-0 | My eyes are dry in the past 7 days [FACIT] |
| 70621-8 | I am bothered by sensitivity around my fingernails or toenails in the past 7 days [FACIT] |
| 70622-6 | Sensitivity around my fingernails makes it difficult to perform household tasks in the past 7 days [FACIT] |
| 70623-4 | I am bothered by increased facial hair in the past 7 days [FACIT] |
| 70624-2 | Functional Assessment of Cancer Therapy for patients with neurotoxicity questionnaire - version 4 (FACT-GOG-NTX) [FACIT] |
| 70625-9 | I have numbness or tingling in my feet in the past 7 days [FACIT] |
| 70626-7 | I feel discomfort in my hands in the past 7 days [FACIT] |
| 70627-5 | I feel discomfort in my feet in the past 7 days [FACIT] |
| 70628-3 | I have joint pain or muscle cramps in the past 7 days [FACIT] |
| 70629-1 | I get a ringing or buzzing in my ears in the past 7 days [FACIT] |
| 70630-9 | I have trouble buttoning buttons in the past 7 days [FACIT] |
| 70631-7 | I have trouble feeling the shape of small objects when they are in my hand in the past 7 days [FACIT] |
| 70632-5 | I have trouble walking in the past 7 days [FACIT] |
| 70633-3 | Functional Assessment of Cancer Therapy for patients with neurotoxicity questionnaire - 12 items - version 4 (FACT-GOG-NTX 12) [FACIT] |
| 70634-1 | I have difficulty breathing when I am exposed to cold temperatures in the past 7 days [FACIT] |
| 70635-8 | Functional Assessment of Cancer Therapy for patients with neurotoxicity questionnaire - 13 items - version 4 (FACT-GOG-NTX 13) [FACIT] |
| 70636-6 | Functional Assessment of Cancer Therapy for patients with neurotoxicity questionnaire - 4 items - version 4 (FACT-GOG-NTX-4) [FACIT] |
| 70637-4 | Functional Assessment of Cancer Therapy for patients undergoing bone marrow transplantation questionnaire - version 4 (FACT-BMT) [FACIT] |
| 70638-2 | I am concerned about keeping my job - include work at home - in the past 7 days [FACIT] |
| 70639-0 | I feel distant from other people in the past 7 days [FACIT] |
| 70640-8 | I worry that the transplant will not work in the past 7 days [FACIT] |
| 70641-6 | The effects of treatment are worse than I had imagined in the past 7 days [FACIT] |
| 70642-4 | I have confidence in my nurse-s in the past 7 days [FACIT] |
| 70643-2 | I regret having the bone marrow transplant in the past 7 days [FACIT] |
| 70644-0 | I have frequent colds-infections in the past 7 days [FACIT] |
| 70645-7 | My eyesight is blurry in the past 7 days [FACIT] |
| 70646-5 | I have tremors in the past 7 days [FACIT] |
| 70647-3 | My illness is a personal hardship for my close family members in the past 7 days [FACIT] |
| 70648-1 | The cost of my treatment is a burden on me or my family in the past 7 days [FACIT] |
| 70649-9 | Functional Assessment of Cancer Therapy for patients receiving biologic response modifiers questionnaire - version 4 (FACT-BRM) [FACIT] |
| 70650-7 | I am bothered by sweating in the past 7 days [FACIT] |
| 70651-5 | I have trouble remembering things in the past 7 days [FACIT] |
| 70652-3 | I get depressed easily in the past 7 days [FACIT] |
| 70653-1 | I get annoyed easily in the past 7 days [FACIT] |
| 70654-9 | I feel motivated to do things in the past 7 days [FACIT] |
| 70655-6 | Functional Assessment of Cancer Therapy - Taxane Questionnaire - version 4 (FACT-Taxane) [FACIT] |
| 70656-4 | I feel bloated in the past 7 days [FACIT] |
| 70657-2 | My hands are swollen in the past 7 days [FACIT] |
| 70658-0 | My legs or feet are swollen in the past 7 days [FACIT] |
| 70659-8 | I have pain in my fingertips in the past 7 days [FACIT] |
| 70660-6 | I am bothered by the way my hands or nails look in the past 7 days [FACIT] |
| 70663-0 | I can remember things in the past 7 days [FACIT] |
| 70668-9 | I am bothered by a change in the way food tastes in the past 7 days [FACIT] |
| 70669-7 | I have trouble with my bowels in the past 7 days [FACIT] |
| 70670-5 | I have pain in my joints in the past 7 days [FACIT] |
| 70672-1 | Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel |
| 70673-9 | Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel |
| 70674-7 | Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel |
| 70675-4 | Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel |
| 70676-2 | Functional Assessment of Anorexia-Cachexia Treatment Questionnaire - version 4 (FAACT) [FACIT] |
| 70677-0 | The amount I eat is sufficient to meet my needs in the past 7 days [FACIT] |
| 70678-8 | I am worried about my weight in the past 7 days [FACIT] |
| 70679-6 | Most food tastes unpleasant to me in the past 7 days [FACIT] |
| 70680-4 | I am concerned about how thin I look in the past 7 days [FACIT] |
| 70681-2 | My interest in food drops as soon as I try to eat in the past 7 days [FACIT] |
| 70682-0 | I have difficulty eating rich or heavy foods in the past 7 days [FACIT] |
| 70683-8 | My family or friends are pressuring me to eat in the past 7 days [FACIT] |
| 70684-6 | When I eat, I seem to get full quickly in the past 7 days [FACIT] |
| 70685-3 | My general health is improving in the past 7 days [FACIT] |
| 70686-1 | Functional Assessment of Chronic Illness Therapy for patients with abdominal symptoms questionnaire - version 4 (FACIT-AD) |
| 70687-9 | Stomach pain interferes with my daily functioning in the past 7 days [FACIT] |
| 70688-7 | Functional Assessment of Chronic Illness Therapy for patients with ascites questionnaire (FACIT-AI) |
| 70689-5 | I have been emotionally distressed in the past 7 days [FACIT] |
| 70690-3 | Functional Assessment of Chronic Illness Therapy for patients with cervical dysplasia questionnaire - version 4 (FACIT-CD) |
| 70691-1 | Treatment satisfaction [FACIT] |
| 70692-9 | General perceptions [FACIT] |
| 70693-7 | Relationships [FACIT] |
| 70694-5 | I have to limit my sexual activity because of the infection in the past 7 days [FACIT] |
| 70695-2 | I worry about spreading the infection in the past 7 days [FACIT] |
| 70696-0 | I am hopeful about the future in the past 7 days [FACIT] |
| 70697-8 | I find comfort in my faith or spiritual beliefs in the past 7 days [FACIT] |
| 70698-6 | I feel that I can manage things that come up around this infection in the past 7 days [FACIT] |
| 70699-4 | I have accepted that I have this infection in the past 7 days [FACIT] |
| 70700-0 | I worry that the infection will get worse in the past 7 days [FACIT] |
| 70701-8 | I have hidden this problem so others will not notice in the past 7 days [FACIT] |
| 70702-6 | I have concerns about my ability to become pregnant in the past 7 days [FACIT] |
| 70703-4 | I worry about other peoples attitudes towards me in the past 7 days [FACIT] |
| 70704-2 | I feel embarrassed about the infection in the past 7 days [FACIT] |
| 70705-9 | I tend to blame myself for the infection in the past 7 days [FACIT] |
| 70706-7 | I was careful who I told about the infection in the past 7 days [FACIT] |
| 70707-5 | I have had difficulty telling my partner - spouse about the infection in the past 7 days [FACIT] |
| 70708-3 | I am frustrated by the infection in the past 7 days [FACIT] |
| 70709-1 | I am depressed about the infection in the past 7 days [FACIT] |
| 70710-9 | I have told my partner - spouse about my infection in the past 7 days [FACIT] |
| 70711-7 | I get emotional support from my partner - spouse in the past 7 days [FACIT] |
| 70712-5 | I have told family members about my infection in the past 7 days [FACIT] |
| 70713-3 | I get emotional support from family members in the past 7 days [FACIT] |
| 70714-1 | I have people to help me if I need it in the past 7 days [FACIT] |
| 70715-8 | Functional Assessment of Chronic Illness Therapy-Diarrhea Questionnaire - version 4 (FACIT-D) |
| 70716-6 | I move my bowels more frequently than usual in the past 7 days [FACIT] |
| 70717-4 | I am afraid to be far from a toilet in the past 7 days [FACIT] |
| 70718-2 | I have to limit my social activity because of diarrhea in the past 7 days [FACIT] |
| 70719-0 | I have to limit my physical activity because of diarrhea in the past 7 days [FACIT] |
| 70720-8 | I have to limit my sexual activity because of diarrhea in the past 7 days [FACIT] |
| 70721-6 | I am embarrassed by having diarrhea in the past 7 days [FACIT] |
| 70722-4 | I have abdominal cramps or discomfort due to my diarrhea in the past 7 days [FACIT] |
| 70723-2 | My problem with diarrhea keeps - wakes - me up at night in the past 7 days [FACIT] |
| 70724-0 | I must move my bowels frequently to avoid accidents in the past 7 days [FACIT] |
| 70725-7 | I wear protection for soiling of stool in the past 7 days [FACIT] |
| 70726-5 | Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire - version 4 (FACIT-F) |
| 70727-3 | I feel listless - washed out - in the past 7 days [FACIT] |
| 70728-1 | I have trouble starting things because I am tired in the past 7 days [FACIT] |
| 70729-9 | I have trouble finishing things because I am tired in the past 7 days [FACIT] |
| 70730-7 | I have energy in the past 7 days [FACIT] |
| 70731-5 | I need to sleep during the day in the past 7 days [FACIT] |
| 70732-3 | I am too tired to eat in the past 7 days [FACIT] |
| 70733-1 | I am frustrated by being too tired to do the things I want to do in the past 7 days [FACIT] |
| 70734-9 | I have to limit my social activity because I am tired in the past 7 days [FACIT] |
| 70735-6 | Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire -13 items - version 4 (FACIT - fatigue 13) |
| 70736-4 | Functional Assessment of Cancer Therapy for patients with anemia - fatigue questionnaire - version 4 (FACT-An) [FACIT] |
| 70737-2 | I have pain in my chest in the past 7 days [FACIT] |
| 70738-0 | I am motivated to do my usual activities in the past 7 days [FACIT] |
| 70739-8 | Functional Assessment of Cancer Therapy for Patients with lymphedema questionnaire - version 4 (FACT-B + 4) [FACIT] |
| 70740-6 | On which side was your breast operation [FACIT] |
| 70741-4 | Movement of my arm on this side is painful in the past 7 days [FACIT] |
| 70742-2 | I have a poor range of arm movements on this side in the past 7 days [FACIT] |
| 70743-0 | My arm on this side feels numb in the past 7 days [FACIT] |
| 70744-8 | I have stiffness of my arm on this side in the past 7 days [FACIT] |
| 70745-5 | Functional Assessment of Cancer Therapy for patients with bone pain questionnaire (FACT-BP) [FACIT] |
| 70746-3 | In how many places in your body have you felt bone pain [FACIT] |
| 70747-1 | It hurts when I put weight or pressure on the place where I have bone pain in the past 7 days [FACIT] |
| 70748-9 | I have bone pain even when I sit or lie still in the past 7 days [FACIT] |
| 70749-7 | I need help doing my usual activities because of bone pain in the past 7 days [FACIT] |
| 70750-5 | I am forced to rest during the day because of bone pain in the past 7 days [FACIT] |
| 70751-3 | I have trouble walking because of bone pain in the past 7 days [FACIT] |
| 70752-1 | Bone pain interferes with my ability to care for myself - bathing, dressing, eating, etc - in the past 7 days [FACIT] |
| 70753-9 | Bone pain interferes with my social activities in the past 7 days [FACIT] |
| 70754-7 | Bone pain wakes me up at night in the past 7 days [FACIT] |
| 70755-4 | I am frustrated by my bone pain in the past 7 days [FACIT] |
| 70756-2 | I feel depressed about my bone pain in the past 7 days [FACIT] |
| 70757-0 | I worry that my bone pain will get worse in the past 7 days [FACIT] |
| 70758-8 | My family has trouble understanding when my bone pain interferes with my activity in the past 7 days [FACIT] |
| 70759-6 | Functional Assessment of Cancer Therapy for patients with cognitive function issues questionnaire - version 3 (FACT-Cog) [FACIT] |
| 70760-4 | I have had trouble forming thoughts in the past 7 days [FACIT] |
| 70761-2 | My thinking has been slow in the past 7 days [FACIT] |
| 70762-0 | I have had trouble concentrating in the past 7 days [FACIT] |
| 70763-8 | I have had trouble finding my way to a familiar place in the past 7 days [FACIT] |
| 70764-6 | I have had trouble remembering where I put things, like my keys or my wallet in the past 7 days [FACIT] |
| 70765-3 | I have had trouble remembering new information, like phone numbers or simple instructions in the past 7 days [FACIT] |
| 70766-1 | I have had trouble recalling the name of an object while talking to someone in the past 7 days [FACIT] |
| 70767-9 | I have had trouble finding the right words to express myself in the past 7 days [FACIT] |
| 70768-7 | I have used the wrong word when I referred to an object in the past 7 days [FACIT] |
| 70769-5 | I have had trouble saying what I mean in conversations with others in the past 7 days [FACIT] |
| 70770-3 | I have walked into a room and forgotten what I meant to get or do there in the past 7 days [FACIT] |
| 70771-1 | I have had to work really hard to pay attention or I would make a mistake in the past 7 days [FACIT] |
| 70772-9 | I have forgotten names of people soon after being introduced in the past 7 days [FACIT] |
| 70773-7 | My reactions in everyday situations have been slow in the past 7 days [FACIT] |
| 70774-5 | Comments from others [FACIT] |
| 70775-2 | Other people have told me I seemed to have trouble remembering information in the past 7 days [FACIT] |
| 70776-0 | I have had to work harder than usual to keep track of what I was doing in the past 7 days [FACIT] |
| 70777-8 | My thinking has been slower than usual in the past 7 days [FACIT] |
| 70778-6 | I have had to work harder than usual to express myself clearly in the past 7 days [FACIT] |
| 70779-4 | I have had to use written lists more often than usual so I would not forget things in the past 7 days [FACIT] |
| 70780-2 | I have trouble keeping track of what I am doing if I am interrupted in the past 7 days [FACIT] |
| 70781-0 | I have trouble shifting back and forth between different activities that require thinking in the past 7 days [FACIT] |
| 70782-8 | Other people have told me I seemed to have trouble speaking clearly in the past 7 days [FACIT] |
| 70783-6 | Other people have told me I seemed to have trouble thinking clearly in the past 7 days [FACIT] |
| 70784-4 | Other people have told me I seemed confused in the past 7 days [FACIT] |
| 70785-1 | Perceived cognitive abilities [FACIT] |
| 70786-9 | I have been able to concentrate in the past 7 days [FACIT] |
| 70787-7 | I have been able to bring to mind words that I wanted to use while talking to someone in the past 7 days [FACIT] |
| 70788-5 | I have been able to remember things, like where I left my keys or wallet, in the past 7 days [FACIT] |
| 70789-3 | I have been able to remember to do things, like take medicine or buy something I needed, in the past 7 days [FACIT] |
| 70790-1 | I am able to pay attention and keep track of what I am doing without extra effort in the past 7 days [FACIT] |
| 70791-9 | My mind is as sharp as it has always been in the past 7 days [FACIT] |
| 70792-7 | My memory is as good as it has always been in the past 7 days [FACIT] |
| 70793-5 | I am able to shift back and forth between two activities that require thinking in the past 7 days [FACIT] |
| 70794-3 | I am able to keep track of what I am doing, even if I am interrupted in the past 7 days [FACIT] |
| 70795-0 | Impact on quality of life [FACIT] |
| 70796-8 | I have been upset about these problems in the past 7 days [FACIT] |
| 70797-6 | These problems have interfered with my ability to work in the past 7 days [FACIT] |
| 70798-4 | These problems have interfered with my ability to do things I enjoy in the past 7 days [FACIT] |
| 70799-2 | These problems have interfered with the quality of my life in the past 7 days [FACIT] |
| 70800-8 | Functional Assessment of Cancer Therapy for patients with endocrine symptoms questionnaire - version 4 (FACT-ES) [FACIT] |
| 70801-6 | I have vaginal itching - irritation - in the past 7 days [FACIT] |
| 70802-4 | I have vaginal dryness in the past 7 days [FACIT] |
| 70803-2 | I have lost interest in sex in the past 7 days [FACIT] |
| 70804-0 | I have breast sensitivity - tenderness - in the past 7 days [FACIT] |
| 70805-7 | I have mood swings in the past 7 days [FACIT] |
| 70806-5 | I am irritable in the past 7 days [FACIT] |
| 70807-3 | Functional assessment of cancer therapy for patients with neutropenia questionnaire - version 4 (FACT-N) [FACIT] |
| 70808-1 | I worry about getting sick due to low blood counts in the past 7 days [FACIT] |
| 70809-9 | I avoid public places for fear of getting an infection in the past 7 days [FACIT] |
| 70810-7 | I get aches and pains that bother me in the past 7 days [FACIT] |
| 70811-5 | I worry my condition will not improve if my treatment is delayed in the past 7 days [FACIT] |
| 70812-3 | My partner worries about me when my blood counts are low in the past 7 days [FACIT] |
| 70813-1 | My low blood counts interfere with my intimate relationships in the past 7 days [FACIT] |
| 70814-9 | I am bothered by headaches in the past 7 days [FACIT] |
| 70815-6 | I need to rest during the day in the past 7 days [FACIT] |
| 70816-4 | Functional Assessment of Cancer Therapy for patients with thrombocytopenia questionnaire -11 items - version 4 (FACT-Th11) [FACIT] |
| 70817-2 | I worry about problems with bruising or bleeding in the past 7 days [FACIT] |
| 70818-0 | I am bothered by nosebleeds in the past 7 days [FACIT] |
| 70819-8 | I am bothered by pinpoint bruising beneath my skin in the past 7 days [FACIT] |
| 70820-6 | I am bothered by blood in my urine or stool in the past 7 days [FACIT] |
| 70821-4 | I avoid or limit physical activity, because of concern with bleeding or bruising, in the past 7 days [FACIT] |
| 70822-2 | I am frustrated by not being able to do my usual activities in the past 7 days [FACIT] |
| 70823-0 | I worry that my treatment will be delayed, because of low blood counts, in the past 7 days [FACIT] |
| 70824-8 | Functional Assessment of Cancer Therapy for patients with thrombocytopenia questionnaire -18 items - version 4 (FACT-Th18) [FACIT] |
| 70825-5 | I worry about the possibility of serious bleeding in the past 7 days [FACIT] |
| 70826-3 | I am bothered by bleeding in my gums or mouth in the past 7 days [FACIT] |
| 70827-1 | I am inconvenienced by platelet transfusions in the past 7 days [FACIT] |
| 70828-9 | I avoid or limit social activity, because of concern with bleeding or bruising, in the past 7 days [FACIT] |
| 70829-7 | I worry that my treatment dose will be reduced, because of low blood counts, in the past 7 days [FACIT] |
| 70830-5 | For women only - I am bothered by vaginal bleeding in the past 7 days [FACIT] |
| 70831-3 | Functional Assessment of Incontinence Therapy - Fecal Questionnaire - version 4 ( [FACIT] |
| 70832-1 | I am comfortable discussing my condition with friends in the past 7 days [FACIT] |
| 70833-9 | I have to limit my sexual activity because of my condition in the past 7 days [FACIT] |
| 70834-7 | I am embarrassed by my condition in the past 7 days [FACIT] |
| 70835-4 | My condition wakes or keeps me up at night in the past 7 days [FACIT] |
| 70836-2 | I can be far from home - work without fearing soilage in the past 7 days [FACIT] |
| 70837-0 | Functional Assessment of Incontinence Therapy - Urinary Questionnaire - version 4 (FAIT-U) [FACIT] |
| 70838-8 | My condition wakes me up at night in the past 7 days [FACIT] |
| 70839-6 | I must urinate frequently to avoid leaking in the past 7 days [FACIT] |
| 70840-4 | I wear protection for leakage of urine in the past 7 days [FACIT] |
| 70841-2 | I have discomfort in my pelvic area in the past 7 days [FACIT] |
| 70842-0 | I have pain in my pelvic area in the past 7 days [FACIT] |
| 70843-8 | I have cramping in my pelvic area in the past 7 days [FACIT] |
| 70844-6 | Are you sexually active or would you like to be sexually active [FACIT] |
| 70845-3 | I have confidence in my doctors in the past 7 days [FACIT] |
| 70846-1 | I feel that I received the treatment that was right for me in the past 7 days [FACIT] |
| 70847-9 | My doctor gave me explanations that I could understand in the past 7 days [FACIT] |
| 70848-7 | My doctor explained the possible benefits of my treatment in the past 7 days [FACIT] |
| 70849-5 | Perceived cognitive impairments [FACIT] |
| 70868-5 | Additional concerns - FACT-B [FACIT] |
| 70869-3 | Additional concerns - FACT-Bl [FACIT] |
| 70870-1 | Additional concerns - FACT-Br [FACIT] |
| 70871-9 | Additional concerns - FACT-C [FACIT] |
| 70872-7 | Additional concerns - FACT-CNS [FACIT] |
| 70873-5 | Additional concerns - FACT-Cx [FACIT] |
| 70874-3 | Additional concerns - FACT-E [FACIT] |
| 70875-0 | Additional concerns - FACT-En [FACIT] |
| 70876-8 | Additional concerns - FACT-Ga [FACIT] |
| 70877-6 | Additional concerns - FACT-Hep [FACIT] |
| 70878-4 | Additional concerns - FACT-H and N [FACIT] |
| 70879-2 | Additional concerns - FACT-L [FACIT] |
| 70880-0 | Additional concerns - FACT-Leu [FACIT] |
| 70881-8 | Additional concerns - FACT-Lym [FACIT] |
| 70882-6 | Additional concerns - FACT-M [FACIT] |
| 70883-4 | Additional concerns - FACT-MM [FACIT] |
| 70884-2 | Additional concerns - FACT-NP [FACIT] |
| 70885-9 | Additional concerns - FACT-O [FACIT] |
| 70886-7 | Additional concerns - FACT-V [FACIT] |
| 70887-5 | Additional concerns - FACT-GOG-NTX [FACIT] |
| 70888-3 | Additional concerns - FACT-GOG-NTX-12 [FACIT] |
| 70889-1 | Additional concerns - FACT-GOG-NTX-13 [FACIT] |
| 70890-9 | Additional concerns - FACT-BMT [FACIT] |
| 70891-7 | Additional concerns - FACT-BRM [FACIT] |
| 70892-5 | Additional concerns - FACT-Taxane [FACIT] |
| 70893-3 | Additional concerns - FAACT [FACIT] |
| 70894-1 | Additional concerns - FACIT-D [FACIT] |
| 70895-8 | Additional concerns - FACIT-F [FACIT] |
| 70896-6 | Additional concerns - FACT-An [FACIT] |
| 70897-4 | Additional concerns - FACT-B+4 [FACIT] |
| 70898-2 | Additional concerns - FACT-ES [FACIT] |
| 70899-0 | Additional concerns - FACT-N [FACIT] |
| 70900-6 | Additional concerns - FACT-Th11 [FACIT] |
| 70901-4 | Additional concerns - FACT-Th18 [FACIT] |
| 70902-2 | Additional concerns - FAIT-F [FACIT] |
| 70903-0 | Additional concerns - FAIT-U [FACIT] |
| 70904-8 | Additional concerns - FACIT-AD [FACIT] |
| 70905-5 | Physical well-being - FACIT-CD [FACIT] |
| 70906-3 | Emotional well being - FACIT-CD [FACIT] |
| 70912-1 | Additional concerns - physical [FACIT] |
| 70913-9 | Additional concerns - mental [FACIT] |
| 70914-7 | Would you like to answer the question referring to your sex life [FACIT] |
| 70950-1 | Residual renal function testing performed [ESRD] |
| 70951-9 | Interdialytic time [ESRD] |
| 70952-7 | Date of peritoneal dialysis adequacy measurement [ESRD] |
| 70953-5 | Body surface area measurement method |
| 70954-3 | Standard process followed for residual renal function assessed in calculating Kt/V [ESRD] |
| 70955-0 | Prescription changed following the peritoneal dialysis adequacy measurement [ESRD] |
| 70956-8 | Minutes of hemodialysis completed when BUN drawn [ESRD] |
| 70957-6 | Creatinine clearance corrected for body surface area using standard methods [ESRD] |
| 70958-4 | Dialysis method [ESRD] |
| 70959-2 | Protein catabolic rate adjusted for body weight based on Serum or Plasma [Calculated] |
| 70960-0 | Kt/V.Peritoneal Dialysis |
| 70961-8 | Kt/V.Hemodialysis |
| 70962-6 | Body weight Measured --at peritoneal dialysis adequacy measurement |
| 70963-4 | Kt/V.Peritoneal Dialysis [Hume] |
| 70964-2 | Kt/V.Peritoneal Dialysis [Watson] |
| 70965-9 | Kt/V.Hemodialysis [Daugirdas II] |
| 70966-7 | Kt/V.Hemodialysis [UKM] |
| 70967-5 | Motor arm Right arm [NIH Stroke Scale] |
| 70968-3 | Motor leg Leg - right [NIH Stroke Scale] |
| 70971-7 | How short of breath did you get dressing yourself without help in the past 7 days [FACIT] |
| 70972-5 | How short of breath did you get walking 50 steps-paces on flat ground at a normal speed without stopping in the past 7 days [FACIT] |
| 70973-3 | How short of breath did you get walking up 20 stairs - 2 flights - without stopping in the past 7 days [FACIT] |
| 70974-1 | How short of breath did you get preparing meals in the past 7 days [FACIT] |
| 70975-8 | How short of breath did you get washing dishes in the past 7 days [FACIT] |
| 70976-6 | How short of breath did you get sweeping or mopping in the past 7 days [FACIT] |
| 70977-4 | How short of breath did you get making a bed in the past 7 days [FACIT] |
| 70978-2 | How short of breath did you get lifting something weighing 10-20 lbs, about 4.5-9kg , like a large bag of groceries, in the past 7 days [FACIT] |
| 70979-0 | How short of breath did you get carrying something weighing 10-20 lbs, about 4.5-9kg, like a large bag of groceries, from one room to another in the past 7 days [FACIT] |
| 70980-8 | How short of breath did you get walking faster than your usual speed for half a mile, almost 1 km, without stopping in the past 7 days [FACIT] |
| 70981-6 | Why you did not do this in the past 7 days [FACIT] |
| 70982-4 | Functional Assessment of Chronic Illness Therapy - Dyspnea Questionnaire - 10 items (FACIT-Dyspnea - 10) |
| 70983-2 | Functional Assessment of Chronic Illness Therapy - Dyspnea Questionnaire - 33 items (FACIT-Dyspnea - 33) |
| 70984-0 | How short of breath did you get taking a bath without help in the past 7 days [FACIT] |
| 70985-7 | How short of breath did you get taking a shower in the past 7 days [FACIT] |
| 70986-5 | How short of breath did you get putting on socks or stockings in the past 7 days [FACIT] |
| 70987-3 | How short of breath did you get standing for at least 5 minutes in the past 7 days [FACIT] |
| 70988-1 | How short of breath did you get walking 10 steps - paces on flat ground at a normal speed without stopping in the past 7 days [FACIT] |
| 70989-9 | How short of breath did you get walking half a mile, almost 1 km, on flat ground at a normal speed, without stopping in the past 7 days [FACIT] |
| 70990-7 | How short of breath did you get walking up 5 stairs without stopping in the past 7 days [FACIT] |
| 70991-5 | How short of breath did you get walking up 10 stairs, 1 flight, without stopping in the past 7 days [FACIT] |
| 70992-3 | How short of breath did you get walking up 30 stairs, 3 flights, without stopping in the past 7 days [FACIT] |
| 70993-1 | How short of breath did you get lifting something weighing less than 5 lbs, about 2 kg, like a houseplant, in the past 7 days [FACIT] |
| 70994-9 | How short of breath did you get lifting something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes in the past 7 days [FACIT] |
| 70995-6 | How short of breath did you get lifting something weighing more than 20 lbs, about 9 kg, like a medium-sized suitcase in the past 7 days [FACIT] |
| 70996-4 | How short of breath did you get carrying something weighing less than 5 lbs, about 2 kg, like a houseplant, from one room to another in the past 7 days [FACIT] |
| 70997-2 | How short of breath did you get carrying something weighing 5-10 lbs, about 2-4.5 kg, like a basket of clothes, from one room to another in the past 7 days [FACIT] |
| 70998-0 | How short of breath did you get getting in or out of a car in the past 7 days [FACIT] |
| 70999-8 | How short of breath did you get dining out in the past 7 days [FACIT] |
| 71000-4 | How short of breath did you get low-intensity leisure activity - gardening, etc, in the past 7 days [FACIT] |
| 71001-2 | How short of breath did you get moderate-intensity leisure activity - bicycling on level terrain, etc, in the past 7 days [FACIT] |
| 71002-0 | How short of breath did you get walking, faster than your usual speed, for 50 steps without stopping in the past 7 days [FACIT] |
| 71003-8 | How short of breath did you get walking, faster than your usual speed, for at least 1 mile, a little more than 1.5 km, without stopping in the past 7 days [FACIT] |
| 71004-6 | How short of breath did you get singing or humming in the past 7 days [FACIT] |
| 71005-3 | How short of breath did you get talking while walking in the past 7 days [FACIT] |
| 71006-1 | How short of breath did you get scrubbing the floor or counter in the past 7 days [FACIT] |
| 71007-9 | Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal) |
| 71008-7 | Additional concerns - FACIT-Pal [FACIT] |
| 71009-5 | I maintain contact with my friends in the past 7 days [FACIT] |
| 71010-3 | I have family members who will take on my responsibilities in the past 7 days [FACIT] |
| 71011-1 | I feel that my family appreciates me in the past 7 days [FACIT] |
| 71012-9 | I feel like a burden to my family in the past 7 days [FACIT] |
| 71013-7 | I am constipated in the past 7 days [FACIT] |
| 71014-5 | I have swelling in parts of my body in the past 7 days [FACIT] |
| 71015-2 | My mouth and throat are dry in the past 7 days [FACIT] |
| 71016-0 | I feel useful in the past 7 days [FACIT] |
| 71017-8 | I make each day count in the past 7 days [FACIT] |
| 71018-6 | I have peace of mind in the past 7 days [FACIT] |
| 71019-4 | I feel hopeful in the past 7 days [FACIT] |
| 71020-2 | I am able to make decisions in the past 7 days [FACIT] |
| 71021-0 | I have been able to reconcile, make peace, with other people in the past 7 days [FACIT] |
| 71022-8 | I am able to openly discuss my concerns with the people closest to me in the past 7 days [FACIT] |
| 71023-6 | Functional Assessment of Chronic Illness Therapy - Spiritual well-being Questionnaire - 12 items - version 4 (FACIT-Sp-12) |
| 71024-4 | I feel peaceful in the past 7 days [FACIT] |
| 71025-1 | I have a reason for living in the past 7 days [FACIT] |
| 71026-9 | My life has been productive in the past 7 days [FACIT] |
| 71027-7 | I have trouble feeling peace of mind in the past 7 days [FACIT] |
| 71028-5 | I feel a sense of purpose in my life in the past 7 days [FACIT] |
| 71029-3 | I am able to reach down deep into myself for comfort in the past 7 days [FACIT] |
| 71030-1 | I feel a sense of harmony within myself in the past 7 days [FACIT] |
| 71031-9 | My life lacks meaning and purpose in the past 7 days [FACIT] |
| 71032-7 | I find strength in my faith or spiritual beliefs in the past 7 days [FACIT] |
| 71033-5 | My illness has strengthened my faith or spiritual beliefs in the past 7 days [FACIT] |
| 71034-3 | I know that whatever happens with my illness things will be okay in the past 7 days [FACIT] |
| 71035-0 | Functional Assessment of Chronic Illness Therapy - Spiritual well-being, expanded version questionnaire - version 4 (FACIT-Sp-Ex) |
| 71036-8 | I feel connected to a higher power, or God, in the past 7 days [FACIT] |
| 71037-6 | I feel connected to other people in the past 7 days [FACIT] |
| 71038-4 | I feel loved in the past 7 days [FACIT] |
| 71039-2 | I feel love for others in the past 7 days [FACIT] |
| 71040-0 | I am able to forgive others for any harm they have ever caused me in the past 7 days [FACIT] |
| 71041-8 | I feel forgiven for any harm I may have ever caused in the past 7 days [FACIT] |
| 71042-6 | Throughout the course of my day, I feel a sense of thankfulness for my life in the past 7 days [FACIT] |
| 71043-4 | Throughout the course of my day, I feel a sense of thankfulness for what others bring to my life in the past 7 days [FACIT] |
| 71044-2 | I feel a sense of appreciation for the beauty of nature in the past 7 days [FACIT] |
| 71045-9 | I feel compassion for others in the difficulties they are facing in the past 7 days [FACIT] |
| 71046-7 | Functional Assessment of Chronic Illness Therapy - Spiritual well-being - non-illness questionnaire - version 4 (FACIT-Sp - non-illness) |
| 71047-5 | Functional Assessment of Chronic Illness Therapy - Satisfaction with Pharmacist Scale - version 4 (FACIT - SWiP) |
| 71048-3 | My pharmacist advises me on the proper use of my medicines in the past 7 days [FACIT] |
| 71049-1 | My pharmacist advises me on the adverse - side - effects of my medicines in the past 7 days [FACIT] |
| 71050-9 | I have confidence in my pharmacist-s in the past 7 days [FACIT] |
| 71051-7 | My pharmacist is available to answer my questions in the past 7 days [FACIT] |
| 71052-5 | My pharmacist helps with the arrangements necessary to obtain my medicines in the past 7 days [FACIT] |
| 71053-3 | My pharmacist is aware of my treatment-related needs in the past 7 days [FACIT] |
| 71054-1 | My pharmacist responds to my treatment-related needs in the past 7 days [FACIT] |
| 71055-8 | Functional Assessment of Chronic Illness Therapy - Treatment satisfaction - General Questionnaire - version 1 (FACIT-TS-G) |
| 71056-6 | Compared to what you expected, how do you rate the effectiveness of the treatment so far [FACIT] |
| 71057-4 | Compared to what you expected, how do you rate the side effects of treatment so far [FACIT] |
| 71058-2 | Did your doctor-s help you evaluate the effects of your treatment so far [FACIT] |
| 71059-0 | Do you feel you received the treatment that was right for you [FACIT] |
| 71060-8 | Are you satisfied with the effects of this treatment so far [FACIT] |
| 71061-6 | Would you recommend this treatment to others with your illness [FACIT] |
| 71062-4 | Would you choose this treatment again |
| 71063-2 | How do you rate this treatment overall [FACIT] |
| 71064-0 | Name of treatment [FACIT] |
| 71065-7 | Functional Assessment of Chronic Illness therapy - Treatment satisfaction - patient satisfaction questionnaire - version 1 (FACIT-TS-PS) |
| 71066-5 | Visits you would like to rate [FACIT] |
| 71067-3 | Explanations [FACIT] |
| 71068-1 | Did your doctor-s give explanations that you could understand [FACIT] |
| 71069-9 | Did your doctor-s explain the possible benefits of your treatment [FACIT] |
| 71070-7 | Did your doctor-s explain the possible side effects or risks of your treatment [FACIT] |
| 71071-5 | Did you have an opportunity to ask questions [FACIT] |
| 71072-3 | Interpersonal [FACIT] |
| 71073-1 | Did you get to say the things that were important to you [FACIT] |
| 71074-9 | Did your doctor-s seem to understand what was important to you [FACIT] |
| 71075-6 | Did your doctor-s show genuine concern for you [FACIT] |
| 71076-4 | Comprehensive care [FACIT] |
| 71077-2 | Did your doctor-s seem to understand your needs [FACIT] |
| 71078-0 | Did you feel that the treatment staff worked together towards the same goal [FACIT] |
| 71079-8 | Were you able to talk to your doctor-s when you needed to [FACIT] |
| 71080-6 | Did the treatment staff discuss how your health and treatment may affect your normal work - including housework [FACIT] |
| 71081-4 | Did the treatment staff discuss how your health and treatment may affect your normal daily activities [FACIT] |
| 71082-2 | Did the treatment staff discuss how your health and treatment may affect your personal relationships [FACIT] |
| 71083-0 | Did the treatment staff discuss how your health and treatment may affect you emotionally [FACIT] |
| 71084-8 | Technical quality [FACIT] |
| 71085-5 | Did you feel your doctors had experience treating your illness [FACIT] |
| 71086-3 | Did you feel your doctor-s knew about the latest medical developments for your illness [FACIT] |
| 71087-1 | Was the treatment staff thorough in examining and treating you [FACIT] |
| 71088-9 | Decision-making [FACIT] |
| 71089-7 | Did your doctor-s discuss other treatments, example, alternative medicine or new for treatments [FACIT] |
| 71090-5 | Were you encouraged to participate in decisions about your health care [FACIT] |
| 71091-3 | Did you have enough time to make decisions about your health care [FACIT] |
| 71092-1 | Did you have enough information to make decisions about your health care [FACIT] |
| 71093-9 | Did your doctor-s seem to respect your opinions [FACIT] |
| 71094-7 | Nurses [FACIT] |
| 71095-4 | Did your nurses give explanations that you could understand [FACIT] |
| 71096-2 | Did your nurses show genuine concern for you [FACIT] |
| 71097-0 | Did your nurse-s seem to understand your needs [FACIT] |
| 71098-8 | Trust [FACIT] |
| 71099-6 | Did you feel that the treatment staff answered your questions honestly [FACIT] |
| 71100-2 | Did the treatment staff respect your privacy [FACIT] |
| 71101-0 | Did you have confidence in your doctor-s [FACIT] |
| 71102-8 | Did you trust your doctor-s suggestions for treatment [FACIT] |
| 71103-6 | Overall [FACIT] |
| 71104-4 | Would you recommend this clinic or office to others [FACIT] |
| 71105-1 | Would you choose this clinic or office again [FACIT] |
| 71106-9 | How do you rate the care you received [FACIT] |
| 71107-7 | Functional Assessment of multiple sclerosis questionnaire - version 4 (FAMS) [FACIT] |
| 71108-5 | Mobility [FACIT] |
| 71109-3 | I have trouble getting around in public places in the past 7 days [FACIT] |
| 71110-1 | I have to take my condition into account when making plans in the past 7 days [FACIT] |
| 71111-9 | I am bothered by muscle pains in the past 7 days [FACIT] |
| 71112-7 | Emotional well-being - FAMS [FACIT] |
| 71113-5 | I feel trapped by my condition in the past 7 days [FACIT] |
| 71114-3 | I am depressed about my condition in the past 7 days [FACIT] |
| 71115-0 | I feel useless in the past 7 days [FACIT] |
| 71116-8 | General contentment [FACIT] |
| 71117-6 | I am frustrated by my condition in the past 7 days [FACIT] |
| 71118-4 | Thinking and fatigue [FACIT] |
| 71119-2 | My family has trouble understanding when my condition gets worse in the past 7 days [FACIT] |
| 71120-0 | I feel left out of things in the past 7 days [FACIT] |
| 71121-8 | Additional concerns - FAMS [FACIT] |
| 71122-6 | Heat worsens my symptoms in the past 7 days [FACIT] |
| 71123-4 | I am bothered by muscle spasms in the past 7 days [FACIT] |
| 71124-2 | Difficult times have strengthened my faith or spiritual beliefs in the past 7 days [FACIT] |
| 71125-9 | Even during difficult times, I know that things will be okay in the past 7 days [FACIT] |
| 71126-7 | Physical well-being - FAHI [FACIT] |
| 71127-5 | Emotional well-being - living with HIV [FACIT] |
| 71128-3 | Functional and global well-being [FACIT] |
| 71129-1 | Social well-being [FACIT] |
| 71130-9 | Cognitive functioning [FACIT] |
| 71131-7 | Additional concerns - FACIT-Sp [FACIT] |
| 71132-5 | Additional concerns - FACIT-Sp-NI [FACIT] |
| 71133-3 | Functional Assessment of HIV Infection Questionnaire - version 4 (FAHI) [FACIT] |
| 71134-1 | I am unhappy with my appearance in the past 7 days [FACIT] |
| 71135-8 | It is hard to tell other people about my infection in the past 7 days [FACIT] |
| 71136-6 | I worry about spreading my infection in the past 7 days [FACIT] |
| 71137-4 | I am concerned about what the future holds for me in the past 7 days [FACIT] |
| 71138-2 | I am embarrassed by my illness in the past 7 days [FACIT] |
| 71139-0 | My thinking is slower than before in the past 7 days [FACIT] |
| 71140-8 | I have trouble learning new tasks or directions in the past 7 days [FACIT] |
| 71141-6 | Social - family well-being - FAMS [FACIT] |
| 71142-4 | Pediatric - Functional Assessment of Anorexia Cachexia - Adolescent Questionnaire - version 1 (Peds-FAACT - adoles) [FACIT] |
| 71143-2 | Pediatric - Functional Assessment of Anorexia Cachexia - Child Questionnaire - version 1 (Peds-FAACT - child) [FACIT] |
| 71144-0 | Pediatric - Functional Assessment of Anorexia Cachexia - Parent_adolescent Questionniare - version 1 (Peds-FAACT - adoles) [FACIT] |
| 71145-7 | Pediatric - Functional Assessment of Anorexia Cachexia - Parent_child Questionnaire - version 1 (Peds-FAACT - parent_child) [FACIT] |
| 71146-5 | Pediatric - Functional Assessment of Anorexia Cachexia Questionnaire - 10 items - version 2 (Peds-FAACT- 10 - v2) [FACIT] |
| 71147-3 | Pediatric - patients with brain cancer - Adolescent Questionnaire - version 2 (Peds-FACT-Br - adoles) [FACIT] |
| 71148-1 | Pediatric - patients with brain cancer - Child Questionnaire - version 2 (Peds-FACT-Br - child) [FACIT] |
| 71149-9 | Pediatric - Patients with brain cancer - Parent_adolescent Questionnaire - version 1 (Peds-FACT-Br - parent_adoles) [FACIT] |
| 71150-7 | Pediatric - Patients with brain cancer - Parent_child Questionnaire - version 1 (Peds-FACT-Br - parent_child) [FACIT] |
| 71151-5 | Pediatric - Functional Assessment of Chronic Illness Therapy - Fatigue Questionnaire (Peds-FACIT-Fatigue) |
| 71152-3 | I eat as much as I want in the past 7 days [FACIT] |
| 71153-1 | I eat enough food for me to do whatever I need to do in the past 7 days [FACIT] |
| 71154-9 | Most food tastes bad to me in the past 7 days [FACIT] |
| 71155-6 | As soon as I start eating, I feel like stopping in the past 7 days [FACIT] |
| 71156-4 | I am afraid to eat because it may make me sick in the past 7 days [FACIT] |
| 71157-2 | My family or friends try to get me to eat more in the past 7 days [FACIT] |
| 71158-0 | I have been throwing up in the past 7 days [FACIT] |
| 71159-8 | I have pain in my stomach in the past 7 days [FACIT] |
| 71160-6 | I feel like I am getting better in the past 7 days [FACIT] |
| 71161-4 | I have energy or strength in the past 7 days [FACIT] |
| 71162-2 | I could do my usual things at home in the past 7 days [FACIT] |
| 71163-0 | I lose balance or fall down easily in the past 7 days [FACIT] |
| 71164-8 | I have trouble getting myself dressed in the past 7 days [FACIT] |
| 71165-5 | I have trouble running like other people in the past 7 days [FACIT] |
| 71166-3 | My arms or legs feel weak in the past 7 days [FACIT] |
| 71167-1 | I get ill easily in the past 7 days [FACIT] |
| 71168-9 | I have trouble writing with a pen or pencil in the past 7 days [FACIT] |
| 71169-7 | I feel happy in the past 7 days [FACIT] |
| 71170-5 | When I try to do something, I usually believe I will do it well in the past 7 days [FACIT] |
| 71171-3 | The cancer-tumor experience makes me a stronger person in the past 7 days [FACIT] |
| 71172-1 | The cancer-tumor experience has taught me to appreciate life in the past 7 days [FACIT] |
| 71173-9 | I often feel that other people are better than me in the past 7 days [FACIT] |
| 71174-7 | I worry about getting another cancer-tumor in the past 7 days [FACIT] |
| 71175-4 | I often switch from good moods to bad moods in the past 7 days [FACIT] |
| 71176-2 | I worry when I go back to the hospital or clinic in the past 7 days [FACIT] |
| 71177-0 | I get nervous - frightened easily in the past 7 days [FACIT] |
| 71178-8 | I worry about having a good life in the future in the past 7 days [FACIT] |
| 71179-6 | I worry about being able to have a girlfriend or boyfriend because of my illness in the past 7 days [FACIT] |
| 71180-4 | I worry about being able to go to college because of my illness in the past 7 days [FACIT] |
| 71181-2 | I worry about getting a job because of my illness in the past 7 days [FACIT] |
| 71182-0 | Other people pick on - tease me in the past 7 days [FACIT] |
| 71183-8 | I think I have fewer friends than others in the past 7 days [FACIT] |
| 71184-6 | Other people avoid hanging out with me because I am different in the past 7 days [FACIT] |
| 71185-3 | I feel lonely in the past 7 days [FACIT] |
| 71186-1 | I would rather do something by myself than with other people in the past 7 days [FACIT] |
| 71187-9 | My parents worry too much about me in the past 7 days [FACIT] |
| 71188-7 | My parents spoil me in the past 7 days [FACIT] |
| 71189-5 | I am worried about how thin I am in the past 7 days [FACIT] |
| 71190-3 | What would be important about how you feel about eating, food, and how food affects your life in the past 7 days [FACIT] |
| 71191-1 | I often feel that other children are better than me in the past 4 weeks [FACIT] |
| 71192-9 | I think I have fewer friends than other children in the past 7 days [FACIT] |
| 71193-7 | Other children avoid playing with me because I am different in the past 7 days [FACIT] |
| 71194-5 | I would rather play alone than with other children in the past 7 days [FACIT] |
| 71195-2 | My child loses balance or falls down easily in the past 4 weeks [FACIT] |
| 71196-0 | My child has trouble getting dressed on his-her own in the past 4 weeks [FACIT] |
| 71197-8 | My child has trouble running like other people in the past 4 weeks [FACIT] |
| 71198-6 | My child gets tired easily in the past 4 weeks [FACIT] |
| 71199-4 | My child's arms or legs seem weak in the past 4 weeks [FACIT] |
| 71200-0 | My child gets ill easily in the past 4 weeks [FACIT] |
| 71201-8 | My child has trouble writing with a pen or pencil in the past 4 weeks [FACIT] |
| 71202-6 | My child has pain in the past 7 days [FACIT] |
| 71203-4 | My child seems happy in the past 4 weeks [FACIT] |
| 71204-2 | When my child tries to do something, s-he usually believes s-he will do it well in the past 4 weeks [FACIT] |
| 71205-9 | The cancer-tumor experience makes my child a stronger person in the past 7 days [FACIT] |
| 71206-7 | The cancer-tumor experience has taught my child to appreciate life in the past 7 days [FACIT] |
| 71207-5 | My child often feels inferior to other people in the past 4 weeks [FACIT] |
| 71208-3 | My child worries about getting another cancer-tumor in the past 4 weeks [FACIT] |
| 71209-1 | My child is moody or irritable in the past 4 weeks [FACIT] |
| 71210-9 | My child worries when we go back to the hospital or clinic in the past 4 weeks [FACIT] |
| 71211-7 | My child gets nervous - frightened easily in the past 4 weeks [FACIT] |
| 71212-5 | My child worries about having a good life in the future in the past 4 weeks [FACIT] |
| 71213-3 | My child worries about being able to have a girlfriend or boyfriend because of his-her illness in the past 4 weeks [FACIT] |
| 71214-1 | My child worries about being able to go to college because of his-her illness in the past 4 weeks [FACIT] |
| 71215-8 | My child worries about getting a job because of his-her illness in the past 4 weeks [FACIT] |
| 71216-6 | Physical well-being - FACIT-peds [FACIT] |
| 71217-4 | Emotional well-being and illness experience FACIT |
| 71218-2 | Social - family well-being - FAACT-peds [FACIT] |
| 71219-0 | Other people pick on - tease my child in the past 4 weeks [FACIT] |
| 71220-8 | My child has fewer friends than others in the past 4 weeks [FACIT] |
| 71221-6 | Other people avoid hanging out with my child because s-he is different in the past 4 weeks [FACIT] |
| 71222-4 | My child seems lonely in the past 4 weeks [FACIT] |
| 71223-2 | My child prefers to do something alone in the past 4 weeks [FACIT] |
| 71224-0 | My child thinks I worry too much about him-her in the past 7 days [FACIT] |
| 71225-7 | My child thinks I spoil him-her in the past 7 days [FACIT] |
| 71226-5 | Additional concerns - FAACT-child_adoles [FACIT] |
| 71228-1 | Additional concerns - FACT-Br-peds [FACIT] |
| 71229-9 | Additional concerns - FACT-Br-parent [FACIT] |
| 71231-5 | The illness experience has taught my child to appreciate life in the past 4 weeks [FACIT] |
| 71232-3 | The illness experience makes my child a stronger person in the past 4 weeks [FACIT] |
| 71233-1 | I often feel that other children are better than me in the past 7 days [FACIT] |
| 71234-9 | Physical well being - FAACT-peds - parent [FACIT] |
| 71235-6 | Emotional well being - FAACT-peds - parent_adoles [FACIT] |
| 71236-4 | My child seems happy in the past 7 days [FACIT] |
| 71237-2 | When my child tries to do something, s-he usually believes s-he will do it well in the past 7 days [FACIT] |
| 71238-0 | My child often feels inferior to other people in the past 7 days [FACIT] |
| 71239-8 | My child worries about getting another cancer-tumor in the past 7 days [FACIT] |
| 71240-6 | My child is moody or irritable in the past 7 days [FACIT] |
| 71241-4 | My child worries when we go back to the hospital or clinic in the past 7 days [FACIT] |
| 71242-2 | My child gets nervous - frightened easily in the past 7 days [FACIT] |
| 71243-0 | My child worries about having a good life in the future in the past 7 days [FACIT] |
| 71244-8 | My child worries about being able to have a girlfriend or boyfriend because of his-her illness in the past 7 days [FACIT] |
| 71245-5 | My child worries about being able to go to college because of his-her illness in the past 7 days [FACIT] |
| 71246-3 | My child worries about getting a job because of his-her illness in the past 7 days [FACIT] |
| 71247-1 | My child has fewer friends than others in the past 7 days [FACIT] |
| 71248-9 | Other people avoid hanging out with my child because s-he is different in the past 7 days [FACIT] |
| 71249-7 | My child seems lonely in the past 7 days [FACIT] |
| 71250-5 | My child prefers to do something alone in the past 7 days [FACIT] |
| 71251-3 | Additional concerns - FAACT-parent [FACIT] |
| 71252-1 | My child eats as much as s-he wants in the past 7 days [FACIT] |
| 71253-9 | My child eats enough to do whatever s-he needs to do in the past 7 days [FACIT] |
| 71254-7 | My child is worried about his-her weight in the past 7 days [FACIT] |
| 71255-4 | Most food tastes bad to my child in the past 7 days [FACIT] |
| 71256-2 | My child is worried about how thin s-he is in the past 7 days [FACIT] |
| 71257-0 | As soon as my child starts eating, s-he feels like stopping in the past 7 days [FACIT] |
| 71258-8 | My child is afraid to eat because it may make her-him sick in the past 7 days [FACIT] |
| 71260-4 | My child has been throwing up in the past 7 days [FACIT] |
| 71261-2 | When my child eats, s-he seems to get full quickly in the past 7 days [FACIT] |
| 71262-0 | My child has pain in his-her stomach in the past 7 days [FACIT] |
| 71263-8 | My child feels like s-he is getting better in the past 7 days [FACIT] |
| 71264-6 | Social - family well-being - FAACT-parent_adoles [FACIT] |
| 71265-3 | My child loses balance or falls down easily in the past 7 days [FACIT] |
| 71266-1 | My child has trouble getting dressed on his-her own in the past 7 days [FACIT] |
| 71267-9 | My child has trouble running like other people in the past 7 days [FACIT] |
| 71268-7 | My child gets tired easily in the past 7 days [FACIT] |
| 71269-5 | My child's arms or legs seem weak in the past 7 days [FACIT] |
| 71270-3 | My child gets ill easily in the past 7 days [FACIT] |
| 71271-1 | My child has trouble writing with a pen or pencil in the past 7 days [FACIT] |
| 71272-9 | Other people pick on - tease my child in the past 7 days [FACIT] |
| 71273-7 | Family or friends try to get my child to eat more in the past 7 days [FACIT] |
| 71274-5 | Emotional well being - FAACT-peds - parent_child [FACIT] |
| 71275-2 | Social well being - FAACT-peds - parent_child [FACIT] |
| 71276-0 | Other children avoid playing with my child because s-he is different in the past 7 days [FACIT] |
| 71277-8 | My child prefers to play alone in the past 7 days [FACIT] |
| 71278-6 | I lose my balance or fall down easily in the past 4 weeks [FACIT] |
| 71279-4 | I have trouble getting myself dressed in the past 4 weeks [FACIT] |
| 71280-2 | I have trouble running like other people in the past 4 weeks [FACIT] |
| 71281-0 | I get tired easily in the past 4 weeks [FACIT] |
| 71282-8 | My arms or legs are weak in the past 4 weeks [FACIT] |
| 71283-6 | I get ill easily in the past 4 weeks [FACIT] |
| 71284-4 | I have trouble writing with a pen or pencil in the past 4 weeks [FACIT] |
| 71285-1 | I feel happy in the past 4 weeks [FACIT] |
| 71286-9 | When I try to do something, I usually believe I will do it well in the past 4 weeks [FACIT] |
| 71287-7 | The illness experience makes me a stronger person in the past 4 weeks [FACIT] |
| 71288-5 | The illness experience has taught me to appreciate life in the past 4 weeks [FACIT] |
| 71289-3 | I often feel that other people are better than me in the past 4 weeks [FACIT] |
| 71290-1 | I worry about being sick again in the past 4 weeks [FACIT] |
| 71291-9 | I often switch from good moods to bad moods in the past 4 weeks [FACIT] |
| 71292-7 | I worry when I go back to the hospital or clinic in the past 4 weeks [FACIT] |
| 71293-5 | I get nervous - frightened easily in the past 4 weeks [FACIT] |
| 71294-3 | I worry about having a good life in the future in the past 4 weeks [FACIT] |
| 71295-0 | I worry about being able to date because of my illness history in the past 4 weeks [FACIT] |
| 71296-8 | I worry about being able to go to college because of my illness history in the past 4 weeks [FACIT] |
| 71297-6 | I worry about getting a job to support myself because of my illness history in the past 4 weeks [FACIT] |
| 71298-4 | Other people pick on - tease me in the past 4 weeks [FACIT] |
| 71299-2 | I think I have fewer friends than others in the past 4 weeks [FACIT] |
| 71300-8 | Other people avoid hanging out with me because of my illness history in the past 4 weeks [FACIT] |
| 71301-6 | I feel lonely in the past 4 weeks [FACIT] |
| 71302-4 | I would rather do something by myself than with other people in the past 4 weeks [FACIT] |
| 71303-2 | I am bothered by being shorter than other people in the past 4 weeks [FACIT] |
| 71304-0 | I am bothered by being unable to see well in the past 4 weeks [FACIT] |
| 71305-7 | I am bothered by being unable to hear well in the past 4 weeks [FACIT] |
| 71306-5 | I am bothered by headaches in the past 4 weeks [FACIT] |
| 71307-3 | When I speak, people have trouble understanding me in the past 4 weeks [FACIT] |
| 71308-1 | I need to work harder than other people to get my school work done in the past 4 weeks [FACIT] |
| 71309-9 | My grades are worse than they were before I was sick in the past 4 weeks [FACIT] |
| 71310-7 | I forget things easily in the past 4 weeks [FACIT] |
| 71311-5 | It is hard for me to concentrate in school in the past 4 weeks [FACIT] |
| 71312-3 | I have to read things several times so I can understand them in the past 4 weeks [FACIT] |
| 71313-1 | When I play games or sports, I react more slowly than most people my age in the past 4 weeks [FACIT] |
| 71314-9 | It is hard for me to find the right words to say what I mean in the past 4 weeks [FACIT] |
| 71315-6 | Emotional well-being and illness experience - FACT-Br -peds-adoles [FACIT] |
| 71316-4 | Emotional well-being and illness experience - FACT-Br -peds-child [FACIT] |
| 71317-2 | Social - family well-being - FACT-Br-peds [FACIT] |
| 71318-0 | Physical well-being - FACT-Br -peds-parent [FACIT] |
| 71319-8 | Emotional well being - FACT-Br -peds-parent_adoles [FACIT] |
| 71320-6 | Emotional well-being - FACT-Br -peds-parent_child [FACIT] |
| 71321-4 | Social and family well-being - FACT-Br -peds-parent_child [FACIT] |
| 71322-2 | Social and family well-being - FACT-Br -peds-parent_adoles [FACIT] |
| 71323-0 | My child is bothered by being shorter than his-her peers in the past 4 weeks [FACIT] |
| 71324-8 | My child is bothered by poor vision in the past 4 weeks [FACIT] |
| 71325-5 | My child is bothered by poor hearing in the past 4 weeks [FACIT] |
| 71326-3 | My child is bothered by headaches in the past 4 weeks [FACIT] |
| 71327-1 | My child's speech is hard for others to understand in the past 4 weeks [FACIT] |
| 71328-9 | My child needs to work harder than his-her peers to get school work done in the past 4 weeks [FACIT] |
| 71329-7 | My child's school performance is worse than it was before s-he was diagnosed in the past 4 weeks [FACIT] |
| 71330-5 | My child forgets things easily in the past 4 weeks [FACIT] |
| 71331-3 | It is hard for my child to concentrate in school in the past 4 weeks [FACIT] |
| 71332-1 | My child has to read things several times so s-he can understand them in the past 4 weeks [FACIT] |
| 71333-9 | When my child plays games or sports, s-he reacts more slowly than his-her peers in the past 4 weeks [FACIT] |
| 71334-7 | My child has difficulty using the right words in the past 4 weeks [FACIT] |
| 71335-4 | My child often feels inferior to other children in the past 4 weeks [FACIT] |
| 71336-2 | I feel weak in the past 7 days [FACIT] |
| 71337-0 | Being tired made me sad in the past 7 days [FACIT] |
| 71338-8 | Being tired made me mad-angry in the past 7 days [FACIT] |
| 71339-6 | Urea renal clearance/1.73 sq M--hemodialysis Urine and Serum or Plasma [ESRD] |
| 71341-2 | Kt/V.Peritoneal Dialysis [Percent of body weight] |
| 71342-0 | Kt/V.Hemodialysis [Derived] |
| 71343-8 | Emotional well-being and illness experience - FAACT-peds-child [FACIT] |
| 71344-6 | I have been able to laugh and see the funny side of things in the past 7 days [EPDS] |
| 71345-3 | I have looked forward with enjoyment to things in the past 7 days [EPDS] |
| 71346-1 | I have blamed myself unnecessarily when things went wrong in the past 7 days [EPDS] |
| 71347-9 | I have been anxious or worried for no good reason in the past 7 days [EPDS] |
| 71348-7 | I have felt scared or panicky for no very good reason in the past 7 days [EPDS] |
| 71349-5 | Things have been getting on top of me in the past 7 days [EPDS] |
| 71350-3 | I have been so unhappy that I have had difficulty sleeping in the past 7 days [EPDS] |
| 71351-1 | I have felt sad or miserable in the past 7 days [EPDS] |
| 71352-9 | I have been so unhappy that I have been crying in the past 7 days [EPDS] |
| 71353-7 | The thought of harming myself has occurred to me in the past 7 days [EPDS] |
| 71354-5 | Edinburgh Postnatal Depression Scale [EPDS] |
| 71379-2 | I had trouble starting things because I was too tired in the past 7 days [FACIT] |
| 71380-0 | I had trouble finishing things because I was too tired in the past 7 days [FACIT] |
| 71381-8 | I needed to sleep during the day in the past 7 days [FACIT] |
| 71382-6 | I got upset by being too tired to do things I wanted to do in the past 7 days [FACIT] |
| 71383-4 | Being tired made it hard for me to play or go out with my friends as much as I'd like in the past 7 days [FACIT] |
| 71384-2 | I was too tired to eat in the past 7 days [FACIT] |
| 71385-9 | I needed help doing my usual things at home in the past 7 days [FACIT] |
| 71388-3 | CMS - physical exam panel |
| 71389-1 | CMS - constitutional exam panel |
| 71390-9 | CMS - head and face exam panel |
| 71391-7 | CMS - eye exam panel |
| 71392-5 | CMS - ear-nose-mouth-throat exam panel |
| 71393-3 | CMS - neck exam panel |
| 71394-1 | CMS - respiratory exam panel |
| 71395-8 | CMS - cardiovascular exam panel |
| 71396-6 | CMS - breast exam panel |
| 71397-4 | CMS - gastrointestinal - abdomen - exam panel |
| 71398-2 | CMS - genitourinary exam - male panel |
| 71399-0 | CMS - genitourinary exam - female panel |
| 71400-6 | CMS - lymphatic exam panel |
| 71401-4 | CMS - extremities exam panel |
| 71402-2 | CMS - musculoskeletal exam panel |
| 71403-0 | CMS - skin exam panel |
| 71404-8 | CMS - neurologic exam panel |
| 71405-5 | CMS - psychiatric exam panel |
| 71406-3 | CMS - review of systems panel |
| 71407-1 | CMS - constitutional symptoms panel |
| 71408-9 | CMS - eye panel |
| 71409-7 | CMS - ear-nose-mouth-throat panel |
| 71410-5 | CMS - cardiovascular panel |
| 71411-3 | CMS - respiratory panel |
| 71412-1 | CMS - gastrointestinal panel |
| 71413-9 | CMS - genitourinary panel |
| 71414-7 | CMS - musculoskeletal panel |
| 71415-4 | CMS - integumentary panel |
| 71416-2 | CMS - neurological panel |
| 71417-0 | CMS - psychiatric panel |
| 71418-8 | CMS - endocrine panel |
| 71419-6 | CMS - hematologic - lymphatic panel |
| 71420-4 | CMS - allergic - immunologic panel |
| 71421-2 | CMS - past family - social history panel |
| 71422-0 | CMS - social history panel |
| 71423-8 | CMS - family history panel |
| 71424-6 | CMS - past medical - surgical history panel |
| 71428-7 | CMS - history of present illness panel |
| 71433-7 | Functional Assessment of Cancer Therapy for patients with prostate cancer questionnaire - version 4 (FACT-P) [FACIT] |
| 71434-5 | Additional concerns - FACT-P [FACIT] |
| 71435-2 | I have aches and pains that bother me in the past 7 days [FACIT] |
| 71436-0 | I am satisfied with my present level of comfort in the past 7 days [FACIT] |
| 71437-8 | I am able to feel like a man in the past 7 days [FACIT] |
| 71438-6 | I am able to have and maintain an erection in the past 7 days [FACIT] |
| 71439-4 | Functional Assessment of Chronic Illness Therapy Spiritual Well-being Questionnaire - version 4 (FACIT-Sp) |
| 71440-2 | Discharge type [CMS Assessment] |
| 71441-0 | Level II Preadmission Screening and Resident Review (PASRR) during assessment period [CMS Assessment] |
| 71442-8 | Weight gain [MDSv3] |
| 71443-6 | Preference to avoid asking Q0500B again [MDSv3] |
| 71444-4 | Nutritional approaches during last 7 days - while not a resident [CMS Assessment] |
| 71445-1 | Nutritional approaches during last 7 days - while a resident [CMS Assessment] |
| 71447-7 | Received scheduled pain medication regimen during assessment period [CMS Assessment] |
| 71448-5 | Received PRN pain medications or was offered and declined during assessment period [CMS Assessment] |
| 71449-3 | Received non-medication intervention for pain during assessment period [CMS Assessment] |
| 71450-1 | Skin tear(s) [MDSv3] |
| 71451-9 | Moisture associated skin damage (MASD) [MDSv3] |
| 71452-7 | Intellectual disability and developmental disability with organic condition [MDSv3] |
| 71453-5 | Intellectual disability and developmental disability with no organic condition [MDSv3] |
| 71454-3 | Conditions related to intellectual disability and developmental disability status [MDSv3] |
| 71455-0 | Other organic condition related to intellectual disability and developmental disability status [MDSv3] |
| 71457-6 | Erythropoiesis-stimulating agent panel [ESRD] |
| 71458-4 | Was erythropoiesis-stimulating agent prescribed [ESRD] |
| 71459-2 | Infection panel [ESRD] |
| 71460-0 | Outpatient antibiotics prescribed in past month [ESRD] |
| 71461-8 | Vascular infection source [ESRD] |
| 71462-6 | Method of identifying vascular access infection [ESRD] |
| 71463-4 | Date of infection onset [ESRD] |
| 71464-2 | Date first prescribed Medication |
| 71465-9 | Date prescription changed Medication |
| 71466-7 | Date prescription stopped Medication |
| 71467-5 | Erythropoiesis-stimulating agent prescribed Medication |
| 71468-3 | Route Medication |
| 71469-1 | Medication frequency Medication [ESRD] |
| 71470-9 | ESRD antibiotic panel |
| 71471-7 | Antibiotic administered Medication |
| 71472-5 | Date of blood culture |
| 71473-3 | Infected dialysis site [ESRD] |
| 71474-1 | Date of infection hospitalization [ESRD] |
| 71475-8 | New infection suspected [ESRD] |
| 71476-6 | Clinical sepsis symptoms present [ESRD] |
| 71477-4 | Did the infection require hospitalization [ESRD] |
| 71478-2 | Signs of soft tissue infection present [ESRD] |
| 71479-0 | Date access infection confirmed [ESRD] |
| 71480-8 | Location of death [ESRD] |
| 71481-6 | Did the death of this person involve injury of any kind |
| 71483-2 | Total score [HKOI] |
| 71492-3 | Total score [SLUMS] |
| 71493-1 | Total score [IQCODE] |
| 71495-6 | Network code Dialysis facility [ESRD] |
| 71496-4 | Corporate organization code Dialysis facility [ESRD] |
| 71497-2 | Dialysis organization affiliation Dialysis facility [ESRD] |
| 71498-0 | Manager Dialysis facility [ESRD] |
| 71499-8 | Owner Dialysis facility [ESRD] |
| 71500-3 | Program Dialysis facility [ESRD] |
| 71501-1 | Open-closed status Dialysis facility [ESRD] |
| 71502-9 | Profit status Dialysis facility [ESRD] |
| 71503-7 | Date opened Dialysis facility [ESRD] |
| 71504-5 | Date closed Dialysis facility [ESRD] |
| 71505-2 | Date changed ownership Dialysis facility [ESRD] |
| 71506-0 | Date initially certified by medicare Dialysis facility [ESRD] |
| 71507-8 | Fax number Dialysis facility [ESRD] |
| 71508-6 | Website Dialysis facility [ESRD] |
| 71509-4 | Phone number extension Dialysis facility [ESRD] |
| 71510-2 | Medicaid certified stations Dialysis facility # [ESRD] |
| 71511-0 | Isolation stations Dialysis facility # [ESRD] |
| 71512-8 | Medicare certified services offered Dialysis facility [ESRD] |
| 71513-6 | Non-medicare certified services offered Dialysis facility [ESRD] |
| 71514-4 | Opening time Dialysis facility [ESRD] |
| 71515-1 | Closing time Dialysis facility [ESRD] |
| 71516-9 | Personnel job code Dialysis facility [ESRD] |
| 71518-5 | Transplant referral [ESRD] |
| 71519-3 | On transplant waiting list [ESRD] |
| 71520-1 | Hospitalized due to presumptive diagnosis [ESRD] |
| 71521-9 | Location Dialysis facility [ESRD] |
| 71522-7 | Certified program Dialysis facility [ESRD] |
| 71523-5 | Date personnel record submitted Dialysis facility [ESRD] |
| 71524-3 | Partial owner organization Dialysis facility [ESRD] |
| 71525-0 | Authorized batch submitting organization Agency [ESRD] |
| 71526-8 | Personnel employment name Dialysis facility [ESRD] |
| 71527-6 | Record status [ESRD] |
| 71528-4 | Personnel job description Dialysis facility [ESRD] |
| 71529-2 | Back up NPI Dialysis facility [ESRD] |
| 71530-0 | Business name Dialysis facility [ESRD] |
| 71531-8 | ESRD hospitalization panel |
| 71533-4 | Dialysis shifts Dialysis facility # [ESRD] |
| 71534-2 | Phone number Dialysis facility [ESRD] |
| 71536-7 | Source of information [ESRD] |
| 71538-3 | Sent to hospital directly from dialysis facility [ESRD] |
| 71539-1 | Record status ESRD type |
| 71541-7 | I feel sad, down in the dumps or unhappy in the last 2 weeks or more [M3] |
| 71542-5 | Nothing seems to give me much pleasure in the last 2 weeks or more [M3] |
| 71543-3 | I feel tired - have no energy in the last 2 weeks or more [M3] |
| 71544-1 | I have had thoughts of suicide in the last 2 weeks or more [M3] |
| 71545-8 | I have difficulty sleeping in the last 2 weeks or more [M3] |
| 71546-6 | I have been sleeping too much in the last 2 weeks or more [M3] |
| 71547-4 | I have lost some appetite in the last 2 weeks or more [M3] |
| 71548-2 | I have been eating more in the last 2 weeks or more [M3] |
| 71549-0 | I feel tense, anxious or can't sit still in the last 2 weeks or more [M3] |
| 71550-8 | I feel worried or fearful in the last 2 weeks or more [M3] |
| 71551-6 | I have attacks of anxiety or panic in the last 2 weeks or more [M3] |
| 71552-4 | I worry about dying or losing control in the last 2 weeks or more [M3] |
| 71553-2 | I am nervous or shaky in social situations in the last 2 weeks or more [M3] |
| 71554-0 | I have nightmares or flashbacks in the last 2 weeks or more [M3] |
| 71555-7 | I am jumpy or feel startled easily in the last 2 weeks or more [M3] |
| 71556-5 | I avoid places that strongly remind me of a bad experience in the last 2 weeks or more [M3] |
| 71557-3 | I feel dull, numb, or detached in the last 2 weeks or more [M3] |
| 71558-1 | I can't get certain things out of my mind in the last 2 weeks or more [M3] |
| 71559-9 | I feel I must repeat certain acts or rituals in the last 2 weeks or more [M3] |
| 71560-7 | I feel the need to check and recheck things in the last 2 weeks or more [M3] |
| 71561-5 | At any time in your life, have you had more energy than usual [M3] |
| 71562-3 | At any time in your life, have you felt unusually irritable or angry [M3] |
| 71563-1 | At any time in your life have you felt unusually excited, revved up or high [M3] |
| 71564-9 | At any time in your life have you needed less sleep than usual [M3] |
| 71565-6 | These symptoms interfere with work or school [M3] |
| 71566-4 | These symptoms affect my relationships with friends or family [M3] |
| 71567-2 | These symptoms have led to my using alcohol to get by [M3] |
| 71568-0 | These symptoms have led to my using drugs [M3] |
| 71569-8 | M3 Checklist [M3] |
| 71570-6 | Changes in sleeping patterns [M3] |
| 71571-4 | Changes in appetite [M3] |
| 71572-2 | I can't concentrate or focus in the last 2 weeks more [M3] |
| 71590-4 | Hospitalized or emergency room [ESRD] |
| 71722-3 | Total score [AD8] |
| 71742-1 | Date most recent record submitted Facility [ESRD] |
| 71745-4 | Day closed Facility |
| 71746-2 | Personnel contact information panel [ESRD] Personnel |
| 71747-0 | Facility panel [ESRD] |
| 71748-8 | Total dialysis stations Facility # [ESRD] |
| 71750-4 | Primary contact phone number extension Facility |
| 71751-2 | Primary contact phone number Facility |
| 71752-0 | Primary contact first name Facility |
| 71753-8 | Primary contact last name Facility |
| 71754-6 | PTSD score [M3] |
| 71755-3 | Anxiety score [M3] |
| 71756-1 | Score out of range [M3] |
| 71757-9 | Depression score [M3] |
| 71758-7 | Bipolar score [M3] |
| 71766-0 | Primary contact email Facility |
| 71777-7 | Total score [M3] |
| 71785-0 | Exam findings communicated to clinician managing diabetic care |
| 71789-2 | Change in systolic blood pressure |
| 71798-3 | Reason immunization not given |
| 71799-1 | Adherence to prescribed medication instructions [Reported] |
| 71800-7 | Reason medication not prescribed [Reported] |
| 71801-5 | Reason for intervention refusal |
| 71802-3 | Housing status |
| 71803-1 | Client status |
| 71806-4 | I feel sad, down in the dumps or unhappy since I took my last screen [M3] |
| 71807-2 | Nothing seems to give me much pleasure since I took my last screen [M3] |
| 71808-0 | I feel tired - have no energy since I took my last screen [M3] |
| 71809-8 | I have had thoughts of suicide since I took my last screen [M3] |
| 71810-6 | I have difficulty sleeping since I took my last screen [M3] |
| 71811-4 | I have been sleeping too much since I took my last screen [M3] |
| 71812-2 | I have lost some appetite since I took my last screen [M3] |
| 71813-0 | I have been eating more since I took my last screen [M3] |
| 71814-8 | I feel tense, anxious or can't sit still since I took my last screen [M3] |
| 71815-5 | I feel worried or fearful since I took my last screen [M3] |
| 71816-3 | I have attacks of anxiety or panic since I took my last screen [M3] |
| 71817-1 | I worry about dying or losing control since I took my last screen [M3] |
| 71818-9 | I am nervous or shaky in social situations since I took my last screen [M3] |
| 71819-7 | I have nightmares or flashbacks since I took my last screen [M3] |
| 71820-5 | I am jumpy or feel startled easily since I took my last screen [M3] |
| 71821-3 | I avoid places that strongly remind me of a bad experience since I took my last screen [M3] |
| 71822-1 | I feel dull, numb, or detached since I took my last screen [M3] |
| 71823-9 | I can't get certain things out of my mind since I took my last screen [M3] |
| 71824-7 | I feel I must repeat certain acts or rituals since I took my last screen [M3] |
| 71825-4 | I feel the need to check and recheck things since I took my last screen [M3] |
| 71826-2 | I can't concentrate or focus since I took my last screen [M3] |
| 71827-0 | Score interpretation [M3] |
| 71891-6 | M3 Checklist - follow-up [M3] |
| 71895-7 | Pediatric blood pressure screening results |
| 71896-5 | Pediatric blood pressure percentile [Per age, sex and height] |
| 71897-3 | Compared to one year ago, how would you rate your emotional problems, such as feeling anxious,depressed or irritable, now [Veterans RAND] |
| 71898-1 | Compared to one year ago, how would you rate your physical health in general now [Veterans RAND] |
| 71899-9 | My health is excellent [Veterans RAND] |
| 71900-5 | I expect my health to get worse [Veterans RAND] |
| 71901-3 | I am as healthy as anyone I know [Veterans RAND] |
| 71902-1 | I seem to get sick a lot easier than other people [Veterans RAND] |
| 71903-9 | During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities - like visiting with friends, relatives, etc. [Veterans RAND] |
| 71904-7 | Did you feel tired during the past 4 weeks [Veterans RAND] |
| 71905-4 | Have you been a happy person during the past 4 weeks [Veterans RAND] |
| 71906-2 | Did you feel worn out during the past 4 weeks [Veterans RAND] |
| 71907-0 | Have you felt downhearted and blue during the past 4 weeks [Veterans RAND] |
| 71908-8 | Did you have a lot of energy during the past 4 weeks [Veterans RAND] |
| 71909-6 | Have you felt calm and peaceful during the past 4 weeks [Veterans RAND] |
| 71910-4 | Have you felt so down in the dumps that nothing could cheer you up during the past 4 weeks [Veterans RAND] |
| 71911-2 | Have you been a very nervous person during the past 4 weeks [Veterans RAND] |
| 71912-0 | Did you feel full of pep during the past 4 weeks [Veterans RAND] |
| 71913-8 | During the past 4 weeks, much did pain interfere with your normal work - including both work outside the home and house work [Veterans RAND] |
| 71914-6 | How much bodily pain have you had during the past 4 weeks [Veterans RAND] |
| 71915-3 | During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors or groups [Veterans RAND] |
| 71916-1 | As a result of any emotional problems, you didn't do work or other activities as carefully as usual in the past 4 weeks [Veterans RAND] |
| 71917-9 | As a result of any emotional problems, have you accomplished less than you would like in the past 4 weeks [Veterans RAND] |
| 71918-7 | As a result of any emotional problems, have you cut down the amount of time you spent on work or other activities in the past 4 weeks [Veterans RAND] |
| 71919-5 | As a result of your physical health, have you had difficulty performing the work or other activities - for example, it took extra effort in the past 4 weeks [Veterans RAND] |
| 71920-3 | As a result of your physical health, were you limited in the kind of work in the past 4 weeks [Veterans RAND] |
| 71921-1 | As a result of your physical health, have you accomplished less than you would like in the past 4 weeks [Veterans RAND] |
| 71922-9 | As a result of your physical health, have you cut down the amount of time you spent on work or other activities in the past 4 weeks [Veterans RAND] |
| 71923-7 | Does your health now limit you in bathing or dressing yourself [Veterans RAND] |
| 71924-5 | Does your health now limit you in walking one block [Veterans RAND] |
| 71925-2 | Does your health now limit you in walking several blocks [Veterans RAND] |
| 71926-0 | Does your health now limit you in walking more than a mile [Veterans RAND] |
| 71927-8 | Does your health now limit you in bending, kneeling, stooping [Veterans RAND] |
| 71928-6 | Does your health now limit you in climbing one flight of stairs [Veterans RAND] |
| 71929-4 | Does your health now limit you in climbing several flights of stairs [Veterans RAND] |
| 71930-2 | Does your health now limit you in lifting or carrying groceries [Veterans RAND] |
| 71931-0 | Does your health now limit you in moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf [Veterans RAND] |
| 71932-8 | Does your health now limit you in vigorous activities, such as running, lifting heavy objects, participating in strenuous sports [Veterans RAND] |
| 71933-6 | Veterans Rand health survey - 36 item (VR-36) |
| 71934-4 | Veterans Rand health survey - 12 item (VR-12) |
| 71935-1 | Parents' evaluation of developmental status - developmental milestones (PEDS_DM) [P.E.D.S.-DM] |
| 71936-9 | Parents' Evaluation of Developmental Status (PEDS) [P.E.D.S.] |
| 71937-7 | Tolerance, worried, eye- opener, amnesia, cutdown screening test [TWEAK] |
| 71938-5 | Total score [MLHFQ] |
| 71939-3 | Minnesota Living with Heart Failure Questionnaire [MLHFQ] |
| 71940-1 | Overall summary score [KCCQ] |
| 71941-9 | Kansas City Cardiomyopathy Questionnaire [KCCQ] |
| 71942-7 | Car, Relax, Alone, Forget, Friends, Trouble Screening Test [CRAFFT] |
| 71943-5 | Michigan Alcoholism Screening Test - Geriatric Version [MAST-G] |
| 71944-3 | Michigan Alcoholism Screening Test [MAST] |
| 71945-0 | Ascertain Dementia 8 [AD8] |
| 71946-8 | Short Informant Questionnaire on Cognitive Decline in the Elderly [IQCODE] |
| 71947-6 | St. Louis University Mental Status (SLUMS) Examination [SLUMS] |
| 71948-4 | Hip and knee outcomes questionnaire [HKOI] |
| 71949-2 | Falls Behavioral Scale for Older People [FaB] |
| 71950-0 | Health Assessment Questionnaire [HAQ] |
| 71951-8 | Infant Development Inventory [IDI] |
| 71952-6 | Child Development Inventory [CDI] |
| 71953-4 | Bayley Infant Neurodevelopmental Screener [BINS] |
| 71954-2 | Ages and Stages Questionnaires [ASQ] |
| 71955-9 | PROMIS-29 Sleep disturbance score T-score |
| 71956-7 | PROMIS-29 Sleep disturbance score |
| 71957-5 | PROMIS-29 Satisfaction with participation in social roles score T-score |
| 71958-3 | PROMIS-29 Satisfaction with participation in social roles score |
| 71959-1 | PROMIS-29 Physical function score T-score |
| 71960-9 | PROMIS-29 Physical function score |
| 71961-7 | PROMIS-29 Pain interference score T-score |
| 71962-5 | PROMIS-29 Pain interference score |
| 71963-3 | PROMIS-29 Fatigue score T-score |
| 71964-1 | PROMIS-29 Fatigue score |
| 71965-8 | PROMIS-29 Depression score T-score |
| 71966-6 | PROMIS-29 Depression score |
| 71967-4 | PROMIS-29 Anxiety score T-score |
| 71968-2 | PROMIS-29 Anxiety score |
| 71969-0 | PROMIS-10 Global Mental Health (GMH) score T-score |
| 71970-8 | PROMIS-10 Global Mental Health (GMH) score |
| 71971-6 | PROMIS-10 Global Physical Health (GPH) score T-score |
| 71972-4 | PROMIS-10 Global Physical Health (GPH) score |
| 71973-2 | VR-36 Mental health (MH) score - oblique method |
| 71974-0 | VR-36 Role emotion (RE) score - oblique method |
| 71975-7 | VR-36 Social functioning (SF) score - oblique method |
| 71976-5 | VR-36 Vitality (VT) score - oblique method |
| 71977-3 | VR-36 General health (GH) score - oblique method |
| 71978-1 | VR-36 Bodily pain (BP) score - oblique method |
| 71979-9 | VR-36 Role physical (RP) score - oblique method |
| 71980-7 | VR-36 Physical functioning (PF) score - oblique method |
| 71981-5 | VR-36 Mental health (MH) score - oblique method T-score |
| 71982-3 | VR-36 Role emotion (RE) score - oblique method T-score |
| 71983-1 | VR-36 Social functioning (SF) score - oblique method T-score |
| 71984-9 | VR-36 Vitality (VT) score - oblique method T-score |
| 71985-6 | VR-36 General health (GH) score - oblique method T-score |
| 71986-4 | VR-36 Bodily pain (BP) score - oblique method T-score |
| 71987-2 | VR-36 Role physical (RP) score - oblique method T-score |
| 71988-0 | VR-36 Physical functioning (PF) score - oblique method T-score |
| 71989-8 | VR-36 Physical component summary (PCS) score - oblique method T-score |
| 71990-6 | VR-36 Mental component summary (MCS) score - oblique method T-score |
| 71991-4 | VR-36 Mental health (MH) score - orthogonal method |
| 71992-2 | VR-36 Role emotion (RE) score - orthogonal method |
| 71993-0 | VR-36 Social functioning (SF) score - orthogonal method |
| 71994-8 | VR-36 Vitality (VT) score - orthogonal method |
| 71995-5 | VR-36 General health (GH) score - orthogonal method |
| 71996-3 | VR-36 Bodily pain (BP) score - orthogonal method |
| 71997-1 | VR-36 Role physical (RP) score - orthogonal method |
| 71998-9 | VR-36 Physical functioning (PF) score - orthogonal method |
| 71999-7 | VR-36 Mental health (MH) score - orthogonal method T-score |
| 72000-3 | VR-36 Role emotion (RE) score - orthogonal method T-score |
| 72001-1 | VR-36 Social functioning (SF) score - orthogonal method T-score |
| 72002-9 | VR-36 Vitality (VT) score - orthogonal method T-score |
| 72003-7 | VR-36 General health (GH) score - orthogonal method T-score |
| 72004-5 | VR-36 Bodily pain (BP) score - orthogonal method T-score |
| 72005-2 | VR-36 Role physical (RP) score - orthogonal method T-score |
| 72006-0 | VR-36 Physical functioning (PF) score - orthogonal method T-score |
| 72007-8 | VR-36 Physical component summary (PCS) score - orthogonal method T-score |
| 72008-6 | VR-36 Mental component summary (MCS) score - orthogonal method T-score |
| 72009-4 | VR-12 Mental health (MH) score - oblique method |
| 72010-2 | VR-12 Role emotion (RE) score - oblique method |
| 72011-0 | VR-12 Social functioning (SF) score - oblique method |
| 72012-8 | VR-12 Vitality (VT) score - oblique method |
| 72013-6 | VR-12 General health (GH) score - oblique method |
| 72014-4 | VR-12 Bodily pain (BP) score - oblique method |
| 72015-1 | VR-12 Role physical (RP) score - oblique method |
| 72016-9 | VR-12 Physical functioning (PF) score - oblique method |
| 72017-7 | VR-12 Mental health (MH) score - oblique method T-score |
| 72018-5 | VR-12 Role emotion (RE) score - oblique method T-score |
| 72019-3 | VR-12 Social functioning (SF) score - oblique method T-score |
| 72020-1 | VR-12 Vitality (VT) score - oblique method T-score |
| 72021-9 | VR-12 General health (GH) score - oblique method T-score |
| 72022-7 | VR-12 Bodily pain (BP) score - oblique method T-score |
| 72023-5 | VR-12 Role physical (RP) score - oblique method T-score |
| 72024-3 | VR-12 Physical functioning (PF) score - oblique method T-score |
| 72025-0 | VR-12 Physical component summary (PCS) score - oblique method T-score |
| 72026-8 | VR-12 Mental component summary (MCS) score - oblique method T-score |
| 72027-6 | VR-12 Physical component summary (PCS) score - orthogonal method T-score |
| 72028-4 | VR-12 Mental component summary (MCS) score - orthogonal method T-score |
| 72029-2 | Vaccination exclusion - medical reason |
| 72030-0 | Type oral vitamin D analog prescribed [ESRD] |
| 72031-8 | Oral vitamin D analog prescribed [ESRD] |
| 72032-6 | Type non-oral vitamin D analog prescribed [ESRD] |
| 72033-4 | Non-oral vitamin D analog prescribed [ESRD] |
| 72034-2 | Vitamin D panel [ESRD] |
| 72035-9 | Arteriovenous graft assessed frequency |
| 72036-7 | Arteriovenous graft assessed using intra-access flow |
| 72037-5 | Arteriovenous graft assessed frequency [US.doppler] |
| 72038-3 | Arteriovenous graft assessed using doppler [US.doppler] |
| 72039-1 | How often was static venous pressure measured |
| 72040-9 | Testing of arteriovenous graft performed using static venous pressure [ESRD] |
| 72041-7 | Testing of arteriovenous graft for access dysfunction performed [ESRD] |
| 72042-5 | How often was arterial pre-pump pressure measured [ESRD] |
| 72043-3 | Measurement of arterial pre-pump pressure performed [ESRD] |
| 72044-1 | Dialysis access physical exam frequency |
| 72045-8 | Physical examination dialysis access performed prior, during and after cannulation [ESRD] |
| 72046-6 | Arteriovenous graft status |
| 72047-4 | Arteriovenous fistula status [ESRD] |
| 72048-2 | Date arteriovenous fistula usable |
| 72049-0 | Date dialysis session [ESRD] |
| 72050-8 | Dialysis access |
| 72051-6 | Date catheter removal |
| 72052-4 | Date catheter placement |
| 72053-2 | Date arteriovenous fistula creation [ESRD] |
| 72054-0 | Date change of dialysis access type [ESRD] |
| 72055-7 | Vascular access panel [ESRD] |
| 72056-5 | Hepatitis B vaccination received |
| 72057-3 | Pneumococcal vaccination been received |
| 72058-1 | Influenza virus vaccination received |
| 72059-9 | Vaccination exclusion |
| 72060-7 | Where was vaccine received |
| 72061-5 | Vaccination panel [ESRD] |
| 72062-3 | Medication allergies panel [ESRD] |
| 72063-1 | Type oral iron prescribed [ESRD] |
| 72064-9 | Oral iron prescribed [ESRD] |
| 72065-6 | Type intravenous iron prescribed [ESRD] |
| 72066-4 | Intravenous iron prescribed [ESRD] |
| 72067-2 | Iron prescription current [ESRD] |
| 72068-0 | Iron panel [ESRD] |
| 72069-8 | Sodium profiling-modeling prescribed for any dialysis sessions in the reporting month [ESRD] |
| 72070-6 | Left ventricular hypertrophy |
| 72071-4 | Edema present |
| 72072-2 | Breath sounds |
| 72073-0 | Post-dialysis target weight for session prescribed [ESRD] |
| 72074-8 | Date last formal post dialysis weight [ESRD] |
| 72075-5 | Did patient provide the home blood pressure values to the dialysis unit [ESRD] |
| 72076-3 | Blood pressure home reading |
| 72077-1 | Sodium restriction education received [ESRD] |
| 72078-9 | Date of echocardiogram |
| 72079-7 | Dry weight order present [ESRD] |
| 72080-5 | Did prescribed dialysate sodium concentration exceed 138 mEq/L for any dialysis session during the Mo [ESRD] |
| 72081-3 | Date of sodium education [ESRD] |
| 72082-1 | Constant dialysate sodium prescribed [ESRD] |
| 72083-9 | Left ventricular hypertrophy change [ESRD] |
| 72084-7 | Fluid and weight panel [ESRD] |
| 72085-4 | Vaccination exclusion - patient reason [ESRD] |
| 72086-2 | Brigance Screens II [BS II] |
| 72087-0 | Blessed Orientation-Memory-Concentration Test [BOMC] |
| 72088-8 | Clinical Dementia Rating scale [CDR] |
| 72089-6 | Total score [NIH Stroke Scale] |
| 72091-2 | Knee injury and Osteoarthritis Outcome Score [KOOS] |
| 72092-0 | Hip Dysfunction and Osteoarthritis Outcome Score [HOOS] |
| 72093-8 | Quality of life score [HOOS] |
| 72094-6 | Sport-recreation score [HOOS] |
| 72095-3 | Activities of daily living score [HOOS] |
| 72096-1 | Symptoms score [HOOS] |
| 72097-9 | Pain score [HOOS] |
| 72098-7 | Quality of life score [KOOS] |
| 72099-5 | Sport-recreation score [KOOS] |
| 72100-1 | Activities of daily living score [KOOS] |
| 72101-9 | Symptoms score [KOOS] |
| 72102-7 | Pain score [KOOS] |
| 72106-8 | Total score [MMSE] |
| 72107-6 | Mini-Mental State Examination [MMSE] |
| 72109-2 | Alcohol Use Disorder Identification Test - Consumption [AUDIT-C] |
| 72110-0 | Alcohol Use Disorder Identification Test [AUDIT] |
| 72116-7 | Total score - Ages and Stages Questionnaires 36 months [ASQ] |
| 72117-5 | Total score - Ages and Stages Questionnaires 33 months [ASQ] |
| 72118-3 | Total score - Ages and Stages Questionnaires 30 months [ASQ] |
| 72119-1 | Total score - Ages and Stages Questionnaires 27 months [ASQ] |
| 72120-9 | Total score - Ages and Stages Questionnaires 24 months [ASQ] |
| 72121-7 | Total score - Ages and Stages Questionnaires 22 months [ASQ] |
| 72122-5 | Total score - Ages and Stages Questionnaires 20 months [ASQ] |
| 72123-3 | Total score - Ages and Stages Questionnaires 18 months [ASQ] |
| 72124-1 | Total score - Ages and Stages Questionnaires 16 months [ASQ] |
| 72125-8 | Total score - Ages and Stages Questionnaires 14 months [ASQ] |
| 72126-6 | Total score - Ages and Stages Questionnaires 12 months [ASQ] |
| 72127-4 | Total score - Ages and Stages Questionnaires 10 months [ASQ] |
| 72128-2 | Total score - Ages and Stages Questionnaires 9 months [ASQ] |
| 72129-0 | Total score - Ages and Stages Questionnaires 8 months [ASQ] |
| 72130-8 | Total score - Ages and Stages Questionnaires 6 months [ASQ] |
| 72131-6 | Total score - Ages and Stages Questionnaires 4 months [ASQ] |
| 72132-4 | Total score - Ages and Stages Questionnaires 2 months [ASQ] |
| 72133-2 | Montreal Cognitive Assessment [MoCA] |
| 72136-5 | Risk for venous thromboembolism |
| 72143-1 | Sex [HL7.v3] |
| 72144-9 | Post-natal maternal vital status [RHEA] |
| 72145-6 | Perineal tear classification [RHEA] |
| 72146-4 | Neonatal vital status at delivery [RHEA] |
| 72147-2 | Gestational age--at birth [RHEA] |
| 72148-0 | Person attending birth [RHEA] |
| 72149-8 | Delivery method [RHEA] |
| 72150-6 | Delivery location |
| 72151-4 | Arrived at clinic with partner [RHEA] |
| 72152-2 | Tested for HIV [RHEA] |
| 72153-0 | Last born child vital status [RHEA] |
| 72154-8 | Pregnancy risk factors [RHEA] |
| 72155-5 | Position in womb Fetus [RHEA] |
| 72156-3 | Rwandan maternal screening panel [RHEA] |
| 72164-7 | Pediatric diastolic blood pressure percentile [Per age, sex and height] |
| 72165-4 | Pediatric systolic blood pressure percentile [Per age, sex and height] |
| 72172-0 | Total score [MoCA] |
| 72173-8 | Total score [BOMC] |
| 72175-3 | Physician assessment necessary [RHEA] |
| 72176-1 | Facility recommended for birth [RHEA] |
| 72177-9 | Congenital anomalies noted [RHEA] |
| 72178-7 | Given a mosquito net [RHEA] |
| 72179-5 | Given pyrimethamine sulfadoxine - starting at 4th month [RHEA] |
| 72180-3 | Given iron and folic acid [RHEA] |
| 72181-1 | HIV results shared with partner [RHEA] |
| 72182-9 | Tested for HIV Significant other [RHEA] |
| 72183-7 | Treated for syphillis Significant other [RHEA] |
| 72184-5 | Treated for syphillis [RHEA] |
| 72185-2 | Medical history [RHEA] |
| 72186-0 | Obstetrical risk [RHEA] |
| 72187-8 | Date tetanus vaccine given [RHEA] |
| 72188-6 | Clinical summary score [KCCQ] |
| 72189-4 | Quality of life score [KCCQ] |
| 72190-2 | Self-efficacy score [KCCQ] |
| 72191-0 | Total symptom score [KCCQ] |
| 72192-8 | Symptom burden score [KCCQ] |
| 72193-6 | Symptom frequency score [KCCQ] |
| 72194-4 | Symptom stability score [KCCQ] |
| 72195-1 | Physical limitation score [KCCQ] |
| 72196-9 | Social limitation score [KCCQ] |
| 72204-1 | Changes in appetite - follow up [M3] |
| 72205-8 | Changes in sleeping patterns - follow up [M3] |
| 72233-0 | Total score [Mini-Cog] |
| 72234-8 | Mini-Cog |
| 72349-4 | Level of fatigue on average over the past month [Reported] |
| 72350-2 | Severity of pain on average over the past 1 month [Reported] |
| 72351-0 | Social interaction with other people - family, friends, or others - over the past month [Reported] |
| 72352-8 | Overall emotional well being over the past month [Reported] |
| 72353-6 | Overall physical well being over the past month [Reported] |
| 72354-4 | Overall quality of life over the past month [Reported] |
| 72355-1 | Patient Reported Outcome Quality of Life tool |
| 72513-5 | Vital signs with smoking status and pain scale [VSP] |
| 72519-2 | Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth] |
| 72636-4 | Total score [BSL-SUPP] |
| 72637-2 | I had uncontrollable sexual encounters of which I was later ashamed or which made me angry in last week [BSL-SUPP] |
| 72638-0 | I had outbreaks of uncontrolled anger or physically attacked others in last week [BSL-SUPP] |
| 72639-8 | I took medication that had not been prescribed or if had been prescribed, I took more than the prescribed dose in last week [BSL-SUPP] |
| 72640-6 | I took drugs in last week [BSL-SUPP] |
| 72641-4 | I got drunk in last week [BSL-SUPP] |
| 72681-0 | I displayed high-risk behavior by knowingly driving too fast, running around on the roofs of high buildings, balancing on bridges, etc. in last week [BSL-SUPP] |
| 72682-8 | I induced vomiting in lthe last week [BSL-SUPP] |
| 72683-6 | I had episodes of binge eating in the last week [BSL-SUPP] |
| 72684-4 | I tried to commit suicide in last week [BSL-SUPP] |
| 72685-1 | I told other people that I was going to kill myself in the last week [BSL-SUPP] |
| 72686-9 | I hurt myself by cutting, burning, strangling, headbanging etc. in last week [BSL-SUPP] |
| 72687-7 | Now we would like to know in addition the quality of your overall personal state in the course of the last week [BSL-23] |
| 72688-5 | Mean score [BSL-23] |
| 72689-3 | Total score [BSL-23] |
| 72690-1 | I felt worthless in the last week [BSL-23] |
| 72691-9 | I felt as if I was far away from myself in last week [BSL-23] |
| 72692-7 | I felt disgusted by myself in last week [BSL-23] |
| 72698-4 | I was afraid of losing control in last week [BSL-23] |
| 72699-2 | Everything seemed senseless to me in last week [BSL-23] |
| 72700-8 | The idea of death had a certain fascination for me in last week [BSL-23] |
| 72701-6 | I felt vulnerable in last week [BSL-23] |
| 72702-4 | Criticism had a devastating effect on me in last week [BSL-23] |
| 72703-2 | I suffered from voices and noises from inside or outside my head in last week [BSL-23] |
| 72704-0 | My mood rapidly cycled in terms of anxiety, anger, and depression in last week [BSL-23] |
| 72705-7 | I suffered from shame in last week [BSL-23] |
| 72706-5 | I wanted to punish myself in last week [BSL-23] |
| 72707-3 | I hated myself in last week [BSL-23] |
| 72708-1 | I had images that I was very much afraid of in last week [BSL-23] |
| 72709-9 | I experienced stressful inner tension in last week [BSL-23] |
| 72710-7 | I was lonely in last week [BSL-23] |
| 72711-5 | I didn't believe in my right to live in last week [BSL-23] |
| 72712-3 | I didn't trust other people in last week [BSL-23] |
| 72713-1 | I thought of hurting myself in last week [BSL-23] |
| 72714-9 | I felt disgust in last week [BSL-23] |
| 72715-6 | I was absent-minded and unable to remember what I was actually doing in last week [BSL-23] |
| 72716-4 | I felt helpless in last week [BSL-23] |
| 72717-2 | It was hard for me to concentrate in last week [BSL-23] |
| 72718-0 | Borderline symptom list - behavior supplement [BSL-SUPP] |
| 72719-8 | Borderline symptom list - 23 item [BSL-23] |
| 73756-9 | Infant is being breastfed at discharge [US Standard Certificate of Live Birth] |
| 73757-7 | Infant living at time of report [US Standard Certificate of Live Birth] |
| 73758-5 | Infant was transferred within 24 hours of delivery [US Standard Certificate of Live Birth] |
| 73759-3 | Hysterotomy or hysterectomy was performed at delivery [US Standard Report of Fetal Death] |
| 73760-1 | If cesarean, a trial of labor was attempted [US Standard Certificate of Live Birth] |
| 73761-9 | Fetal presentation--at birth [US Standard Certificate of Live Birth] |
| 73762-7 | Final route and method of delivery [US Standard Certificate of Live Birth] |
| 73763-5 | Mother was transferred for maternal medical or fetal indications for delivery [US Standard Certificate of Live Birth] |
| 73764-3 | Birth attendant title Provider [US Standard Certificate of Live Birth] |
| 73765-0 | Mother Planned to deliver at home [US Standard Certificate of Live Birth] |
| 73766-8 | Place where birth occurred [US Standard Certificate of Live Birth] |
| 73767-6 | Histological placental examination was performed [US Standard Report of Fetal Death] |
| 73768-4 | Autopsy was performed [US Standard Report of Fetal Death] |
| 73769-2 | Infections present AndOr treated during this pregnancy for fetal death [US Standard Report of Fetal Death] |
| 73770-0 | Name of facility infant transferred to |
| 73771-8 | Birth order |
| 73772-6 | Number of fetal deaths delivered |
| 73773-4 | Number of infants in this delivery delivered alive |
| 73774-2 | Onset of labor [US Standard Certificate of Live Birth] |
| 73775-9 | Mothers Risk factors in this pregnancy [US Standard Certificate of Live Birth] |
| 73776-7 | No prenatal care [US Standard Certificate of Live Birth] |
| 73777-5 | Name of facility mother transferred from |
| 73778-3 | Suspected chromosomal disorder karyotype status [US Standard Certificate of Live Birth] |
| 73779-1 | Down syndrome karyotype status [US Standard Certificate of Live Birth] |
| 73780-9 | Congenital anomalies of the newborn [US Standard Certificate of Live Birth] |
| 73781-7 | Maternal morbidity [US Standard Certificate of Live Birth] |
| 73782-5 | Neonatal pressure ulcer risk evaluation [NSRAS] |
| 73783-3 | Neonatal pressure injury risk total score [NSRAS] |
| 73784-1 | Moisture [NSRAS] |
| 73785-8 | Nutrition [NSRAS] |
| 73786-6 | Activity [NSRAS] |
| 73787-4 | Mobility [NSRAS] |
| 73788-2 | Mental status [NSRAS] |
| 73789-0 | General physical condition [NSRAS] |
| 73790-8 | Neonatal skin risk assessment scale panel [NSRAS] |
| 73811-2 | Estimated timing of fetal death [US Standard Report of Fetal Death] |
| 73812-0 | Abnormal conditions of the newborn [US Standard Certificate of Live Birth] |
| 73813-8 | Characteristics of labor and delivery [US Standard Certificate of Live Birth] |
| 73814-6 | Obstetric procedures performed [US Standard Certificate of Live Birth] |
| 73820-3 | External cephalic version outcome |
| 74050-6 | Actual route of administration - attempted or completed [AHRQ] |
| 74051-4 | Intended route of administration [AHRQ] |
| 74052-2 | Medication or substance was given [AHRQ] |
| 74053-0 | Medication or substance was prescribed [AHRQ] |
| 74056-3 | Clinical drug component - RxNorm RXCUI of Medication |
| 74057-1 | Medication strength |
| 74058-9 | Manufacturer name of Medication |
| 74059-7 | Brand name - RxNorm RXCUI of Medication |
| 74060-5 | Brand name of Medication |
| 74061-3 | Ingredient - RxNorm RXCUI of Medication |
| 74062-1 | Generic or investigational drug name of Medication |
| 74063-9 | Stage in the process that the event originated, regardless of the stage at which it was discovered [AHRQ] |
| 74064-7 | Medication or substance contraindication - potential or actual interaction [AHRQ] |
| 74065-4 | History of allergies or sensitivities to the medication or substance administered was documented [AHRQ] |
| 74066-2 | Expiration date of Medication [AHRQ] |
| 74067-0 | Best description for incorrect strength or concentration [AHRQ] |
| 74068-8 | Best description for the incorrect rate [AHRQ] |
| 74069-6 | Best description for the incorrect timing [AHRQ] |
| 74070-4 | Best description for the incorrect dose [AHRQ] |
| 74071-2 | Incorrect action [AHRQ] |
| 74072-0 | Best characterization of medication or other substance event [AHRQ] |
| 74073-8 | Type of nutritional product [AHRQ] |
| 74074-6 | Biological product of Medication [AHRQ] |
| 74075-3 | Medication type [AHRQ] |
| 74076-1 | Medication or substance involved [AHRQ] |
| 74077-9 | Ingredients for compounded preparations Medication |
| 74078-7 | Medication or other substance details panel [AHRQ] |
| 74079-5 | Event [AHRQ] |
| 74080-3 | Patient safety event report - hospital - medication or other substance - version 1.2 [AHRQ] |
| 74081-1 | Patient safety event [AHRQ] |
| 74171-0 | Total number of staff completing the job satisfaction survey [NMMDS] |
| 74172-8 | Generally speaking, I am very satisfied with my own level of autonomy [NMMDS] |
| 74173-6 | Generally speaking, I am very satisfied with interactions with non-physician health care team members [NMMDS] |
| 74174-4 | Generally speaking, I am very satisfied with interactions with physicians [NMMDS] |
| 74175-1 | Generally speaking, I am very satisfied with nursing administration [NMMDS] |
| 74176-9 | Generally speaking, I am very satisfied with nursing management [NMMDS] |
| 74177-7 | Nursing staff on this job rarely think of quitting [NMMDS] |
| 74178-5 | Most nursing staff on this job are very satisfied with the job [NMMDS] |
| 74179-3 | I am generally satisfied with the kind of work I do in this job [NMMDS] |
| 74180-1 | I rarely think of quitting this job [NMMDS] |
| 74181-9 | Generally speaking, I am very satisfied with this job [NMMDS] |
| 74182-7 | Job satisfaction panel [NMMDS] |
| 74183-5 | Nursing job class [NMMDS] |
| 74466-4 | Feedback to user--post question response |
| 74467-2 | Number of allowed answer responses interval Question |
| 74495-3 | Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ] |
| 74497-9 | Medical examiner or coroner was contacted [US Standard Certificate of Death] |
| 74498-7 | Autopsy or histological placental examination results were used [US Standard Report of Fetal Death] |
| 74499-5 | Death pronouncer details |
| 74500-0 | Age at time of event [AHRQ] |
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
| 74502-6 | Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ] |
| 74546-3 | Reporter job or position |
| 74547-1 | Reporter email |
| 74548-9 | Reporter phone number |
| 74549-7 | Reporter of adverse event or unsafe condition |
| 74550-5 | Anonymous reporter [AHRQ] |
| 74551-3 | Perinatal incident that affected a neonate [AHRQ] |
| 74552-1 | Categories associated with patient safety event or unsafe condition [AHRQ] |
| 74553-9 | Location of patient safety event or unsafe condition - Narrative [AHRQ] |
| 74554-7 | Description of patient safety event or unsafe condition [AHRQ] |
| 74555-4 | Event discovery date and time |
| 74556-2 | Family or guardian was notified [AHRQ] |
| 74557-0 | Increased length of stay due to incident [AHRQ] |
| 74558-8 | Timing of harm assessment [AHRQ] |
| 74559-6 | Anticipated duration of harm to the patient [AHRQ] |
| 74560-4 | Extent of harm to the patient [AHRQ] |
| 74561-2 | Documented rescue interventions [AHRQ] |
| 74562-0 | Rescue intervention was attempted [AHRQ] |
| 74563-8 | Incident preventability [AHRQ] |
| 74564-6 | National Quality Forum (NQF) serious reportable event [AHRQ] |
| 74565-3 | Event was a National Quality Forum (NQF) serious reportable event [AHRQ] |
| 74566-1 | Contributing factors for event [AHRQ] |
| 74567-9 | Contributing factors for event were known [AHRQ] |
| 74568-7 | Event was associated with a handover [AHRQ] |
| 74569-5 | Action that prevented the near miss incident from reaching the patient [AHRQ] |
| 74570-3 | Additional details of event or unsafe condition [AHRQ] |
| 74571-1 | Healthcare professional type [AHRQ] |
| 74572-9 | Reporter of adverse event or unsafe condition [AHRQ] |
| 74573-7 | Location of patient safety event or unsafe condition - Nominal [AHRQ] |
| 74693-3 | Race [AHRQ] |
| 74694-1 | Ethnicity [AHRQ] |
| 74698-2 | Sex [AHRQ] |
| 74700-6 | Ergonomics or human AndOr device interface issue [AHRQ] |
| 74701-4 | Problem that resulted from the equipment or device function problem [AHRQ] |
| 74702-2 | Circumstances involving the health information technology device in the event or unsafe condition [AHRQ] |
| 74703-0 | Electronic health record system component [AHRQ] |
| 74704-8 | Administrative or billing system component [AHRQ] |
| 74705-5 | Best characterization of health information technology (HIT) device [AHRQ] |
| 74706-3 | Health information technology (HIT) device was involved [AHRQ] |
| 74707-1 | Medication or other substance was involved [AHRQ] |
| 74708-9 | Device intended for single use was reused in the event or unsafe condition [AHRQ] |
| 74709-7 | Device intended for single use was involved in the event or unsafe condition [AHRQ] |
| 74721-2 | Event resulted in the device being removed [AHRQ] |
| 74722-0 | At the time of the event, the device was placed within the patient's tissue [AHRQ] |
| 74723-8 | Device involved in patient safety event or unsafe condition [AHRQ] |
| 74724-6 | Best description of the event or unsafe condition [AHRQ] |
| 74725-3 | Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ] |
| 74734-5 | Death certifier details |
| 74770-9 | Reporter Information [AHRQ] |
| 74771-7 | Neonatal Patient Information [AHRQ] |
| 74772-5 | Patient Information [AHRQ] |
| 75163-6 | Mother's Trimester of first prenatal visit [CDC.CS] |
| 75164-4 | Mother's Non-treponemal or treponemal test was performed at first prenatal visit [CDC.CS] |
| 75165-1 | Mother's Non-treponemal or treponemal test was performed at 28-32 weeks gestation [CDC.CS] |
| 75166-9 | Mother's Non-treponemal or treponemal test was performed at delivery [CDC.CS] |
| 75167-7 | Mother's Date most recent non-treponemal test |
| 75168-5 | Mother's Most recent non-treponemal test result [CDC.CS] |
| 75169-3 | Mother's Most recent non-treponemal test titer |
| 75170-1 | Mother's Date first non-treponemal test |
| 75171-9 | Mother's First non-treponemal test result [CDC.CS] |
| 75172-7 | Mother's First non-treponemal test titer |
| 75173-5 | Mother's Date of first treponemal test |
| 75174-3 | Mother's First treponemal test type [CDC.CS] |
| 75175-0 | Mother's First treponemal test result [CDC.CS] |
| 75176-8 | Mother's Date of most recent treponemal test |
| 75177-6 | Mother's Most recent treponemal test type [CDC.CS] |
| 75178-4 | Mother's Most recent treponemal result [CDC.CS] |
| 75179-2 | Mother's HIV status during pregnancy [CDC.CS] |
| 75180-0 | Mother's Clinical stage of syphilis during pregnancy [CDC.CS] |
| 75181-8 | Mother's Surveillance stage of syphilis during pregnancy [CDC.CS] |
| 75182-6 | Mother's Date of first syphilis treatment during pregnancy |
| 75183-4 | When mother received first dose of benzathine penicillin [CDC.CS] |
| 75184-2 | Mother's Amount of benzathine penicillin treatment [CDC.CS] |
| 75185-9 | Mother had appropriate serologic response following syphilis treatment [CDC.CS] |
| 75186-7 | Vital status [CDC.CS] |
| 75187-5 | Non-treponemal test was reactive [CDC.CS] |
| 75188-3 | Date of first reactive non-treponemal test |
| 75189-1 | First reactive non-treponemal test titer |
| 75190-9 | Treponemal test was reactive [CDC.CS] |
| 75191-7 | Date of first reactive treponemal test |
| 75192-5 | Darkfield exam, DFA, or special stain was performed and test findings [CDC.CS] |
| 75193-3 | Clinical signs of congenital syphilis [CDC.CS] |
| 75194-1 | Long bone x-rays were performed and consistent with congenital syphilis [CDC.CS] |
| 75195-8 | CSF Venereal Disease Research Laboratory test was performed and test findings [CDC.CS] |
| 75196-6 | Leukocyte count or protein test was performed on CSF and test findings [CDC.CS] |
| 75197-4 | Syphilis treatment was given and treatment description [CDC.CS] |
| 75199-0 | Congenital syphilis case investigation and report panel [CDC.CS] |
| 75200-6 | Mother's Date first prenatal visit |
| 75201-4 | Mother's Pregnancies # [Reported] |
| 75202-2 | Mother's Births.live # [Reported] |
| 75203-0 | Mother's Last menstrual period start date before delivery |
| 75204-8 | Prenatal care indicator [CDC.CS] |
| 75207-1 | Stillbirth indicator [CDC.CS] |
| 75208-9 | Maternal information section [CDC.CS] |
| 75209-7 | Infant or child information section [CDC.CS] |
| 75243-6 | Norton scale panel |
| 75244-4 | Physical condition [Norton scale] |
| 75245-1 | Mental condition [Norton scale] |
| 75246-9 | Activity [Norton scale] |
| 75247-7 | Mobility [Norton scale] |
| 75248-5 | Incontinence [Norton scale] |
| 75249-3 | Norton scale total score |
| 75250-1 | Are you deaf or do you have difficulty hearing [HHS.ACA Section 4302.ONC] |
| 75251-9 | Are you blind or do you have difficulty seeing [HHS.ACA Section 4302.ONC] |
| 75252-7 | Do you have difficulty walking or climbing stairs [HHS.ACA Section 4302.ONC] |
| 75253-5 | Because of a physical, mental, or emotional condition, do you have difficulty doing errands such as visiting a doctor's office or shopping [HHS.ACA Section 4302.ONC] |
| 75254-3 | Do you have difficulty communicating, reading, or do you have limited proficiency in English [HHS.ACA Section 4302.ONC] |
| 75255-0 | Assistance needed [HHS.ACA Section 4302.ONC] |
| 75256-8 | Disability information and assistance needed panel [HHS.ACA Section 4302.ONC] |
| 75257-6 | Mother's Marital status [CDC.CS] |
| 75258-4 | PROMIS short form - sleep disturbance 4a - version 1.0 |
| 75259-2 | PROMIS short form - pain intensity 3a - version 1.0 |
| 75260-0 | What is your level of pain right now [PROMIS] |
| 75261-8 | How intense was your average pain in the past 7 days [PROMIS] |
| 75262-6 | How intense was your pain at its worse in the past 7 days [PROMIS] |
| 75330-1 | Environmental condition panel [NMMDS] |
| 75331-9 | Total number of staff completing the environmental conditions survey [NMMDS] |
| 75332-7 | To what extent do you agree or disagree with cultural factors contributing to the phenomenon of complexity [NMMDS] |
| 75333-5 | Within the last month, how often have you experienced cultural factors [NMMDS] |
| 75334-3 | To what extent do you agree or disagree with psychosocial factors contributing to the phenomenon of complexity [NMMDS] |
| 75335-0 | Within the last month, how often have you experienced psychosocial factors [NMMDS] |
| 75336-8 | To what extent do you agree or disagree with physical factors contributing to the phenomenon of complexity [NMMDS] |
| 75337-6 | Within the last month, how often have you experienced physical factors [NMMDS] |
| 75412-7 | Rate all your health care in the last 12 months [AHRQ] |
| 75413-5 | I have a good life [NIH Toolbox] |
| 75414-3 | How often do your parents listen to your ideas [PROMIS.PEDS] |
| 75415-0 | How often do you have fun with friends [PROMIS.PEDS] |
| 75416-8 | How often do you feel really sad [PROMIS.PEDS] |
| 75417-6 | I have trouble doing all of my regular leisure activities with others [PROMIS] |
| 75418-4 | PCORI patient-reported outcomes common measures - core and recommended [PROMIS] |
| 75419-2 | PCORI patient-reported outcomes recommended measures [PROMIS] |
| 75420-0 | PCORI patient-reported outcomes core pediatric measures [PROMIS] |
| 75421-8 | PCORI patient-reported outcomes core adult measures [PROMIS] |
| 75519-9 | Encounter identifier |
| 75520-7 | Biobank specimens are stored and available for research |
| 75521-5 | Information source for data [PCORnet] |
| 75522-3 | Admission time |
| 75523-1 | Discharge time |
| 75524-9 | Facility identifier |
| 75525-6 | Type of encounter [MSCDM] |
| 75526-4 | Internal identifier for Provider |
| 75527-2 | Vital status at discharge |
| 75529-8 | Admitted from Facility [MSCDM] |
| 75530-6 | Able to request or review patient chart Abstractor [MSCDM] |
| 75531-4 | Enrollment basis |
| 75532-2 | Applicable accrediting agency for unit [NMMDS] |
| 75533-0 | NMMDS accreditation, certification, and licensure panel [NMMDS] |
| 75534-8 | Accreditation received [NMMDS] |
| 75535-5 | Certification received [NMMDS] |
| 75536-3 | Applicable certification agency for unit [NMMDS] |
| 75537-1 | Applicable licensing agency for unit [NMMDS] |
| 75538-9 | Licensing received [NMMDS] |
| 75610-6 | Oxygen therapy at arrival |
| 75611-4 | Patient seen in this ED in last 72 hours and discharged |
| 75612-2 | Number of visits to this healthcare entity in the last 12 months |
| 75613-0 | ED episode of care |
| 75614-8 | Three level triage system [NAMCS] |
| 75615-5 | Four level triage system [NAMCS] |
| 75616-3 | Generic five level triage system [NAMCS] |
| 75617-1 | Residence [NAMCS] |
| 75624-7 | Total score [AUDIT] |
| 75626-2 | Total score [AUDIT-C] |
| 75636-1 | Emergency severity index [ESI] |
| 75698-1 | Total score [COOP.WONCA] |
| 75699-9 | During the past 2 weeks, what was the hardest physical activity you could do for at least 2 minutes [COOP.WONCA] |
| 75700-5 | During the past 2 weeks, how much have you been bothered by emotional problems such as feeling anxious, depressed, irritable or downhearted and blue [COOP.WONCA] |
| 75701-3 | During the past 2 weeks, how much difficulty have you had doing your usual activities or tasks, both inside and outside the house because of your physical and emotional health [COOP.WONCA] |
| 75702-1 | During the past 2 weeks, has your physical and emotional health limited your social activities with family, friends, neighbors or groups [COOP.WONCA] |
| 75703-9 | During the past 2 weeks, how much bodily pain have you generally had [COOP.WONCA] |
| 75704-7 | How would you rate your overall health now compared to 2 weeks ago [COOP.WONCA] |
| 75705-4 | During the past 2 weeks, how would you rate your health in general [COOP.WONCA] |
| 75706-2 | During the past 2 weeks, was someone available to help you if you needed and wanted help [COOP.WONCA] |
| 75707-0 | How have things been going for you during the past 2 weeks [COOP.WONCA] |
| 75742-7 | Dartmouth COOP Functional Assessment Charts - 2 weeks |
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
| 75744-3 | Electronic Health Record (EHR) Implementation Stage panel [NMMDS] |
| 75745-0 | Electronic Health Record (EHR) Implementation Stage [NMMDS] |
| 75772-4 | Advance directives panel [ADVault] |
| 75773-2 | Goals, preferences, and priorities for medical treatment [Reported] |
| 75774-0 | Allowance to change advance directive preferences in the future regardless of mental state [Reported] |
| 75775-7 | Decision to inform doctors and nurses about the role religion, faith, culture, or spirituality play in my life [Reported] |
| 75776-5 | Preference on consulting a supportive and palliative care team to help treat physical, emotional, and spiritual discomfort and support family [Reported] |
| 75777-3 | Information to tell doctors if my health deteriorates due to a terminal illness and I am unable to interact meaningfully with family, friends, or surroundings [Reported] |
| 75778-1 | Information to tell doctors if I have a severe, irreversible brain injury or illness and can't dress, feed, or bathe myself, or communicate my medical wishes, but can be kept alive [Reported] |
| 75779-9 | Thoughts on cardiopulmonary resuscitation (CPR) [Reported] |
| 75780-7 | Preferred location to spend final days if possible to choose [Reported] |
| 75781-5 | Thoughts on organ and tissue donations [Reported] |
| 75782-3 | Thoughts regarding autopsy [Reported] |
| 75786-4 | Powers granted to healthcare agent [Reported] |
| 75787-2 | Advance directive - request for intubation |
| 75788-0 | Advance directive - request for tube feeding |
| 75789-8 | Advance directive - request for life support |
| 75790-6 | Advance directive - request for IV fluid and support |
| 75791-4 | Advance directive - request for antibiotics |
| 75792-2 | Advance directive - request for resuscitation that differs from cardiopulmonary resuscitation |
| 75793-0 | Other directives that have not otherwise been documented [Reported] |
| 75795-5 | Special treatments/programs - none of above Set [MDSv3] |
| 75796-3 | Physical well being - FACT-GP [FACIT] |
| 75797-1 | Social - family well being - FACT-GP [FACIT] |
| 75798-9 | Emotional well being - FANLTC [FACIT] |
| 75799-7 | Functional well being - FACT-GP [FACIT] |
| 75800-3 | Emotional well being - FACT-GP [FACIT] |
| 75801-1 | How have things been going for you during the past 4 weeks [COOP] |
| 75802-9 | During the past 4 weeks, was someone available to help you if you needed and wanted help [COOP] |
| 75803-7 | During the past 4 weeks, how would you rate your health in general [COOP] |
| 75804-5 | How would you rate your overall health now compared to 4 weeks ago [COOP] |
| 75805-2 | During the past 4 weeks, how much bodily pain have you generally had [COOP] |
| 75806-0 | During the past 4 weeks, has your physical and emotional health limited your social activities with family, friends, neighbors or groups [COOP] |
| 75807-8 | During the past 4 weeks, how much difficulty have you had doing your usual activities or tasks, both inside and outside the house because of your physical and emotional health [COOP] |
| 75808-6 | During the past 4 weeks, how much have you been bothered by emotional problems such as feeling anxious, depressed, irritable or downhearted and blue [COOP] |
| 75809-4 | During the past 4 weeks, what was the hardest physical activity you could do for at least 2 minutes [COOP] |
| 75810-2 | Total score [COOP] |
| 75820-1 | Over the past week, are you able to dress yourself, including shoelaces and buttons [HAQ] |
| 75821-9 | Over the past week, are you able to shampoo your hair [HAQ] |
| 75822-7 | Over the past week, are you able to stand up from a straight chair [HAQ] |
| 75823-5 | Over the past week, are you able to get in and out of bed [HAQ] |
| 75824-3 | Over the past week, are you able to cut your meat [HAQ] |
| 75825-0 | Over the past week, are you able to lift a full cup or glass to your mouth [HAQ] |
| 75826-8 | Over the past week, are you able to open a new milk carton [HAQ] |
| 75827-6 | Over the past week, are you able to walk outdoors on flat ground [HAQ] |
| 75828-4 | Over the past week, are you able to climb up five steps [HAQ] |
| 75829-2 | Over the past week, are you able to wash and dry your body [HAQ] |
| 75830-0 | Over the past week, are you able to take a tub bath [HAQ] |
| 75831-8 | Over the past week, are you able to get on and off the toilet [HAQ] |
| 75832-6 | Over the past week, are you able to reach and get down a 5 pound object (such as a bag of sugar) from just above your head [HAQ] |
| 75833-4 | Over the past week, are you able to bend down and pick up clothing from the floor [HAQ] |
| 75834-2 | Over the past week, are you able to open car doors [HAQ] |
| 75835-9 | Over the past week, are you able to open jars which have been previously opened [HAQ] |
| 75836-7 | Over the past week, are you able to turn faucets on and off [HAQ] |
| 75837-5 | Over the past week, are you able to run errands and shop [HAQ] |
| 75838-3 | Over the past week, are you able to get in and out of a car [HAQ] |
| 75839-1 | Over the past week, are you able to do chores such as vacuuming or yard work [HAQ] |
| 75840-9 | Total score [PAS] |
| 75841-7 | Total score [PASII] |
| 75842-5 | Clinical disease activity index [CDAI] |
| 75843-3 | Simplified disease activity index [SDAI] |
| 75844-1 | Patient global assessment of disease activity - 0-10 numeric rating [Reported] |
| 75845-8 | Total score [SDAI] |
| 75846-6 | Evaluator global assessment of disease activity - 0-10 (0.5 increments) numeric rating [Observed] |
| 75847-4 | Total score [CDAI] |
| 75848-2 | Over the past week, are you able to do outside work (such as yard work) [HAQII] |
| 75849-0 | Over the past week, are you able to wait in line for 15 minutes [HAQII] |
| 75850-8 | Over the past week, are you able to lift heavy objects [HAQII] |
| 75851-6 | Over the past week, are you able to move heavy objects [HAQII] |
| 75852-4 | Over the past week, are you able to go up two or more flights of stairs [HAQII] |
| 75854-0 | PCORnet common data model set - version 1.0 [PCORnet] |
| 75855-7 | Do you sometimes drink alcoholic beverages [Reported] |
| 75856-5 | Number of falls in the past 12 months [Reported] |
| 75870-6 | PROMIS short form - pain interference 8a - version 1.0 |
| 75872-2 | Aids or devices usually used for dressing and grooming, arising, eating, AndOr walking [HAQ] |
| 75873-0 | Help from another person is usually needed for dressing and grooming, arising, eating, AndOr walking [HAQ] |
| 75874-8 | Total score [HAQ-DI] |
| 75875-5 | Total score [HAQII] |
| 75876-3 | Patient activity scale II [PASII] |
| 75877-1 | Patient activity scale [PAS] |
| 75878-9 | Help from another person usually needed for hygiene, reach, gripping and opening things, AndOr errands and chores [HAQ] |
| 75879-7 | Aids or devices usually used for hygiene, reach, grip, AndOr activities [HAQ] |
| 75889-6 | How often have you had four or more drinks in one day during the past year [Reported] |
| 75893-8 | Pain severity in the past week - 0-10 numeric rating [Reported] |
| 75894-6 | Patient global assessment of disease activity - 0-10 (0.5 increments) numeric rating [Reported] |
| 75895-3 | My child felt uneasy in past 7 days [PROMIS.PARENTPROXY] |
| 75896-1 | How often does your child feel that you listen to his or her ideas [PROMIS.PARENTPROXY] |
| 75897-9 | How often does your child have fun with friends [PROMIS.PARENTPROXY] |
| 75898-7 | In general, would you say your child's health is [PROMIS.PARENTPROXY] |
| 75899-5 | My child got tired easily in past 7 days [PROMIS.PARENTPROXY] |
| 75900-1 | In general, how would you rate your child's mental health, including mood and ability to think [PROMIS.PARENTPROXY] |
| 75901-9 | Rate all your child's health care in the last 12 months [AHRQ] |
| 75902-7 | How many days in the past week did your child miss taking one or more medications # [SAMHSA] |
| 75903-5 | My child has a good life [NIH Toolbox] |
| 75904-3 | How often does your child feel really sad [PROMIS.PARENTPROXY] |
| 75905-0 | My child felt stressed in past 7 days [PROMIS.PARENTPROXY] |
| 75906-8 | My child had trouble sleeping when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 75907-6 | In general, would you say your child's quality of life is [PROMIS.PARENTPROXY] |
| 75908-4 | In general, how would you rate your child's physical health [PROMIS.PARENTPROXY] |
| 75909-2 | Are you able to reach and get down an object (such as a can of soup) from above your head [PROMIS] |
| 75910-0 | Canadian triage and acuity scale [CTAS] |
| 75912-6 | Observation unit stay discharge [NAMCS] |
| 76060-3 | Initiating cause or condition of fetal death [US Standard Report of Fetal Death] |
| 76061-1 | Other significant causes or conditions of fetal death [US Standard Report of Fetal Death] |
| 76342-5 | PROMIS short form - fatigue 4a - version 1.0 |
| 76343-3 | PROMIS short form - emotional distress - depression 4a - version 1.0 |
| 76344-1 | PROMIS short form - emotional distress - anxiety 4a - version 1.0 |
| 76345-8 | I have trouble starting things because I am tired during the past 7 days [PROMIS] |
| 76353-2 | Licensed nursing staff # [NMMDS] |
| 76354-0 | Nurse demographics per unit or service panel [NMMDS] |
| 76355-7 | Employment position panel [NMMDS] |
| 76356-5 | Nurse employment position Provider [NMMDS] |
| 76357-3 | Licensed nursing personnel [#] by employment position [NMMDS] |
| 76358-1 | Licensed nursing staff by employment position/Licensed nursing staff [NMMDS] |
| 76359-9 | Licensed nursing staff and sex panel [NMMDS] |
| 76360-7 | Licensed nursing personnel [#] by sex [NMMDS] |
| 76361-5 | Licensed nursing staff.sex/Licensed nursing staff [NMMDS] |
| 76362-3 | Race or ethnicity panel [NMMDS] |
| 76363-1 | Licensed nursing personnel [#] by race or ethnicity [NMMDS] |
| 76364-9 | Licensed nursing staff.race or ethnicity/Licensed nursing staff [NMMDS] |
| 76365-6 | Age category panel [NMMDS] |
| 76366-4 | Nurse age range Provider [NMMDS] |
| 76367-2 | Licensed nursing personnel [#] by age range [NMMDS] |
| 76368-0 | Licensed nursing staff.age range/Licensed nursing staff [NMMDS] |
| 76369-8 | Entry level nursing degree panel [NMMDS] |
| 76370-6 | Entry level nursing degree Provider [NMMDS] |
| 76371-4 | Licensed nursing personnel [#] by entry level nursing degree [NMMDS] |
| 76372-2 | Licensed nursing staff.entry level nursing degree/Licensed nursing staff [NMMDS] |
| 76373-0 | Highest level of education in a nursing degree panel [NMMDS] |
| 76374-8 | Highest level of education in a nursing degree Provider [NMMDS] |
| 76375-5 | Licensed nursing personnel [#] by highest level of education in a nursing degree [NMMDS] |
| 76376-3 | Licensed nursing staff.highest level of education in a nursing degree/Licensed nursing staff [NMMDS] |
| 76377-1 | Highest level of education in non-nursing degree panel [NMMDS] |
| 76378-9 | Highest level of education in a non-nursing degree Provider [NMMDS] |
| 76379-7 | Licensed nursing personnel [#] by highest level of education in a non-nursing degree [NMMDS] |
| 76380-5 | Licensed nursing staff.highest level of education in a non-nursing degree/Licensed nursing staff [NMMDS] |
| 76381-3 | Nursing license type panel [NMMDS] |
| 76382-1 | Primary nursing license type Provider [NMMDS] |
| 76383-9 | Licensed nursing personnel [#] by primary nursing license type [NMMDS] |
| 76384-7 | Licensed nursing staff.primary nursing license type/Licensed nursing staff [NMMDS] |
| 76385-4 | Nursing certification panel [NMMDS] |
| 76386-2 | Nursing certification Provider [NMMDS] |
| 76387-0 | Licensed nursing personnel [#] by nursing certification [NMMDS] |
| 76388-8 | Licensed nursing staff.nursing certification/Licensed nursing staff [NMMDS] |
| 76389-6 | Employment specialty panel [NMMDS] |
| 76390-4 | Nurse employment specialty Provider [NMMDS] |
| 76391-2 | Licensed nursing personnel [#] by employment specialty [NMMDS] |
| 76392-0 | Licensed nursing staff [NMMDS] |
| 76393-8 | National provider indentifier panel [NMMDS] |
| 76394-6 | Registered nurse staff # [NMMDS] |
| 76395-3 | Registered nurse personnel [#] with a national provider ID [NMMDS] |
| 76396-1 | Registered nurse staff with national provider ID/Registered nurse staff [NMMDS] |
| 76398-7 | Provider has a national provider ID |
| 76400-1 | Fetal delivery information Document [US Standard Report of Fetal Death] |
| 76499-3 | Humiliation, Afraid, Rape, and Kick questionnaire [HARK] |
| 76500-8 | Within the last year, have you been humiliated or emotionally abused in other ways by your partner or ex-partner |
| 76501-6 | Within the last year, have you been afraid of your partner or ex-partner |
| 76502-4 | Within the last year, have you been raped or forced to have any kind of sexual activity by your partner or ex-partner |
| 76503-2 | Within the last year, have you been kicked, hit, slapped, or otherwise physically hurt by your partner or ex-partner |
| 76504-0 | Total score [HARK] |
| 76506-5 | Social connection and isolation panel |
| 76508-1 | In a typical week, how many times do you talk on the telephone with family, friends, or neighbors [NHANES III] |
| 76509-9 | How often do you get together with friends or relatives [NHANES III] |
| 76510-7 | How often do you attend church or religious services [NHANES] |
| 76511-5 | Do you belong to any clubs or organizations such as church groups unions, fraternal or athletic groups, or school groups [NHANES III] |
| 76512-3 | Social isolation score [NHANES] |
| 76513-1 | How hard is it for you to pay for the very basics like food, housing, medical care, and heating |
| 76542-0 | Do you feel stress - tense, restless, nervous, or anxious, or unable to sleep at night because your mind is troubled all the time - these days [OSQ] |
| 76661-8 | Sex of Provider [NMMDS] |
| 76663-4 | Race or ethnicity of Provider [NMMDS] |
| 76700-4 | PROMIS short form - physical function 4a - version 1.0 |
| 76701-2 | PROMIS short form - satisfaction with participation in social roles 8a - version 1.0 |
| 76702-0 | PROMIS short form - physical function 20a - version 1.0 |
| 76703-8 | PROMIS short form - sleep disturbance 6a - version 1.0 |
| 76704-6 | PROMIS short form - satisfaction with participation in social roles 4a - version 1.0 |
| 76706-1 | I have to limit my regular family activities [PROMIS] |
| 76707-9 | I have to limit the things I do for fun with others [PROMIS] |
| 76708-7 | I have trouble doing all of the family activities that I want to do [PROMIS] |
| 76709-5 | I have trouble doing all of my usual work (include work at home) [PROMIS] |
| 76710-3 | I have trouble doing all of the work that is really important to me (include work at home) [PROMIS] |
| 76711-1 | I have to limit my regular activities with friends [PROMIS] |
| 76712-9 | I have trouble doing all of the activities with friends that I want to do [PROMIS] |
| 76713-7 | Do you have someone with whom to have fun [PROMIS] |
| 76714-5 | Do you have someone with whom to relax [PROMIS] |
| 76715-2 | Do you have someone with whom you can do something enjoyable [PROMIS] |
| 76716-0 | Do you have someone to keep you company at home [PROMIS] |
| 76717-8 | Do you have someone to go with you to an event [PROMIS] |
| 76718-6 | Can you find companionship when you want it [PROMIS] |
| 76719-4 | I have someone who will listen to me when I need to talk [PROMIS] |
| 76720-2 | I have someone to confide in or talk to about myself or my problems [PROMIS] |
| 76721-0 | I have someone with whom to share my most private worries and fears [PROMIS] |
| 76722-8 | I have someone who understands my problems [PROMIS] |
| 76723-6 | I have someone who makes me feel appreciated [PROMIS] |
| 76724-4 | I have someone I trust to talk with about my feelings [PROMIS] |
| 76725-1 | I have someone to talk with when I have a bad day [PROMIS] |
| 76726-9 | I have someone I trust to talk with about my problems [PROMIS] |
| 76727-7 | I have someone to give me good advice about a crisis if I need it [PROMIS] |
| 76728-5 | I have someone to turn to for suggestions about how to deal with a problem [PROMIS] |
| 76729-3 | I have someone to give me information if I need it [PROMIS] |
| 76730-1 | I get useful advice about important things in life [PROMIS] |
| 76731-9 | PROMIS short form - ability to participate in social roles and activities 8a - version 2.0 |
| 76732-7 | PROMIS short form - companionship 4a - version 2.0 |
| 76733-5 | PROMIS short form - companionship 6a - version 2.0 |
| 76734-3 | PROMIS short form - emotional support 6a - version 2.0 |
| 76735-0 | PROMIS short form - emotional support 4a - version 2.0 |
| 76736-8 | PROMIS short form - emotional support 8a - version 2.0 |
| 76737-6 | I am satisfied with my ability to do things for my family [PROMIS] |
| 76738-4 | I am satisfied with my ability to do the work that is really important to me (include work at home) [PROMIS] |
| 76739-2 | I am satisfied with my ability to do things for fun outside my home [PROMIS] |
| 76740-0 | I am satisfied with my ability to do things for fun with others [PROMIS] |
| 76741-8 | I feel good about my ability to do things for my friends [PROMIS] |
| 76742-6 | I am satisfied with my ability to meet the needs of my family [PROMIS] |
| 76743-4 | I am satisfied with my ability to meet the needs of my friends [PROMIS] |
| 76744-2 | I am satisfied with my ability to perform my daily routines [PROMIS] |
| 76745-9 | I can get helpful advice from others when dealing with a problem [PROMIS] |
| 76746-7 | I have people I can turn to for help with my problems [PROMIS] |
| 76747-5 | Other people help me get information when I have a problem [PROMIS] |
| 76748-3 | My friends have useful information to help me with my problems [PROMIS] |
| 76749-1 | Is someone available to help you if you need it |
| 76750-9 | Do you have someone to help you if you are confined to bed [PROMIS] |
| 76751-7 | Do you have someone to take you to the doctor if you need it [PROMIS] |
| 76752-5 | Do you have someone to prepare your meals if you are unable to do it yourself [PROMIS] |
| 76753-3 | Do you have someone to help with your daily chores if you are sick [PROMIS] |
| 76754-1 | Do you have someone to help you clean up around the home if you need it [PROMIS] |
| 76755-8 | Do you have someone to run errands if you need it [PROMIS] |
| 76756-6 | Do you have someone to take over all of your responsibilities at home if you need it [PROMIS] |
| 76757-4 | I feel isolated even when I am not alone [PROMIS] |
| 76758-2 | I feel that people avoid talking to me [PROMIS] |
| 76759-0 | I feel detached from other people [PROMIS] |
| 76760-8 | I feel like a stranger to those around me [PROMIS] |
| 76761-6 | I feel left out [PROMIS] |
| 76762-4 | I feel that people barely know me [PROMIS] |
| 76763-2 | I feel isolated from others [PROMIS] |
| 76764-0 | I feel that people are around me but not with me [PROMIS] |
| 76774-9 | PROMIS item bank - satisfaction with social roles and activities - version 2.0 |
| 76775-6 | I am satisfied with the extent of my social activities outside my home [PROMIS] |
| 76776-4 | I am satisfied with my current level of family activities [PROMIS] |
| 76777-2 | I am satisfied with my ability to maintain friendships [PROMIS] |
| 76778-0 | I am satisfied with how often I go out for entertainment [PROMIS] |
| 76779-8 | I am satisfied with my ability to socialize with friends [PROMIS] |
| 76780-6 | I am satisfied with the amount of time I spend doing leisure activities [PROMIS] |
| 76781-4 | I am satisfied with the amount of time I spend doing leisure activities with others [PROMIS] |
| 76782-2 | I am satisfied with how much work I can do (include work at home) [PROMIS] |
| 76783-0 | I feel good about my ability to do things for my family [PROMIS] |
| 76784-8 | I am satisfied with my current level of social activity [PROMIS] |
| 76785-5 | I am satisfied with my ability to participate in family activities [PROMIS] |
| 76786-3 | I am satisfied with my ability to do all of the community activities that are really important to me [PROMIS] |
| 76787-1 | PROMIS item bank - ability to participate in social roles and activities - version 2.0 |
| 76788-9 | PROMIS item bank - companionship - version 2.0 |
| 76789-7 | PROMIS item bank - emotional support - version 2.0 |
| 76790-5 | PROMIS item bank - informational support - version 2.0 |
| 76791-3 | PROMIS item bank - instrumental support - version 2.0 |
| 76792-1 | PROMIS short form - informational support 4a - version 2.0 |
| 76793-9 | PROMIS short form - informational support 6a - version 2.0 |
| 76794-7 | PROMIS short form - informational support 8a - version 2.0 |
| 76795-4 | PROMIS short form - instrumental support 4a - version 2.0 |
| 76796-2 | PROMIS short form - instrumental support 6a - version 2.0 |
| 76797-0 | PROMIS short form - instrumental support 8a - version 2.0 |
| 76798-8 | PROMIS short form - satisfaction with social roles and activities 4a - version 2.0 |
| 76799-6 | PROMIS short form - satisfaction with social roles and activities 6a - version 2.0 |
| 76800-2 | PROMIS short form - satisfaction with social roles and activities 8a - version 2.0 |
| 76801-0 | PROMIS short form - social isolation 4a - version 2.0 |
| 76802-8 | PROMIS short form - social isolation 6a - version 2.0 |
| 76803-6 | PROMIS short form - social isolation 8a - version 2.0 |
| 76804-4 | PROMIS short form - physical function 6b - version 1.2 |
| 76805-1 | PROMIS short form - physical function 8b - version 1.2 |
| 76806-9 | PROMIS item bank - social isolation - version 2.0 |
| 76807-7 | I am satisfied with my ability to do things for my friends [PROMIS] |
| 76808-5 | I am satisfied with the amount of time I spend doing work (include work at home) [PROMIS] |
| 76809-3 | I am happy with how much I do for my family [PROMIS] |
| 76810-1 | I am satisfied with my ability to do leisure activities [PROMIS] |
| 76811-9 | I am satisfied with my ability to do leisure activities with others [PROMIS] |
| 76812-7 | I am satisfied with my ability to work (include work at home) [PROMIS] |
| 76813-5 | I am satisfied with my current level of activities with my friends [PROMIS] |
| 76814-3 | I am satisfied with my ability to engage in activities with friends [PROMIS] |
| 76815-0 | The quality of my work is as good as I want it to be (include work at home) [PROMIS] |
| 76816-8 | I am happy with how much I do for my friends [PROMIS] |
| 76817-6 | I am satisfied with the amount of time I spend visiting friends [PROMIS] |
| 76818-4 | I am satisfied with the amount of time I spend performing my daily routines [PROMIS] |
| 76819-2 | I am satisfied with the amount of time I spend doing things for my family [PROMIS] |
| 76820-0 | I am satisfied with my ability to do household chores and tasks [PROMIS] |
| 76821-8 | I am satisfied with the extent of my social activities with groups of people [PROMIS] |
| 76822-6 | I am satisfied with my ability to keep in touch with others [PROMIS] |
| 76823-4 | I am satisfied with my ability to do regular personal and household responsibilities [PROMIS] |
| 76824-2 | I am satisfied with my ability to do regular personal responsibilities [PROMIS] |
| 76825-9 | I am satisfied with my ability to do things for fun at home (like reading, listening to music, etc.) [PROMIS] |
| 76826-7 | I am satisfied with my ability to meet the needs of those who depend on me [PROMIS] |
| 76827-5 | I am satisfied with my ability to run errands [PROMIS] |
| 76828-3 | I am satisfied with my ability to run errands for others [PROMIS] |
| 76829-1 | I am satisfied with my ability to do all of the leisure activities that are really important to me [PROMIS] |
| 76830-9 | I am satisfied with my ability to do all of the group activities that are really important to me [PROMIS] |
| 76831-7 | I have trouble doing my regular daily work around the house [PROMIS] |
| 76832-5 | I have trouble meeting the needs of my friends [PROMIS] |
| 76833-3 | I have to limit social activities at home [PROMIS] |
| 76834-1 | I have trouble meeting the needs of my family [PROMIS] |
| 76835-8 | I am limited in doing my work (include work at home) [PROMIS] |
| 76836-6 | I have to limit social activities outside my home [PROMIS] |
| 76837-4 | I have trouble participating in recreational activities with others [PROMIS] |
| 76838-2 | I have trouble doing everything for my family that I feel I should do [PROMIS] |
| 76839-0 | I have trouble accomplishing my usual work (include work at home) [PROMIS] |
| 76840-8 | I have trouble doing all of the family activities that I feel I should do [PROMIS] |
| 76841-6 | I have trouble doing all of the family activities that are really important to me [PROMIS] |
| 76842-4 | I have trouble doing everything for work that I want to do (include work at home) [PROMIS] |
| 76843-2 | I have to limit social activities with groups of people [PROMIS] |
| 76844-0 | I have to do my work for shorter periods of time than usual (include work at home) [PROMIS] |
| 76845-7 | I feel limited in the amount of time I have for my family [PROMIS] |
| 76846-5 | I have trouble doing all of the activities with friends that are really important to me [PROMIS] |
| 76847-3 | I have trouble doing all the leisure activities with others that I want to do [PROMIS] |
| 76848-1 | I have trouble keeping up with my family responsibilities [PROMIS] |
| 76849-9 | I have trouble taking care of my regular personal responsibilities [PROMIS] |
| 76850-7 | I have trouble doing everything for my friends that I want to do [PROMIS] |
| 76851-5 | I have trouble doing all of the activities with friends that I feel I should do [PROMIS] |
| 76852-3 | I have trouble doing all of the work that I feel I should do (include work at home) [PROMIS] |
| 76853-1 | I feel limited in my ability to visit friends [PROMIS] |
| 76854-9 | I have trouble keeping in touch with others [PROMIS] |
| 76855-6 | I have trouble keeping up with my work responsibilities (include work at home) [PROMIS] |
| 76856-4 | I have trouble doing everything for my friends that I feel I should do [PROMIS] |
| 76857-2 | I feel limited in the amount of time I have to visit friends [PROMIS] |
| 76858-0 | Do you have someone to help you get your mind off things if you need it [PROMIS] |
| 76859-8 | Do you have someone you can call when you want to chat [PROMIS] |
| 76860-6 | Do you have someone with whom you can celebrate holidays [PROMIS] |
| 76861-4 | Do you have someone with whom you can celebrate special occasions [PROMIS] |
| 76862-2 | Do you have someone to call if you are bored [PROMIS] |
| 76863-0 | Do you get invitations to go out and do things with other people [PROMIS] |
| 76864-8 | I have people who I can talk to about my health [PROMIS] |
| 76865-5 | I feel close to my friends [PROMIS] |
| 76866-3 | I get emotional support from my family [PROMIS] |
| 76867-1 | I have someone who makes me feel needed [PROMIS] |
| 76868-9 | I have people who care about what happens to me [PROMIS] |
| 76869-7 | I get love and affection [PROMIS] |
| 76870-5 | I feel there are people who really understand me [PROMIS] |
| 76871-3 | There are people I can talk to [PROMIS] |
| 76872-1 | I get support from my friends [PROMIS] |
| 76873-9 | I feel close to my partner (or the person who is my main support) [PROMIS] |
| 76874-7 | My family has useful information to help me with my problems [PROMIS] |
| 76875-4 | I have someone to talk with about money matters [PROMIS] |
| 76876-2 | Do you have someone to bring you to an appointment if you need it [PROMIS] |
| 76877-0 | Could you get a friend or family member to help move furniture around your home if you need it [PROMIS] |
| 76878-8 | Do you have someone to pick up a prescription if you need it [PROMIS] |
| 76879-6 | Could you get a friend or family member to help fix something at home if you need it [PROMIS] |
| 76880-4 | Could you get a friend or family member to help you with your finances if you need it [PROMIS] |
| 76881-2 | Could you get a friend or family member to help you if you have financial problems [PROMIS] |
| 76882-0 | I find that friends or relatives have difficulty talking with me about my health [PROMIS] |
| 76883-8 | People get the wrong idea about my situation [PROMIS] |
| 76884-6 | I feel that some of my friends avoid me [PROMIS] |
| 76885-3 | I feel that some of my family members avoid me [PROMIS] |
| 76886-1 | I feel that I am no longer close to anyone [PROMIS] |
| 76887-9 | I feel that I am alone in my interests and ideas [PROMIS] |
| 76888-7 | I like being alone [PROMIS] |
| 76889-5 | PROMIS item bank - alcohol - positive expectancies - version 1.0 |
| 76890-3 | People are outgoing when they drink [PROMIS] |
| 76891-1 | People have more desire for sex when they drink [PROMIS] |
| 76892-9 | People sleep better when they drink [PROMIS] |
| 76893-7 | People have more fun at social occasions when they drink [PROMIS] |
| 76894-5 | Alcohol makes it easier to talk to people [PROMIS] |
| 76895-2 | Drinking eases physical pain [PROMIS] |
| 76896-0 | People forget their problems when they drink [PROMIS] |
| 76897-8 | Drinking improves a person's mood [PROMIS] |
| 76898-6 | People feel happy when they drink [PROMIS] |
| 76899-4 | PROMIS item bank - alcohol - alcohol use - version 1.0 |
| 76900-0 | Did you drink any type of alcoholic beverage in past 30D [PROMIS] |
| 76901-8 | I spent too much time drinking in past 30D [PROMIS] |
| 76902-6 | I finished several drinks fast to get a quick effect in past 30D [PROMIS] |
| 76903-4 | I became drunk or intoxicated in past 30D [PROMIS] |
| 76904-2 | On a typical day when I drank alcohol, I had... [PROMIS] |
| 76905-9 | I spent a whole weekend drinking in past 30D [PROMIS] |
| 76906-7 | I drank heavily at a single sitting in past 30D [PROMIS] |
| 76907-5 | I drank too much in past 30D [PROMIS] |
| 76908-3 | I drank throughout the day in past 30D [PROMIS] |
| 76909-1 | The largest number of drinks that I had in a single day in past 30D was... [PROMIS] |
| 76910-9 | I used alcohol and other drugs together to get high in past 30D [PROMIS] |
| 76911-7 | In a typical week in past 30D, I drank... [PROMIS] |
| 76912-5 | I drank more than planned in past 30D [PROMIS] |
| 76913-3 | I had an urge to continue drinking once I started in past 30D [PROMIS] |
| 76914-1 | I felt that I should cut down on my drinking in past 30D [PROMIS] |
| 76915-8 | I had trouble controlling my drinking in past 30D [PROMIS] |
| 76916-6 | It was difficult for me to stop drinking after one or two drinks in past 30D [PROMIS] |
| 76917-4 | I had urges to drink in past 30D [PROMIS] |
| 76918-2 | I had cravings for alcohol in past 30D [PROMIS] |
| 76919-0 | I felt I needed help for my drinking in past 30D [PROMIS] |
| 76920-8 | I had trouble stopping drinking when I wanted to in past 30D [PROMIS] |
| 76921-6 | It was difficult to get the thought of drinking out of my mind in past 30D [PROMIS] |
| 76922-4 | I drank when I was alone in past 30D [PROMIS] |
| 76923-2 | I drank because I had nothing to do in past 30D [PROMIS] |
| 76924-0 | I drank when I arrived at home in past 30D [PROMIS] |
| 76925-7 | I drank because I was angry with myself in past 30D [PROMIS] |
| 76926-5 | I drank because someone made me angry in past 30D [PROMIS] |
| 76927-3 | I drank because I was irritable in past 30D [PROMIS] |
| 76928-1 | I drank because I deserved it in past 30D [PROMIS] |
| 76929-9 | I drank because I was annoyed in past 30D [PROMIS] |
| 76930-7 | I drank because I felt tense in past 30D [PROMIS] |
| 76931-5 | I drank at the end of a busy day in past 30D [PROMIS] |
| 76932-3 | I drank because I was nervous in past 30D [PROMIS] |
| 76933-1 | I drank because I was sad in past 30D [PROMIS] |
| 76934-9 | I drank because I was lonely in past 30D [PROMIS] |
| 76935-6 | I drank because I was depressed in past 30D [PROMIS] |
| 76936-4 | I drank because I had physical pain in past 30D [PROMIS] |
| 76937-2 | I drank because I was bored in past 30D [PROMIS] |
| 76938-0 | PROMIS item bank - alcohol - negative consequences - version 1.0 |
| 76939-8 | PROMIS item bank - alcohol - positive outcomes - version 1.0 |
| 76940-6 | PROMIS item bank - alcohol - negative expectancies - version 1.0 |
| 76941-4 | People have trouble thinking when they drink [PROMIS] |
| 76942-2 | People feel sick the day after drinking [PROMIS] |
| 76943-0 | People do things they regret while drinking [PROMIS] |
| 76944-8 | People make bad decisions when they drink [PROMIS] |
| 76945-5 | Drinking is harmful to mental health [PROMIS] |
| 76946-3 | People are careless when they drink [PROMIS] |
| 76947-1 | People are irresponsible when they drink [PROMIS] |
| 76948-9 | People are pushy when they drink [PROMIS] |
| 76949-7 | People are rude when they drink [PROMIS] |
| 76950-5 | Drinking can be harmful to physical health [PROMIS] |
| 76951-3 | People are selfish when they drink [PROMIS] |
| 76952-1 | I worried when I drank in past 30D [PROMIS] |
| 76953-9 | I felt angry when I drank in past 30D [PROMIS] |
| 76954-7 | I felt nervous when I drank in past 30D [PROMIS] |
| 76955-4 | My problems seemed worse when I drank in past 30D [PROMIS] |
| 76956-2 | I had trouble keeping appointments after I drank in past 30D [PROMIS] |
| 76957-0 | I got confused when I drank in past 30D [PROMIS] |
| 76958-8 | I took risks when I drank in past 30D [PROMIS] |
| 76959-6 | I was critical of myself when I drank in past 30D [PROMIS] |
| 76960-4 | I felt guilty when I drank in past 30D [PROMIS] |
| 76961-2 | I had a headache after I drank in past 30D [PROMIS] |
| 76962-0 | I got sick when I drank in past 30D [PROMIS] |
| 76963-8 | I felt anxious when I drank in past 30D [PROMIS] |
| 76964-6 | I was clumsy when I drank in past 30D [PROMIS] |
| 76965-3 | I was unreliable after I drank in past 30D [PROMIS] |
| 76966-1 | Others complained about my drinking in past 30D [PROMIS] |
| 76967-9 | I was criticized about my drinking in past 30D [PROMIS] |
| 76968-7 | I got in an argument when I drank in past 30D [PROMIS] |
| 76969-5 | I was loud when I drank in past 30D [PROMIS] |
| 76970-3 | I felt sad when I drank in past 30D [PROMIS] |
| 76971-1 | Drinking created problems between me and others in past 30D [PROMIS] |
| 76972-9 | I said or did embarrassing things when I drank in past 30D [PROMIS] |
| 76973-7 | I lied about my drinking in past 30D [PROMIS] |
| 76974-5 | I disappointed others when I drank in past 30D [PROMIS] |
| 76975-2 | Others had trouble counting on me when I drank in past 30D [PROMIS] |
| 76976-0 | I looked sloppy when I drank in past 30D [PROMIS] |
| 76977-8 | I felt dizzy when I drank in past 30D [PROMIS] |
| 76978-6 | I had a hangover after I drank in past 30D [PROMIS] |
| 76979-4 | I used poor judgment when I drank in past 30D [PROMIS] |
| 76980-2 | I had trouble getting things done after I drank in past 30D [PROMIS] |
| 76981-0 | I was inconsiderate when I drank in past 30D [PROMIS] |
| 76982-8 | I had trouble trusting other people when I drank in past 30D [PROMIS] |
| 76983-6 | My future seemed better when I drank in past 30D [PROMIS] |
| 76984-4 | I was able to express myself better when I drank in past 30D [PROMIS] |
| 76985-1 | I felt comfortable around others when I drank in past 30D [PROMIS] |
| 76986-9 | I felt relaxed when I drank in past 30D [PROMIS] |
| 76987-7 | I felt at ease when I drank in past 30D [PROMIS] |
| 76988-5 | I felt good about myself when I drank in past 30D [PROMIS] |
| 76989-3 | I felt happy when I drank in past 30D [PROMIS] |
| 76990-1 | I felt a sense of control when I drank in past 30D [PROMIS] |
| 76991-9 | I felt like I could do anything when I drank in past 30D [PROMIS] |
| 76992-7 | I calmed down when I drank in past 30D [PROMIS] |
| 76993-5 | I felt creative when I drank in past 30D [PROMIS] |
| 76994-3 | I felt outgoing when I drank in past 30D [PROMIS] |
| 76995-0 | I enjoyed life when I drank in past 30D [PROMIS] |
| 76996-8 | I felt confident when I drank in past 30D [PROMIS] |
| 76997-6 | I slept better after I drank in past 30D [PROMIS] |
| 76998-4 | I could relax when I drank in past 30D [PROMIS] |
| 76999-2 | I fit in better when I drank in past 30D [PROMIS] |
| 77000-8 | I had more fun when I drank in past 30D [PROMIS] |
| 77001-6 | I had more desire for sex when I drank in past 30D [PROMIS] |
| 77002-4 | It was easier to talk to people when I drank in past 30D [PROMIS] |
| 77003-2 | PROMIS short form - alcohol - alcohol use 7a - version 1.0 |
| 77004-0 | PROMIS short form - alcohol - negative consequences 7a - version 1.0 |
| 77005-7 | PROMIS short form - alcohol - negative expectancies 7a - version 1.0 |
| 77006-5 | PROMIS short form - alcohol - positive expectancies 7a - version 1.0 |
| 77007-3 | PROMIS short form - alcohol - positive consequences 7a - version 1.0 |
| 77221-0 | Clinical knowledge, decision making, and mental workload panel [NMMDS] |
| 77222-8 | Knowledge required level [NMMDS] |
| 77223-6 | Nursing staff.knowledge required level/Nursing staff [NMMDS] |
| 77224-4 | Decision making required level [NMMDS] |
| 77225-1 | Nursing staff.decision making required level/Nursing staff [NMMDS] |
| 77226-9 | Workload dimensions panel [NMMDS] |
| 77227-7 | Time load level [NMMDS] |
| 77228-5 | Nursing staff.time load level/Nursing staff [NMMDS] |
| 77229-3 | Mental effort load level [NMMDS] |
| 77230-1 | Nursing staff.mental effort load level/Nursing staff [NMMDS] |
| 77231-9 | Psychological stress load level [NMMDS] |
| 77232-7 | Nursing staff.psychological stress load level/Nursing staff [NMMDS] |
| 77234-3 | How often in the past 12 months would you say the patient was worried or stressed about having enough money to buy nutritious meals [BRFSS] |
| 77235-0 | On a typical weekday in the past week, how much time did the patient spend watching TV AndOr DVDs |
| 77236-8 | On a typical weekend day in the past week, how much time did the patient spend watching TV AndOr DVDs |
| 77237-6 | On a typical weekday in the past week, how much time did the patient spend playing video games and computer games |
| 77238-4 | On a typical weekend day in the past week, how much time did the patient spend playing video games and computer games |
| 77239-2 | Is the patient fed something other than breast milk or formula |
| 77240-0 | How much formula does the patient drink per day |
| 77241-8 | Is the patient having any problems breastfeeding |
| 77242-6 | Physical activity behavior |
| 77243-4 | Dietary behavior |
| 77244-2 | Total combined household income range in last year |
| 77245-9 | Readiness for change for improved nutrition [Reported] |
| 77246-7 | Readiness for change for improved sleep patterns [Reported] |
| 77247-5 | Readiness for change for improved exercise [Reported] |
| 77248-3 | Readiness for change for improved screen-time [Reported] |
| 77251-7 | Percent impairment - confidence [OPTIMAL] |
| 77252-5 | Percent impairment - difficulty [OPTIMAL] |
| 77255-8 | Nursing staff job positions, quantity, turnover, and retention panel [NMMDS] |
| 77256-6 | Nursing staff quantity panel [NMMDS] |
| 77257-4 | Number of actual nursing staff by job position in a reporting period [NMMDS] |
| 77258-2 | Full time equivalent hours of actual nursing staff [NMMDS] |
| 77259-0 | Number of budgeted nursing staff by job position in a reporting period [NMMDS] |
| 77260-8 | Full time equivalent hours of budgeted nursing staff [NMMDS] |
| 77261-6 | Nursing staff.voluntary turnover.transfer/Nursing staff [NMMDS] |
| 77262-4 | Nursing staff.voluntary turnover/Nursing staff [NMMDS] |
| 77263-2 | Number of productive staff in a reporting period [NMMDS] |
| 77264-0 | Number of new nursing staff by job position in a reporting period [NMMDS] |
| 77265-7 | Number of new nursing staff by job position who remained in a reporting period [NMMDS] |
| 77266-5 | Number of new nursing staff by job position who left in a reporting period [NMMDS] |
| 77267-3 | Number of nursing staff by job position at beginning of a reporting period [NMMDS] |
| 77268-1 | Number of nursing staff by job position at beginning of a reporting period who remained [NMMDS] |
| 77269-9 | Number of nursing staff by job position at beginning of a reporting period who left [NMMDS] |
| 77270-7 | Number of nursing staff by job position who left in a reporting period [NMMDS] |
| 77271-5 | Average number of nursing staff by job position in a reporting period [NMMDS] |
| 77272-3 | Number of unfilled nursing staff job positions in a reporting period [NMMDS] |
| 77273-1 | Nursing staff turnover panel [NMMDS] |
| 77274-9 | Nursing staff.voluntary turnover.terminate/Nursing staff [NMMDS] |
| 77275-6 | Nursing staff.involuntary turnover/Nursing staff [NMMDS] |
| 77276-4 | Turnover rate [NMMDS] |
| 77277-2 | Vacancy rate [NMMDS] |
| 77278-0 | Number of budgeted nursing staff job positions filled in a reporting period [NMMDS] |
| 77279-8 | Nursing staff retention panel [NMMDS] |
| 77280-6 | Accession rate [NMMDS] |
| 77281-4 | Stability rate [NMMDS] |
| 77282-2 | Instability rate [NMMDS] |
| 77283-0 | Survival rate [NMMDS] |
| 77284-8 | Nursing staff job positions panel [NMMDS] |
| 77285-5 | Wastage rate [NMMDS] |
| 77286-3 | Direct care staff [NMMDS] |
| 77287-1 | Management, administrative, AndOr support staff [NMMDS] |
| 77293-9 | Days per week of moderate to vigorous physical activity |
| 77294-7 | Yesterday, how many times did the patient eat any vegetables # |
| 77295-4 | Yesterday, how many times did the patient drink bottles or glasses of water # |
| 77296-2 | Yesterday, how many times did the patient drink 100% fruit juice # |
| 77297-0 | Yesterday, how many times did the patient drink any punch, Kool-Aid, Tampico, other fruit-flavored drinks, or sports drinks # |
| 77298-8 | Yesterday, how many times did the patient eat food from any type of restaurant # |
| 77299-6 | Yesterday, how many times the patient eat fruit # |
| 77300-2 | Yesterday, how many times did the patient drink any regular (not diet) sodas or soft drinks # |
| 77308-5 | Yesterday, did the patient eat French fries or chips [IHE.HW] |
| 77315-0 | Yesterday, what percent of snacks were healthy |
| 77316-8 | How often have you added cereal to your baby's bottle of formula or pumped (or expressed) breast milk in the past 2 weeks [IFPS-II] |
| 77317-6 | In the past week, how many times were dinners prepared at home and eaten together |
| 77318-4 | Is the patient breastfed |
| 77352-3 | Thoughts on artificial nutrition and hydration [Reported] |
| 77393-7 | Yesterday, how many 8-ounce portions of milk did the patient drink # |
| 77498-4 | Can pronounce ache [AmNART] |
| 77499-2 | Can pronounce aisle [AmNART] |
| 77500-7 | Can pronounce capon [AmNART] |
| 77501-5 | Can pronounce debt [AmNART] |
| 77502-3 | Can pronounce chord [AmNART] |
| 77503-1 | Can pronounce heir [AmNART] |
| 77504-9 | Can pronounce deny [AmNART] |
| 77505-6 | Can pronounce bouquet [AmNART] |
| 77506-4 | Can pronounce caprice [AmNART] |
| 77507-2 | Can pronounce gauge [AmNART] |
| 77508-0 | Can pronounce worsted [AmNART] |
| 77509-8 | Can pronounce depot [AmNART] |
| 77510-6 | Can pronounce nausea [AmNART] |
| 77511-4 | Can pronounce naive [AmNART] |
| 77512-2 | Can pronounce subtle [AmNART] |
| 77513-0 | Can pronounce pugilist [AmNART] |
| 77514-8 | Can pronounce fetal [AmNART] |
| 77515-5 | Can pronounce blatant [AmNART] |
| 77516-3 | Can pronounce placebo [AmNART] |
| 77517-1 | Can pronounce hiatus [AmNART] |
| 77518-9 | Can pronounce smile [AmNART] |
| 77519-7 | Can pronounce meringue [AmNART] |
| 77520-5 | Can pronounce sieve [AmNART] |
| 77521-3 | Can pronounce chassis [AmNART] |
| 77522-1 | Can pronounce cellist [AmNART] |
| 77523-9 | Can pronounce algae [AmNART] |
| 77524-7 | Can pronounce superfluous [AmNART] |
| 77525-4 | Can pronounce chamois [AmNART] |
| 77526-2 | Can pronounce thyme [AmNART] |
| 77527-0 | Can pronounce apropos [AmNART] |
| 77528-8 | Can pronounce virulent [AmNART] |
| 77529-6 | Can pronounce zealot [AmNART] |
| 77530-4 | Can pronounce facade [AmNART] |
| 77531-2 | Can pronounce cabal [AmNART] |
| 77532-0 | Can pronounce abstemious [AmNART] |
| 77533-8 | Can pronounce detente [AmNART] |
| 77534-6 | Can pronounce scion [AmNART] |
| 77535-3 | Can pronounce papyrus [AmNART] |
| 77536-1 | Can pronounce quadruped [AmNART] |
| 77537-9 | Can pronounce prelate [AmNART] |
| 77538-7 | Can pronounce epitome [AmNART] |
| 77539-5 | Can pronounce beautify [AmNART] |
| 77540-3 | Can pronounce hyperbole [AmNART] |
| 77541-1 | Can pronounce imbroglio [AmNART] |
| 77542-9 | Can pronounce syncope [AmNART] |
| 77543-7 | Correct responses count # [AmNART] |
| 77544-5 | Data collected |
| 77545-2 | Premorbid estimate # [AmNART] |
| 77546-0 | Incorrect responses count # [AmNART] |
| 77547-8 | American National Adult Reading Test (AmNART) panel |
| 77548-6 | Client accessibility panel [NMMDS] |
| 77549-4 | Time to access a patient [NMMDS] |
| 77550-2 | Time to access all patients in a Report Period [NMMDS] |
| 77551-0 | Total number of patient encounters in a reporting period [NMMDS] |
| 77552-8 | Average time to access a patient in a Report Period [NMMDS] |
| 77553-6 | Distance to access a patient [NMMDS] |
| 77554-4 | Distance to access all patients in a Report Period [NMMDS] |
| 77555-1 | Average distance to access a patient in a Report Period [NMMDS] |
| 77556-9 | Method used to connect with a patient [NMMDS] |
| 77557-7 | Time required to gather essential resources for a patient encounter [NMMDS] |
| 77558-5 | Time required to gather essential resources for all patient encounters in a Report Period [NMMDS] |
| 77559-3 | Average time required to gather essential resources for a patient encounter in a Report Period [NMMDS] |
| 77560-1 | Distance required to gather essential resources for a patient encounter [NMMDS] |
| 77561-9 | Distance required to gather essential resources for all patient encounters in a Report Period [NMMDS] |
| 77562-7 | Average distance required to gather essential resources for a patient encounter in a Report Period [NMMDS] |
| 77564-3 | Brief Pain Inventory Short Form - pain interference panel |
| 77565-0 | Pain interference score [BPI Short Form] |
| 77566-8 | During the past 24 hours, how has pain interfered with your general activity [BPI Short Form] |
| 77567-6 | During the past 24 hours, how has pain interfered with your mood [BPI Short Form] |
| 77568-4 | During the past 24 hours, how has pain interfered with your walking ability [BPI Short Form] |
| 77569-2 | During the past 24 hours, how has pain interfered with your normal work [BPI Short Form] |
| 77570-0 | During the past 24 hours, how has pain interfered with your relations with other people [BPI Short Form] |
| 77571-8 | During the past 24 hours, how has pain interfered with your sleep [BPI Short Form] |
| 77572-6 | During the past 24 hours, how has pain interfered with your enjoyment of life [BPI Short Form] |
| 77578-3 | PROMIS parent proxy mobility - version 1.0 T-score |
| 77579-1 | PROMIS pediatric physical function: mobility - version 1.0 T-score |
| 77580-9 | PROMIS physical function w mobility aids - version 1.0 T-score |
| 77582-5 | International Physical Activity Questionnaire Self-Administered Short Form [IPAQ] |
| 77583-3 | During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, digging, aerobics, or fast bicycling for at least 10 minutes at a time [IPAQ] |
| 77584-1 | How much time did you usually spend doing vigorous physical activities on one of those days [IPAQ] |
| 77585-8 | During the last 7 days, on how many days did you do moderate physical activities like carrying light loads, bicycling at a regular pace, or doubles tennis for at least 10 minutes at a time [IPAQ] |
| 77586-6 | How much time did you usually spend doing moderate physical activities on one of those days [IPAQ] |
| 77587-4 | During the last 7 days, on how many days did you walk for at least 10 minutes at a time [IPAQ] |
| 77588-2 | How much time did you usually spend walking on one of those days [IPAQ] |
| 77589-0 | During the last 7 days, how much time did you usually spend sitting on a weekday [IPAQ] |
| 77591-6 | Walking physical activity [IPAQ] |
| 77592-4 | Moderate physical activity [IPAQ] |
| 77593-2 | Vigorous physical activity [IPAQ] |
| 77594-0 | Total physical activity [IPAQ] |
| 77595-7 | Total physical activity score [IPAQ] |
| 77782-1 | PROMIS short form - alcohol - positive consequences 7a - version 1.0 raw score |
| 77783-9 | PROMIS short form - alcohol - positive expectancies 7a - version 1.0 raw score |
| 77784-7 | PROMIS alcohol - positive outcomes - version 1.0 Tscore |
| 77785-4 | PROMIS alcohol - negative consequences - version 1.0 Tscore |
| 77786-2 | PROMIS alcohol - positive expectancies - version 1.0 Tscore |
| 77789-6 | PROMIS alcohol - negative expectancies - version 1.0 Tscore |
| 77792-0 | PROMIS short form - emotional support 4a - version 2.0 raw score |
| 77793-8 | PROMIS short form - alcohol - negative expectancies 7a - version 1.0 raw score |
| 77794-6 | PROMIS short form - alcohol - negative consequences 7a - version 1.0 raw score |
| 77795-3 | PROMIS short form - alcohol - alcohol use 7a - version 1.0 raw score |
| 77796-1 | PROMIS short form - physical function 8b - version 1.2 raw score |
| 77797-9 | PROMIS short form - physical function 6b - version 1.2 raw score |
| 77798-7 | PROMIS short form - social isolation 8a - version 2.0 raw score |
| 77799-5 | PROMIS short form - social isolation 6a - version 2.0 raw score |
| 77800-1 | PROMIS short form - social isolation 4a - version 2.0 raw score |
| 77801-9 | PROMIS short form - satisfaction with social roles and activities 8a - version 2.0 raw score |
| 77802-7 | PROMIS short form - satisfaction with social roles and activities 6a - version 2.0 raw score |
| 77803-5 | PROMIS short form - satisfaction with social roles and activities 4a - version 2.0 raw score |
| 77804-3 | PROMIS short form - instrumental support 8a - version 2.0 raw score |
| 77805-0 | PROMIS short form - instrumental support 6a - version 2.0 raw score |
| 77806-8 | PROMIS short form - instrumental support 4a - version 2.0 raw score |
| 77807-6 | PROMIS short form - informational support 8a - version 2.0 raw score |
| 77808-4 | PROMIS short form - informational support 6a - version 2.0 raw score |
| 77809-2 | PROMIS short form - informational support 4a - version 2.0 raw score |
| 77810-0 | PROMIS short form - emotional support 8a - version 2.0 raw score |
| 77811-8 | PROMIS short form - emotional support 6a - version 2.0 raw score |
| 77812-6 | PROMIS short form - companionship 6a - version 2.0 raw score |
| 77813-4 | PROMIS short form - companionship 4a - version 2.0 raw score |
| 77814-2 | PROMIS short form - ability to participate in social roles and activities 8a - version 2.0 raw score |
| 77815-9 | PROMIS short form - satisfaction with participation in social roles 4a - version 1.0 raw score |
| 77816-7 | PROMIS short form - sleep disturbance 6a - version 1.0 raw score |
| 77817-5 | PROMIS short form - physical function 20a - version 1.0 raw score |
| 77818-3 | PROMIS short form - satisfaction with participation in social roles 8a - version 1.0 raw score |
| 77819-1 | PROMIS short form - physical function 4a - version 1.0 raw score |
| 77820-9 | PROMIS short form - emotional distress - anxiety 4a - version 1.0 raw score |
| 77821-7 | PROMIS short form - emotional distress - depression 4a - version 1.0 raw score |
| 77822-5 | PROMIS short form - fatigue 4a - version 1.0 raw score |
| 77824-1 | PROMIS short form - pain interference 8a - version 1.0 raw score |
| 77825-8 | PROMIS short form - pain intensity 3a - version 1.0 raw score |
| 77826-6 | PROMIS short form - sleep disturbance 4a - version 1.0 raw score |
| 77827-4 | PROMIS short form - physical function 10a - version 1.0 raw score |
| 77828-2 | PROMIS short form - sleep impairment 8a - version 1.0 raw score |
| 77829-0 | PROMIS short form - sleep disturbance 8b - version 1.0 raw score |
| 77830-8 | PROMIS short form - satisfaction with participation in social roles 7a - version 1.0 raw score |
| 77831-6 | PROMIS short form - satisfaction with participation in DSA 7a - version 1.0 raw score |
| 77832-4 | PROMIS short form - pain behavior 7a - version 1.0 raw score |
| 77833-2 | PROMIS short form - pain interference 6b - version 1.0 raw score |
| 77834-0 | PROMIS short form - fatigue 7a - version 1.0 raw score |
| 77835-7 | PROMIS short form - emotional distress - depression 8b - version 1.0 raw score |
| 77836-5 | PROMIS short form - emotional distress - anxiety 7a - version 1.0 raw score |
| 77837-3 | PROMIS short form - emotional distress - anger 8a - version 1.0 raw score |
| 77838-1 | PROMIS short form - global - version 1.1 raw score |
| 77839-9 | PROMIS pediatric short form - pain interference 8a - version 1.0 raw score |
| 77840-7 | PROMIS pediatric short form - fatigue 10a - version 1.0 raw score |
| 77841-5 | PROMIS pediatric short form - peer relationships 8a - version 1.0 raw score |
| 77842-3 | PROMIS pediatric short form - asthma 8a - version 1.0 raw score |
| 77843-1 | PROMIS pediatric short form - physical function - upper extremity 8a - version 1.0 raw score |
| 77844-9 | PROMIS pediatric short form - physical function - mobility 8a - version 1.0 raw score |
| 77845-6 | PROMIS pediatric short form - emotional distress - anxiety 8a - version 1.0 raw score |
| 77846-4 | PROMIS pediatric short form - emotional distress - anger - version 1.0 raw score |
| 77847-2 | PROMIS pediatric short form - depressive symptoms - version 1.0 raw score |
| 77848-0 | PROMIS alcohol - alcohol use - version 1.0 Tscore |
| 77849-8 | PROMIS social isolation - version 2.0 Tscore |
| 77850-6 | PROMIS instrumental support - version 2.0 Tscore |
| 77851-4 | PROMIS informational support - version 2.0 Tscore |
| 77852-2 | PROMIS emotional support - version 2.0 Tscore |
| 77853-0 | PROMIS companionship - version 2.0 Tscore |
| 77854-8 | PROMIS ability to participate in social roles and activities - version 2.0 Tscore |
| 77855-5 | PROMIS satisfaction with social roles and activities - version 2.0 Tscore |
| 77856-3 | PROMIS pain behavior - version 1.0 Tscore |
| 77857-1 | PROMIS satisfaction with participation in roles - version 1.0 Tscore |
| 77858-9 | PROMIS satisfaction with participation in DSA - version 1.0 Tscore |
| 77859-7 | PROMIS sleep related impairment - version 1.0 Tscore |
| 77860-5 | PROMIS sleep disturbance - version 1.0 Tscore |
| 77861-3 | PROMIS emotional distress - depression - version 1.0 Tscore |
| 77862-1 | PROMIS emotional distress - anxiety - version 1.0 Tscore |
| 77863-9 | PROMIS emotional distress - anger - version 1.0 Tscore |
| 77864-7 | PROMIS fatigue - version 1.0 Tscore |
| 77865-4 | PROMIS pain interference - version 1.0 Tscore |
| 77866-2 | PROMIS physical function - version 1.0 Tscore |
| 77867-0 | PROMIS pediatric physical function - upper extremity - version 1.0 Tscore |
| 77868-8 | PROMIS pediatric peer relationships - version 1.0 Tscore |
| 77869-6 | PROMIS pediatric pain interference - version 1.0 Tscore |
| 77871-2 | PROMIS pediatric fatigue - version 1.0 Tscore |
| 77872-0 | PROMIS pediatric asthma - version 1.0 Tscore |
| 77873-8 | PROMIS pediatric emotional distress - anxiety - version 1.0 Tscore |
| 77874-6 | PROMIS physical function - version 1.2 Tscore |
| 77875-3 | PROMIS pediatric short form - emotional distress - anxiety 8b - version 1.1 |
| 77965-2 | Immediate national notifiable condition |
| 77966-0 | Reporting state |
| 77967-8 | Reporting county |
| 77968-6 | National reporting jurisdiction |
| 77969-4 | Jurisdiction code |
| 77970-2 | Date of initial report |
| 77972-8 | Earliest date reported to county |
| 77973-6 | Earliest date reported to state |
| 77979-3 | Case investigation start date |
| 77980-1 | Case is associated with a known outbreak |
| 77981-9 | Case outbreak name |
| 77982-7 | Jurisdiction where disease acquired |
| 77988-4 | Binational reporting criteria [CDC.PHIN] |
| 77990-0 | Case class status [CDC.PHIN] |
| 77991-8 | MMWR Week [CDC.PHIN] |
| 77992-6 | MMWR Year [CDC.PHIN] |
| 77993-4 | State notifiable condition case identifier |
| 77994-2 | Date of first report to Centers for Disease Control and Prevention [CDC.PHIN] |
| 77995-9 | Date of first report to public health department |
| 77997-5 | Legacy case identifier [CDC.PHIN] |
| 77998-3 | Age at time of case investigation |
| 77999-1 | Case notification comment |
| 78000-7 | Case notification panel [CDC.PHIN] |
| 78020-5 | Admission priority [NHCS] |
| 78021-3 | Specialty care unit Type [NHCS] |
| 78022-1 | Care setting Facility [NHCS] |
| 78025-4 | Outpatient visit discharge disposition [NHCS] |
| 78026-2 | Diagnosis present on admission |
| 78027-0 | Follow-up attempt within 24 hours |
| 78028-8 | Follow-up attempt outcome [NHCS] |
| 78029-6 | Patient Point of origin [NHCS] |
| 78030-4 | Episode of care Type |
| 78048-6 | Are you able to dress yourself, including tying shoelaces and buttoning your clothes [PROMIS] |
| 78049-4 | Are you able to run or jog for two miles (3 km) [PROMIS] |
| 78050-2 | Are you able to get up from the floor from lying on your back without help [PROMIS] |
| 78051-0 | Are you able to run at a fast pace for two miles (3 km) [PROMIS] |
| 78052-8 | Does your health now limit you in hiking a couple of miles (3 km) on uneven surfaces, including hills [PROMIS] |
| 78053-6 | Are you able to carry two bags filled with groceries 100 yards (100 m) [PROMIS] |
| 78054-4 | Are you able to lift 10 pounds (5 kg) above your shoulder [PROMIS] |
| 78055-1 | Are you able to reach and get down a 5 pound (2 kg) object from above your head [PROMIS] |
| 78056-9 | Are you able to lift one pound (0.5 kg) to shoulder level without bending your elbow [PROMIS] |
| 78057-7 | Are you able to walk a block (about 100 m) on flat ground [PROMIS] |
| 78058-5 | Are you able to run five miles (8 km) [PROMIS] |
| 78061-9 | Are you able to run 100 yards (100 m) [PROMIS] |
| 78062-7 | Are you able to run ten miles (16 km) [PROMIS] |
| 78064-3 | Does your health now limit you in walking more than a mile (1.6 km) [PROMIS] |
| 78066-8 | Are you able to sit on and get up from the toilet [PROMIS] |
| 78069-2 | I could pick up coins from a table in past 7 days [PROMIS.PEDS] |
| 78070-0 | I could wash my hair by myself in past 7 days [PROMIS.PEDS] |
| 78071-8 | I could put beads on a string in past 7 days [PROMIS.PEDS] |
| 78072-6 | I could comb my hair by myself in past 7 days [PROMIS.PEDS] |
| 78073-4 | I could thread a needle in past 7 days [PROMIS.PEDS] |
| 78074-2 | I could jump up and down in past 7 days [PROMIS.PEDS] |
| 78075-9 | I needed to sleep during the day in past 7 days [PROMIS.PEDS] |
| 78076-7 | I was too tired to eat in past 7 days [PROMIS.PEDS] |
| 78077-5 | Being tired made it hard for me to remember things in past 7 days [PROMIS.PEDS] |
| 78078-3 | I felt tired even when I had not done anything in past 7 days [PROMIS.PEDS] |
| 78079-1 | I felt sad for no reason in past 7 days [PROMIS.PEDS] |
| 78081-7 | Are you able to carry a heavy object (over 10 pounds or 5 kg) [PROMIS] |
| 78082-5 | Are you able to pull heavy objects (10 pounds or 5 kg) towards yourself [PROMIS] |
| 78083-3 | I felt really respected by my family in past 4 weeks [PROMIS.PEDS] |
| 78084-1 | I felt important in my family in past 4 weeks [PROMIS.PEDS] |
| 78085-8 | I felt my family believed in me in past 4 weeks [PROMIS.PEDS] |
| 78086-6 | My family was interested in what I was doing in past 4 weeks [PROMIS.PEDS] |
| 78087-4 | People in my family made me feel good about myself in past 4 weeks [PROMIS.PEDS] |
| 78088-2 | I felt totally accepted by my family in past 4 weeks [PROMIS.PEDS] |
| 78089-0 | I felt that my family understood me in past 4 weeks [PROMIS.PEDS] |
| 78090-8 | I could depend on my family in past 4 weeks [PROMIS.PEDS] |
| 78091-6 | I got the support I needed from my family in past 4 weeks [PROMIS.PEDS] |
| 78092-4 | I knew what I could expect from others in my family in past 4 weeks [PROMIS.PEDS] |
| 78093-2 | I got all the help I needed from my family in past 4 weeks [PROMIS.PEDS] |
| 78094-0 | I could talk to someone in my family if something was bothering me in past 4 weeks [PROMIS.PEDS] |
| 78095-7 | I could talk to someone in my family about my problems in past 4 weeks [PROMIS.PEDS] |
| 78096-5 | I knew my family would help me if I needed it in past 4 weeks [PROMIS.PEDS] |
| 78097-3 | I felt that I could trust the people in my family in past 4 weeks [PROMIS.PEDS] |
| 78098-1 | I could trust others in my family in past 4 weeks [PROMIS.PEDS] |
| 78099-9 | My family treated me fairly in past 4 weeks [PROMIS.PEDS] |
| 78100-5 | I knew that my family would be there if I needed them in past 4 weeks [PROMIS.PEDS] |
| 78101-3 | I felt everyone in my family loved me in past 4 weeks [PROMIS.PEDS] |
| 78102-1 | Everyone in my family loved each other in past 4 weeks [PROMIS.PEDS] |
| 78103-9 | I felt loved by my family in past 4 weeks [PROMIS.PEDS] |
| 78104-7 | My family showed that they cared about me in past 4 weeks [PROMIS.PEDS] |
| 78105-4 | I felt I really belonged in my family in past 4 weeks [PROMIS.PEDS] |
| 78106-2 | I felt I had a strong relationship with my family in past 4 weeks [PROMIS.PEDS] |
| 78107-0 | I felt very close to my family in past 4 weeks [PROMIS.PEDS] |
| 78108-8 | It was easy to be close to everyone in my family in past 4 weeks [PROMIS.PEDS] |
| 78109-6 | I felt a sense of togetherness with my family in past 4 weeks [PROMIS.PEDS] |
| 78110-4 | I believed in helping my family, no matter what in past 4 weeks [PROMIS.PEDS] |
| 78111-2 | I wanted to help my family however I could in past 4 weeks [PROMIS.PEDS] |
| 78112-0 | I felt that I had similar values and beliefs as others in my family in past 4 weeks [PROMIS.PEDS] |
| 78113-8 | I could rely on my family in past 4 weeks [PROMIS.PEDS] |
| 78114-6 | I felt really important to my family in past 4 weeks [PROMIS.PEDS] |
| 78115-3 | People in my family helped each other in past 4 weeks [PROMIS.PEDS] |
| 78116-1 | I felt that my family really respected me in past 4 weeks [PROMIS.PEDS] |
| 78117-9 | I could talk to someone in my family if I needed to in past 4 weeks [PROMIS.PEDS] |
| 78118-7 | Everyone in my family could be completely trusted in past 4 weeks [PROMIS.PEDS] |
| 78119-5 | Everyone in my family loved me in past 4 weeks [PROMIS.PEDS] |
| 78120-3 | I felt that my family loved me in past 4 weeks [PROMIS.PEDS] |
| 78123-7 | My child felt really respected by our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78124-5 | My child felt important in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78125-2 | My child felt that our family believed in him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78126-0 | My child knew our family was interested in what he or she was doing in past 4 weeks [PROMIS.PARENTPROXY] |
| 78127-8 | People in our family made my child feel good about himself or herself in past 4 weeks [PROMIS.PARENTPROXY] |
| 78128-6 | My child felt totally accepted by our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78129-4 | My child felt that our family understood him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78130-2 | My child felt he or she could depend on our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78131-0 | My child felt he or she got the support he or she needed from our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78132-8 | My child knew what he or she could expect from others in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78133-6 | My child felt he or she got all the help he or she needed from our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78134-4 | My child felt he or she could talk to someone in our family if something was bothering him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78135-1 | My child knew he or she could talk to someone in our family about his or her problems in past 4 weeks [PROMIS.PARENTPROXY] |
| 78136-9 | My child knew our family would help if he or she needed it in past 4 weeks [PROMIS.PARENTPROXY] |
| 78137-7 | My child felt that he or she could trust the people in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78138-5 | My child knew he or she could trust others in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78139-3 | My child felt our family treated him or her fairly in past 4 weeks [PROMIS.PARENTPROXY] |
| 78140-1 | My child knew that our family would be there if he or she needed them in past 4 weeks [PROMIS.PARENTPROXY] |
| 78141-9 | My child felt everyone in our family loved him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78142-7 | My child felt everyone in our family loved each other in past 4 weeks [PROMIS.PARENTPROXY] |
| 78143-5 | My child felt loved by our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78144-3 | My child felt that our family showed that they cared about him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78145-0 | My child felt he or she really belonged in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78146-8 | My child felt he or she had a strong relationship with our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78147-6 | My child felt very close to our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78148-4 | My child felt it was easy for him or her to be close to everyone in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78149-2 | My child felt a sense of togetherness with our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78150-0 | My child believed in helping our family, no matter what in past 4 weeks [PROMIS.PARENTPROXY] |
| 78151-8 | My child wanted to help our family however he or she could in past 4 weeks [PROMIS.PARENTPROXY] |
| 78152-6 | My child felt that he or she had similar values and beliefs as others in our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78153-4 | My child knew he or she could rely on our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78154-2 | My child felt he or she was really important to our family in past 4 weeks [PROMIS.PARENTPROXY] |
| 78155-9 | My child felt that people in our family helped each other in past 4 weeks [PROMIS.PARENTPROXY] |
| 78156-7 | My child felt that our family really respected him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78157-5 | My child knew he or she could talk to someone in our family if he or she needed to in past 4 weeks [PROMIS.PARENTPROXY] |
| 78158-3 | My child knew that everyone in our family could be completely trusted in past 4 weeks [PROMIS.PARENTPROXY] |
| 78159-1 | My child knew everyone in our family loved him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78160-9 | My child felt that our family loved him or her in past 4 weeks [PROMIS.PARENTPROXY] |
| 78161-7 | PROMIS pediatric item bank - physical function - upper extremity - version 2.0 |
| 78162-5 | It was hard for me to be away from home because I had pain in past 7 days [PROMIS.PEDS] |
| 78163-3 | It was hard to have fun with friends because I was in pain in past 7 days [PROMIS.PEDS] |
| 78164-1 | I needed help walking when I was in pain in past 7 days [PROMIS.PEDS] |
| 78165-8 | I walked carefully when I was in pain in past 7 days [PROMIS.PEDS] |
| 78166-6 | My pain was so bad that I needed to take medicine to treat it in past 7 days [PROMIS.PEDS] |
| 78167-4 | It was hard to do things with my family because I had pain in past 7 days [PROMIS.PEDS] |
| 78168-2 | I felt too nervous to be with a group of kids my age in past 7 days [PROMIS.PEDS] |
| 78169-0 | I worried that something might happen to my parents or guardians in past 7 days [PROMIS.PEDS] |
| 78170-8 | PROMIS pediatric short form - emotional distress - anxiety 8b - version 1.1 raw score |
| 78171-6 | I was angry when things didn't go my way in past 7 days [PROMIS.PEDS] |
| 78172-4 | I wanted to be alone because I was so angry in past 7 days [PROMIS.PEDS] |
| 78173-2 | I was so mad I did not want to talk to people in past 7 days [PROMIS.PEDS] |
| 78174-0 | I had a bad temper in past 7 days [PROMIS.PEDS] |
| 78369-6 | ADHD hyperactive symptoms mean score percent difference [Calculated] |
| 78370-4 | ADHD diagnostic rating scale interpretation [Vanderbilt ADHD] |
| 78371-2 | ADHD inattentive symptoms mean score [Calculated] |
| 78372-0 | ADHD hyperactive symptoms mean score [Calculated] |
| 78373-8 | ADHD inattentive symptoms mean score percent difference [Calculated] |
| 78997-4 | Can you walk 25 feet on a level surface (with or without support) [PROMIS] |
| 78998-2 | Are you able to go OUTSIDE the home, for example to shop or visit a doctor's office [PROMIS] |
| 78999-0 | Are you able to dial a number on a phone with large buttons [PROMIS] |
| 79000-6 | Are you able to clean up after a meal [PROMIS] |
| 79001-4 | How much difficulty do you currently have opening previously opened jars [PROMIS] |
| 79002-2 | Are you able to dial a number on the keypad of a cell phone [PROMIS] |
| 79003-0 | Are you able to roll onto your stomach while lying in bed [PROMIS] |
| 79004-8 | Are you able to pull up covers while lying in bed [PROMIS] |
| 79005-5 | Are you able to hike a couple of miles on uneven surfaces, including hills [PROMIS] |
| 79006-3 | Are you able to walk more than a mile [PROMIS] |
| 79007-1 | Are you able to open and squeeze a new tube of toothpaste [PROMIS] |
| 79008-9 | How much difficulty do you currently have pulling up and fastening your pants after a bowel movement [PROMIS] |
| 79009-7 | Are you able to fasten and unfasten a seatbelt [PROMIS] |
| 79010-5 | Are you able to do chores such as vacuuming carpet or mopping floors [PROMIS] |
| 79011-3 | Are you able to go up and down stairs [PROMIS] |
| 79012-1 | Are you able to lift small objects (such as a can of soup) above your shoulder [PROMIS] |
| 79013-9 | Are you able to carry a bag of groceries for a short distance [PROMIS] |
| 79014-7 | Able to put on socks [PROMIS] |
| 79015-4 | Are you able to pull a sweater or t-shirt over your head [PROMIS] |
| 79016-2 | How much difficulty do you currently have cleaning yourself after a bowel movement [PROMIS] |
| 79017-0 | Are you able to do an exercise of your choice for 20 minutes several times a week [PROMIS] |
| 79018-8 | Are you able to do strenuous tasks around the house like cleaning the bathroom or scrubbing floors [PROMIS] |
| 79019-6 | Are you able to stand on a moving escalator [PROMIS] |
| 79020-4 | Are you able to pour liquid from a container into a cup [PROMIS] |
| 79021-2 | Are you able to turn pages in a book [PROMIS] |
| 79022-0 | Are you able to prepare simple meals for yourself or for others [PROMIS] |
| 79023-8 | Are you able to reach above your head [PROMIS] |
| 79024-6 | Are you able to do housework like vacuuming or sweeping floors [PROMIS] |
| 79025-3 | Are you able to do yard work like raking leaves or sweeping the driveway [PROMIS] |
| 79026-1 | Are you able to take a letter out of an envelope [PROMIS] |
| 79027-9 | Are you able to push the buttons on a television remote control [PROMIS] |
| 79028-7 | Are you able to get items in and out of a wallet [PROMIS] |
| 79029-5 | Are you able to turn a key to unlock a door [PROMIS] |
| 79030-3 | Are you able to take a shower [PROMIS] |
| 79031-1 | Are you able to turn sink faucets on and off [PROMIS] |
| 79032-9 | Are you able to type a few sentences on a computer keyboard [PROMIS] |
| 79033-7 | Are you able to move about the house [PROMIS] |
| 79034-5 | Are you able to use a regular computer mouse [PROMIS] |
| 79035-2 | Are you able to move wet clothes from the washer to the dryer [PROMIS] |
| 79036-0 | Are you able to move around on a slippery surface outdoors [PROMIS] |
| 79037-8 | Are you able to move about in a dark room or hallway without falling [PROMIS] |
| 79038-6 | Are you able to do vigorous activities, such as playing sports [PROMIS] |
| 79039-4 | Are you able to carry a shopping bag [PROMIS] |
| 79040-2 | Are you able to dress yourself [PROMIS] |
| 79041-0 | Are you able to wash and dry your feet [PROMIS] |
| 79042-8 | Are you able to wash dishes and utensils by hand [PROMIS] |
| 79043-6 | How much difficulty do you currently have sitting down on a low, soft couch [PROMIS] |
| 79044-4 | How much difficulty do you currently have standing up from a low, soft couch [PROMIS] |
| 79045-1 | Are you able to stand upright briefly without support [PROMIS] |
| 79046-9 | Are you able to transfer from a bed to a chair or a wheelchair [PROMIS] |
| 79047-7 | If you need to, are you physically able to rush for a short distance, such as to cross a street [PROMIS] |
| 79048-5 | Are you able to move from the street to the sidewalk without a curb cut [PROMIS] |
| 79049-3 | Are you able to use a moving escalator safely [PROMIS] |
| 79050-1 | Are you able to fasten buttons on a shirt or blouse [PROMIS] |
| 79051-9 | Are you able to hold a card or letter in order to read it [PROMIS] |
| 79052-7 | Are you able to cut your toenails [PROMIS] |
| 79053-5 | Are you able to fold clean laundry [PROMIS] |
| 79054-3 | Are you able to get into a vehicle [PROMIS] |
| 79055-0 | How much difficulty do you currently have getting into and out of a truck, bus, shuttle van or sport utility vehicle [PROMIS] |
| 79056-8 | How much difficulty do you currently have applying spreads to breads using a knife [PROMIS] |
| 79057-6 | How much difficulty do you currently have playing cards or Bingo or other light recreational activities [PROMIS] |
| 79058-4 | How much difficulty do you currently have removing wrappings from small objects [PROMIS] |
| 79059-2 | Are you able to exercise regularly [PROMIS] |
| 79060-0 | Are you able to receive a call on a cell phone [PROMIS] |
| 79061-8 | Are you able to open a tight or new jar [PROMIS] |
| 79062-6 | PROMIS item bank - physical function w mobility aids - version 1.0 |
| 79063-4 | PROMIS short form - physical function w mobility aids - version 1.0 |
| 79064-2 | PROMIS short form - physical function w mobility aids - version 1.0 raw score |
| 79104-6 | Recall [GPCOG] |
| 79105-3 | Can provide correct date [GPCOG] |
| 79106-1 | Can correctly draw all the numbers to indicate the hours of a clock [GPCOG] |
| 79107-9 | Can correctly draw hands to show 10M past eleven o'clock [GPCOG] |
| 79108-7 | Can report something that happened in the news recently [GPCOG] |
| 79109-5 | Can recall John [GPCOG] |
| 79110-3 | Can recall Brown [GPCOG] |
| 79111-1 | Can recall 42 [GPCOG] |
| 79112-9 | Can recall West [GPCOG] |
| 79113-7 | Can recall Kensington [GPCOG] |
| 79114-5 | Total score - Patient examination [GPCOG] |
| 79115-2 | General Practitioner Assessment of Cognition [GPCOG] |
| 79116-0 | Informant interview panel [GPCOG] |
| 79117-8 | Patient examination panel [GPCOG] |
| 79118-6 | Compared to a few years ago, does the patient have more trouble remembering things that have happened recently than she or he used to [GPCOG] |
| 79119-4 | Compared to a few years ago, does he or she have more trouble recalling conversations a few days later [GPCOG] |
| 79120-2 | Compared to a few years ago, when speaking, does the patient have more difficulty in finding the right word or tend to use the wrong words more often [GPCOG] |
| 79121-0 | Compared to a few years ago, is the patient less able to manage money and financial affairs (e.g. paying bills, budgeting) [GPCOG] |
| 79122-8 | Compared to a few years ago, is the patient less able to manage his or her medication independently [GPCOG] |
| 79123-6 | Compared to a few years ago, does the patient need more assistance with transport (either private or public) [GPCOG] |
| 79124-4 | Total score - Informant interview [GPCOG] |
| 79150-9 | Clock drawing panel [GPCOG] |
| 79431-3 | Quality of life score change [HOOS] |
| 79432-1 | Sport-recreation score change [HOOS] |
| 79433-9 | Activities of daily living score change [HOOS] |
| 79434-7 | Symptoms score change [HOOS] |
| 79435-4 | Pain score change [HOOS] |
| 79436-2 | Quality of life score change [KOOS] |
| 79437-0 | Sport-recreation score change [KOOS] |
| 79438-8 | Activities of daily living score change [KOOS] |
| 79439-6 | Symptoms score change [KOOS] |
| 79440-4 | Pain score change [KOOS] |
| 79441-2 | VR-12 Physical component summary (PCS) score change - oblique method |
| 79442-0 | VR-12 Physical component summary (PCS) score change - orthogonal method |
| 79443-8 | VR-12 Mental component summary (MCS) score change - oblique method |
| 79444-6 | VR-12 Mental component summary (MCS) score change - orthogonal method |
| 80356-9 | Cause of death entity axis code [Automated] |
| 80357-7 | Cause of death record axis code [Automated] |
| 80358-5 | Cause of death.underlying [Automated] |
| 80359-3 | Cause of death.underlying [Manual] |
| 80616-6 | Date and time pronounced dead [US Standard Certificate of Death] |
| 80626-5 | Activity at time of death [CDC] |
| 80883-2 | American Urological Association Symptom Index [AUASI] |
| 80884-0 | How often have you had a sensation of not emptying your bladder completely after you finished urinating over the past month [AUASI] |
| 80885-7 | How often have you had to urinate again less than two hours after you finished urinating over the past month [AUASI] |
| 80886-5 | How often have you found you stopped and started again several times when you urinated over the past month [AUASI] |
| 80887-3 | How often have you found it difficult to postpone urination over the past month [AUASI] |
| 80888-1 | How often have you had a weak urinary stream in the last month [AUASI] |
| 80889-9 | How often have you had to push or strain to begin urination over the past month [AUASI] |
| 80890-7 | How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning over the past month [AUASI] |
| 80891-5 | Symptom score [AUASI] |
| 80903-8 | Birth certificate ID |
| 80904-6 | Birth year |
| 80905-3 | Body disposition method |
| 80906-1 | Bridged race [CDC] |
| 80907-9 | Death registration date |
| 80908-7 | Ethnicity [CDC] |
| 80909-5 | Father's last name |
| 80910-3 | State or province of birth |
| 80911-1 | Death pronouncer Provider [Extended Identifier] |
| 80913-7 | Highest level of education [US Standard Certificate of Death] |
| 80976-4 | International Prostate Symptom Score [IPSS] |
| 80977-2 | Tabulated race [CDC] |
| 80978-0 | Tabulated ethnicity [CDC] |
| 81090-3 | If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS] |
| 81224-8 | Vomiting [CCC] |
| 81225-5 | Bleeding risk [CCC] |
| 81226-3 | Electrolyte imbalance [CCC] |
| 81227-1 | Fall risk [CCC] |
| 81329-5 | Thoughts on resuscitation [Reported] |
| 81330-3 | Thoughts on intubation [Reported] |
| 81331-1 | Thoughts on tube feeding [Reported] |
| 81332-9 | Thoughts on IV fluid and support [Reported] |
| 81333-7 | Thoughts on antibiotics [Reported] |
| 81340-2 | Goals AndOr preferences in order of priority [Reported] |
| 81341-0 | Circumstances that activate healthcare agent's powers [Reported] |
| 81342-8 | Healthcare agent appointment intended to be valid in any jurisdiction [Reported] |
| 81343-6 | Healthcare agent advisor [Reported] |
| 81344-4 | Healthcare agent authority to inspect and disclose mental and physical health information [Reported] |
| 81345-1 | Healthcare agent authority to inspect and disclose specially protected health information [Reported] |
| 81346-9 | Limitations placed on healthcare agent [Reported] |
| 81347-7 | Consent for healthcare agent to deviate from stated goals, preferences and priorities [Reported] |
| 81348-5 | Compensation for healthcare agent [Reported] |
| 81349-3 | Thoughts on life-sustaining procedures if pregnant [Reported] |
| 81350-1 | Thoughts on pain management [Reported] |
| 81351-9 | Do Not Resuscitate, Do Not Attempt Resuscitation, or Allow Natural Death order is in place [Reported] |
| 81352-7 | Medical Order for Life-Sustaining Treatment, Physician Order for Life-Sustaining Treatment, or a similar medical order is in place [Reported] |
| 81353-5 | Thoughts on hastening death [Reported] |
| 81354-3 | Prescribed anticipatory medication [Reported] |
| 81355-0 | Location of prescribed anticipatory medication [Reported] |
| 81356-8 | Death arrangements [Reported] |
| 81357-6 | Messages to be delivered after death [Reported] |
| 81358-4 | Person(s) to notify upon death [Reported] |
| 81359-2 | Near death thoughts and feelings to be shared [Reported] |
| 81360-0 | My likes and joys [Reported] |
| 81361-8 | Things that make me laugh [Reported] |
| 81362-6 | My dislikes and fears [Reported] |
| 81363-4 | Things that matter to me [Reported] |
| 81364-2 | Religious or cultural beliefs [Reported] |
| 81365-9 | Religious or cultural affiliation contact to notify [Reported] |
| 81366-7 | Unfinished business [Reported] |
| 81367-5 | Personal advance care plan signer for declarant [Reported] |
| 81368-3 | Statement of witness [Reported] |
| 81375-8 | Self assessment of health status [Reported] |
| 81376-6 | Mental health treatment preferences [Reported] |
| 81377-4 | Goals, preferences, and priorities regarding the appointment of healthcare agents [Reported] |
| 81378-2 | Goals, preferences, and priorities under certain health conditions [Reported] |
| 81379-0 | Goals, preferences, and priorities upon death [Reported] |
| 81380-8 | Goals, preferences, and priorities for care experience [Reported] |
| 81381-6 | Administrative information associated with this personal advance care plan |
| 81382-4 | Statement of document creator [Reported] |
| 81460-8 | I have had trouble forming thoughts in past 7 days [PROMIS] |
| 81461-6 | My thinking has been slow in past 7 days [PROMIS] |
| 81462-4 | My thinking has been foggy in past 7 days [PROMIS] |
| 81463-2 | I have had trouble adding or subtracting numbers in my head in past 7 days [PROMIS] |
| 81464-0 | I have made mistakes when writing down phone numbers in past 7 days [PROMIS] |
| 81465-7 | I have had trouble concentrating in past 7 days [PROMIS] |
| 81466-5 | I have had trouble finding my way to a familiar place in past 7 days [PROMIS] |
| 81467-3 | I have had trouble remembering where I put things, like my keys or my wallet in past 7 days [PROMIS] |
| 81468-1 | I have had trouble remembering whether I did things I was supposed to do, like taking a medicine or buying something I needed in past 7 days [PROMIS] |
| 81469-9 | I have had trouble remembering new information, like phone numbers or simple instructions in past 7 days [PROMIS] |
| 81470-7 | I have had trouble recalling the name of an object while talking to someone in past 7 days [PROMIS] |
| 81471-5 | I have had trouble speaking fluently in past 7 days [PROMIS] |
| 81472-3 | I have walked into a room and forgotten what I meant to get or do there in past 7 days [PROMIS] |
| 81473-1 | I have needed medical instructions repeated because I could not keep them straight in past 7 days [PROMIS] |
| 81474-9 | I have had to work really hard to pay attention or I would make a mistake in past 7 days [PROMIS] |
| 81475-6 | I have forgotten names of people soon after being introduced in past 7 days [PROMIS] |
| 81476-4 | My reactions in everyday situations have been slow in past 7 days [PROMIS] |
| 81477-2 | Other people have told me I seemed to have trouble remembering information in past 7 days [PROMIS] |
| 81478-0 | It has seemed like my brain was not working as well as usual in past 7 days [PROMIS] |
| 81479-8 | I have had to work harder than usual to keep track of what I was doing in past 7 days [PROMIS] |
| 81480-6 | My thinking has been slower than usual in past 7 days [PROMIS] |
| 81481-4 | I have had to work harder than usual to express myself clearly in past 7 days [PROMIS] |
| 81482-2 | I have had more problems conversing with others in past 7 days [PROMIS] |
| 81483-0 | I have had to use written lists more often than usual so I would not forget things in past 7 days [PROMIS] |
| 81484-8 | I have had trouble keeping track of what I was doing when interrupted in past 7 days [PROMIS] |
| 81485-5 | I have had trouble shifting back and forth between different activities that require thinking in past 7 days [PROMIS] |
| 81486-3 | I have hidden my problems with memory, concentration, or making mental mistakes so that others would not notice in past 7 days [PROMIS] |
| 81487-1 | I have been upset about my problems with memory, concentration, or making mental mistakes in past 7 days [PROMIS] |
| 81488-9 | My problems with memory, concentration, or making mental mistakes have interfered with my ability to work in past 7 days [PROMIS] |
| 81489-7 | My problems with memory, concentration, or making mental mistakes have interfered with my ability to do things I enjoy in past 7 days [PROMIS] |
| 81490-5 | My problems with memory, concentration, or making mental mistakes have interfered with the quality of my life in past 7 days [PROMIS] |
| 81491-3 | I have had difficulty multi-tasking in past 7 days [PROMIS] |
| 81492-1 | PROMIS item bank - cognitive function - abilities subset - version 2.0 |
| 81493-9 | I have been able to bring to mind words that I wanted to use while talking to someone in past 7 days [PROMIS] |
| 81494-7 | I have been able to remember to do things, like take medicine or buy something I needed in past 7 days [PROMIS] |
| 81495-4 | I have been able to pay attention and keep track of what I am doing without extra effort in past 7 days [PROMIS] |
| 81496-2 | I have been able to think clearly in past 7 days [PROMIS] |
| 81497-0 | My mind has been as sharp as usual in past 7 days [PROMIS] |
| 81498-8 | My memory has been as good as usual in past 7 days [PROMIS] |
| 81499-6 | My thinking has been as fast as usual in past 7 days [PROMIS] |
| 81500-1 | I have been able to shift back and forth between two activities that require thinking in past 7 days [PROMIS] |
| 81501-9 | I have been able to keep track of what I am doing, even if I am interrupted in past 7 days [PROMIS] |
| 81502-7 | I have been able to concentrate in past 7 days [PROMIS] |
| 81503-5 | I have been able to form thoughts clearly in past 7 days [PROMIS] |
| 81504-3 | I have been able to remember telephone numbers in past 7 days [PROMIS] |
| 81505-0 | I have been able to get my point across when talking with someone in past 7 days [PROMIS] |
| 81506-8 | I have been able to remember the name of a familiar object in past 7 days [PROMIS] |
| 81507-6 | I have been able to think as clearly as usual without extra effort in past 7 days [PROMIS] |
| 81508-4 | I have been able to remember things as easily as usual without extra effort in past 7 days [PROMIS] |
| 81509-2 | My ability to remember important dates has been as good as usual in past 7 days [PROMIS] |
| 81510-0 | My ability to remember names has been as good as usual in past 7 days [PROMIS] |
| 81511-8 | My ability to keep track of lists has been as good as usual in past 7 days [PROMIS] |
| 81512-6 | My thinking has been clear in past 7 days [PROMIS] |
| 81513-4 | My ability to count money has been as good as usual in past 7 days [PROMIS] |
| 81514-2 | My ability to follow driving directions has been as good as usual in past 7 days [PROMIS] |
| 81515-9 | I have been able to handle many tasks at once without losing track of what I was doing in past 7 days [PROMIS] |
| 81516-7 | My ability to remember things that I need to do has been as good as usual in past 7 days [PROMIS] |
| 81517-5 | I have been able to multi-task as easily as usual without extra effort in past 7 days [PROMIS] |
| 81518-3 | I have been able to think clearly without extra effort in past 7 days [PROMIS] |
| 81519-1 | My ability to concentrate has been good in past 7 days [PROMIS] |
| 81520-9 | I have been able to focus my attention in past 7 days [PROMIS] |
| 81521-7 | I have been able to mentally focus in past 7 days [PROMIS] |
| 81522-5 | I have been able to remember the name of a familiar person in past 7 days [PROMIS] |
| 81523-3 | I have been able to learn new things easily, like telephone numbers or instructions in past 7 days [PROMIS] |
| 81524-1 | PROMIS item bank - cognitive function - version 2.0 |
| 81525-8 | PROMIS short form - cognitive function - abilities subset 4a - version 2.0 |
| 81526-6 | PROMIS short form - cognitive function - abilities subset 6a - version 2.0 |
| 81527-4 | PROMIS short form - cognitive function - abilities subset 8a - version 2.0 |
| 81528-2 | PROMIS short form - cognitive function 4a - version 2.0 |
| 81529-0 | PROMIS short form - cognitive function 6a - version 2.0 |
| 81530-8 | PROMIS short form - cognitive function 8a - version 2.0 |
| 81531-6 | PROMIS short form - cognitive function 8a - version 2.0 raw score |
| 81532-4 | PROMIS short form - cognitive function 6a - version 2.0 raw score |
| 81533-2 | PROMIS short form - cognitive function 4a - version 2.0 raw score |
| 81534-0 | PROMIS short form - cognitive function - abilities subset 4a - version 2.0 raw score |
| 81535-7 | PROMIS short form - cognitive function - abilities subset 6a - version 2.0 raw score |
| 81536-5 | PROMIS short form - cognitive function - abilities subset 8a - version 2.0 raw score |
| 81537-3 | PROMIS cognitive function - abilities subset - version 2.0 T-score |
| 81538-1 | PROMIS cognitive function - version 2.0 T-score |
| 82141-3 | Did you live with anyone who was depressed, mentally ill, or suicidal--before 18 years old [ACE.BRFSS] |
| 82142-1 | Did you live with anyone who was a problem drinker or alcoholic--before 18 years old [ACE.BRFSS] |
| 82143-9 | Did you live with anyone who used illegal street drugs or who abused prescription medications--before 18 years old [ACE.BRFSS] |
| 82144-7 | Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility--before 18 years old [ACE.BRFSS] |
| 82145-4 | Were your parents separated or divorced--before 18 years old [ACE.BRFSS] |
| 82146-2 | How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up--before 18 years old [ACE.BRFSS] |
| 82147-0 | Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way--before 18 years old [ACE.BRFSS] |
| 82148-8 | How often did a parent or adult in your home ever swear at you, insult you, or put you down--before 18 years old [ACE.BRFSS] |
| 82149-6 | How often did anyone at least 5 years older than you or an adult, ever touch you sexually--before 18 years old [ACE.BRFSS] |
| 82150-4 | How often did anyone at least 5 years older than you or an adult, try to make you touch sexually--before 18 years old [ACE.BRFSS] |
| 82151-2 | How often did anyone at least 5 years older than you or an adult, force you to have sex--before 18 years old [ACE.BRFSS] |
| 82152-0 | BRFSS ACE Module [ACE.BRFSS] |
| 82153-8 | Total score [ACE.BRFSS] |
| 82226-2 | Neck Disability Index [NDI] |
| 82227-0 | Pain intensity [NDI] |
| 82228-8 | Personal care (washing, dressing, etc) [NDI] |
| 82229-6 | Lifting [NDI] |
| 82230-4 | Reading [NDI] |
| 82231-2 | Headaches [NDI] |
| 82232-0 | Concentration [NDI] |
| 82233-8 | Work [NDI] |
| 82234-6 | Driving [NDI] |
| 82235-3 | Sleeping [NDI] |
| 82236-1 | Recreation [NDI] |
| 82237-9 | Total score [NDI] |
| 82316-1 | Hip dysfunction and osteoarthritis outcome score for joint replacement [HOOSJR] |
| 82317-9 | Amount of hip pain experienced while going up or down stairs in the last week [HOOS] |
| 82318-7 | Amount of hip pain experienced while walking on an uneven surface in the last week [HOOS] |
| 82319-5 | Degree of difficulty experienced due to your hip while rising from sitting in the last week [HOOS] |
| 82320-3 | Degree of difficulty experienced due to your hip while bending to floor AndOr pick up an object in the last week [HOOS] |
| 82321-1 | Degree of difficulty experienced due to your hip while lying in bed (turning over, maintaining hip position) in the last week [HOOS] |
| 82322-9 | Degree of difficulty experienced due to your hip while sitting in the last week [HOOS] |
| 82323-7 | Total interval score [HOOSJR] |
| 82324-5 | Knee injury and osteoarthritis outcome score for joint replacement [KOOSJR] |
| 82325-2 | How severe is your knee stiffness after first wakening in the morning during the last week [KOOS] |
| 82326-0 | Amount of knee pain experienced while twisting AndOr pivoting on your knee in the last week [KOOS] |
| 82327-8 | Amount of knee pain experienced while straightening knee fully in the last week [KOOS] |
| 82328-6 | Amount of knee pain experienced while going up or down stairs in the last week [KOOS] |
| 82329-4 | Amount of knee pain experienced while standing upright in the last week [KOOS] |
| 82330-2 | Degree of difficulty experienced due to your knee while rising from sitting in the last week [KOOS] |
| 82331-0 | Degree of difficulty experienced due to your knee while bending to floor AndOr pick up an object in the last week [KOOS] |
| 82332-8 | Total interval score [KOOSJR] |
| 82608-1 | Advancing care information for population |
| 82609-9 | Clinical practice improvement activity for population |
| 82664-4 | Drug Abuse Screening Test [DAST] |
| 82665-1 | Total score [DAST] |
| 82666-9 | Drug Abuse Screening Test-10 [DAST-10] |
| 82667-7 | Total score [DAST-10] |
| 82668-5 | Total score [ACT] |
| 82669-3 | How much of the time did your asthma keep you from getting as much done at work, school or at home in the past 4 weeks [ACT] |
| 82670-1 | How often have you had shortness of breath during the past 4 weeks [ACT] |
| 82671-9 | How often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning during the past 4 weeks [ACT] |
| 82672-7 | How often have you used your rescue inhaler or nebulizer medication (such as albuterol) during the past 4 weeks [ACT] |
| 82673-5 | How would you rate your asthma control during the past 4 weeks [ACT] |
| 82674-3 | Asthma Control Test [ACT] |
| 82813-7 | Adverse Childhood Experiences [ACE] |
| 82814-5 | Emotional abuse--before 18 years old [ACE] |
| 82815-2 | Physical abuse--before 18 years old [ACE] |
| 82816-0 | Sexual abuse--before 18 years old [ACE] |
| 82817-8 | Emotional neglect--before 18 years old [ACE] |
| 82818-6 | Physical neglect--before 18 years old [ACE] |
| 82819-4 | Parental separation or divorce--before 18 years old [ACE] |
| 82820-2 | Domestic violence--before 18 years old [ACE] |
| 82821-0 | Household substance abuse--before 18 years old [ACE] |
| 82822-8 | Mental illness in household--before 18 years old [ACE] |
| 82823-6 | Criminal household member--before 18 years old [ACE] |
| 82940-8 | Speech [ALSFRS-R] |
| 82941-6 | Salivation [ALSFRS-R] |
| 82942-4 | Swallowing [ALSFRS-R] |
| 82943-2 | Handwriting [ALSFRS-R] |
| 82944-0 | Cutting food and handling utensils (patients without gastrostomy) [ALSFRS-R] |
| 82945-7 | Cutting food and handling utensils (patients with gastrostomy) [ALSFRS-R] |
| 82946-5 | Dressing and hygiene [ALSFRS-R] |
| 82947-3 | Turning in bed and adjusting bed clothes [ALSFRS-R] |
| 82948-1 | Walking [ALSFRS-R] |
| 82949-9 | Climbing stairs [ALSFRS-R] |
| 82950-7 | Dyspnea [ALSFRS-R] |
| 82951-5 | Orthopnea [ALSFRS-R] |
| 82952-3 | Respiratory insufficiency [ALSFRS-R] |
| 82953-1 | Total score [ALSFRS-R] |
| 82954-9 | Amyotrophic lateral sclerosis functional rating scale - revised [ALSFRS-R] |
| 83129-7 | Respondent type |
| 83187-5 | Wheel 50 feet with two turns - functional goal during 3 day assessment period [CMS Assessment] |
| 83188-3 | Wheel 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment] |
| 83189-1 | Picking up object - functional goal during 3 day assessment period [CMS Assessment] |
| 83190-9 | Picking up object - functional ability during 3 day assessment period [CMS Assessment] |
| 83191-7 | 12 steps - functional goal during 3 day assessment period [CMS Assessment] |
| 83192-5 | 12 steps - functional ability during 3 day assessment period [CMS Assessment] |
| 83193-3 | 4 steps - functional goal during 3 day assessment period [CMS Assessment] |
| 83194-1 | 4 steps - functional ability during 3 day assessment period [CMS Assessment] |
| 83195-8 | 1 step (curb) - functional goal during 3 day assessment period [CMS Assessment] |
| 83196-6 | 1 step (curb) - functional ability during 3 day assessment period [CMS Assessment] |
| 83197-4 | Walking 10 feet on uneven surfaces - functional goal during 3 day assessment period [CMS Assessment] |
| 83198-2 | Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period [CMS Assessment] |
| 83199-0 | Walk 150 feet - functional goal during 3 day assessment period [CMS Assessment] |
| 83200-6 | Walk 150 feet - functional ability during 3 day assessment period [CMS Assessment] |
| 83201-4 | Walk 50 feet with two turns - functional goal during 3 day assessment period [CMS Assessment] |
| 83202-2 | Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment] |
| 83203-0 | Walk 10 feet - functional goal during 3 day assessment period [CMS Assessment] |
| 83204-8 | Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment] |
| 83205-5 | Car transfer - functional goal during 3 day assessment period [CMS Assessment] |
| 83206-3 | Car transfer - functional ability during 3 day assessment period [CMS Assessment] |
| 83207-1 | Toilet transfer - functional goal during 3 day assessment period [CMS Assessment] |
| 83208-9 | Toilet transfer - functional ability during 3 day assessment period [CMS Assessment] |
| 83209-7 | Bed-to-chair transfer - functional goal during 3 day assessment period [CMS Assessment] |
| 83210-5 | Bed-to-chair transfer - functional ability during 3 day assessment period [CMS Assessment] |
| 83211-3 | Sit to stand - functional goal during 3 day assessment period [CMS Assessment] |
| 83212-1 | Sit to stand - functional ability during 3 day assessment period [CMS Assessment] |
| 83213-9 | Lying to sitting on side of bed - functional goal during 3 day assessment period [CMS Assessment] |
| 83214-7 | Lying to sitting on side of bed - functional ability during 3 day assessment period [CMS Assessment] |
| 83215-4 | Sit to lying - functional goal during 3 day assessment period [CMS Assessment] |
| 83216-2 | Sit to lying - functional ability during 3 day assessment period [CMS Assessment] |
| 83217-0 | Roll left and right - functional goal during 3 day assessment period [CMS Assessment] |
| 83218-8 | Roll left and right - functional ability during 3 day assessment period [CMS Assessment] |
| 83219-6 | Putting on/taking off footwear - functional goal during 3 day assessment period [CMS Assessment] |
| 83220-4 | Putting on/taking off footwear - functional ability during 3 day assessment period [CMS Assessment] |
| 83221-2 | Lower body dressing - functional goal during 3 day assessment period [CMS Assessment] |
| 83222-0 | Lower body dressing - functional ability during 3 day assessment period [CMS Assessment] |
| 83223-8 | Upper body dressing - functional goal during 3 day assessment period [CMS Assessment] |
| 83224-6 | Upper body dressing - functional ability during 3 day assessment period [CMS Assessment] |
| 83225-3 | Shower/bathe self - functional goal during 3 day assessment period [CMS Assessment] |
| 83226-1 | Shower/bathe self - functional ability during 3 day assessment period [CMS Assessment] |
| 83227-9 | Toileting hygiene - functional goal during 3 day assessment period [CMS Assessment] |
| 83228-7 | Toileting hygiene - functional ability during 3 day assessment period [CMS Assessment] |
| 83229-5 | Oral hygiene - functional goal during 3 day assessment period [CMS Assessment] |
| 83230-3 | Oral hygiene - functional ability during 3 day assessment period [CMS Assessment] |
| 83231-1 | Eating - functional goal during 3 day assessment period [CMS Assessment] |
| 83232-9 | Eating - functional ability during 3 day assessment period [CMS Assessment] |
| 83233-7 | Self-care - admission performance [CMS Assessment] |
| 83234-5 | Prior device use during assessment period [CMS Assessment] |
| 83235-2 | Wheel 150 feet - functional ability during 3 day assessment period [CMS Assessment] |
| 83236-0 | Wheel 150 feet - functional goal during 3 day assessment period [CMS Assessment] |
| 83237-8 | Bladder and bowel [CMS Assessment] |
| 83238-6 | Bladder continence during 3 day assessment period [CMS Assessment] |
| 83239-4 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2, OASIS E - Prior functioning: everyday activities during assessment period [CMS Assessment] |
| 83241-0 | CMS - Staff assessment for mental status during assessment period [CMS Assessment] |
| 83242-8 | Bowel continence during 3 day assessment period [CMS Assessment] |
| 83243-6 | Comorbidities and coexisting conditions |
| 83244-4 | IRF-PAI v2.0 - Swallowing/nutritional status - admission [CMS Assessment] |
| 83245-1 | Usual ability to swallow during 3 day assessment period [CMS Assessment] |
| 83246-9 | IRF-PAI v3.0, LCDS v4.00 - Current number of unhealed pressure injuries at each stage - admission during assessment period [CMS Assessment] |
| 83247-7 | IRF-PAI v2.0, LCDS v4.00 - Special treatments, procedures, and programs - discharge during assessment period [CMS Assessment] |
| 83248-5 | Should brief interview for mental status be conducted during 3 day assessment period [CMS Assessment] |
| 83249-3 | Understanding verbal content during 3 day assessment period [CMS Assessment] |
| 83250-1 | Expression of ideas and wants during 3 day assessment period [CMS Assessment] |
| 83251-9 | IRF-PAI - Hearing, speech, and vision - admission during assessment period [CMS Assessment] |
| 83252-7 | Special treatments, procedures, and programs at admission [CMS Assessment] |
| 83254-3 | Self-care - discharge performance [CMS Assessment] |
| 83256-8 | IRF-PAI v3.0, LCDS v4.00 - Current number of unhealed pressure injuries at each stage - discharge during assessment period [CMS Assessment] |
| 83258-4 | IRF-PAI - Healed pressure injuries during assessment period [CMS Assessment] |
| 83260-0 | Number of pressure injuries noted on prior assessment that have completely closed - stage 1 during assessment period [CMS Assessment] |
| 83261-8 | IRF-PAI v3.0 - Special treatments, procedures, and programs - admission during assessment period [CMS Assessment] |
| 83264-2 | IRF-PAI - Active diagnoses during assessment period [CMS Assessment] |
| 83266-7 | IRF-PAI - Quality indicators - admission during assessment period [CMS Assessment] |
| 83267-5 | IRF-PAI - Cognitive patterns - admission during assessment period [CMS Assessment] |
| 83268-3 | IRF-PAI - Functional abilities and goals - admission during assessment period [CMS Assessment] |
| 83269-1 | IRF-PAI - Mobility - admission performance during 3 day assessment period [CMS Assessment] |
| 83270-9 | Does the patient walk - admission performance during 3 day assessment period [CMS Assessment] |
| 83271-7 | Does the patient use a wheelchair or scooter during 3 day assessment period [CMS Assessment] |
| 83272-5 | Indicate the type of wheelchair or scooter used during 3 day assessment period [CMS Assessment] |
| 83273-3 | IRF-PAI - Health conditions - admission during assessment period [CMS Assessment] |
| 83274-1 | Did the patient have major surgery during the 100 days prior to admission [CMS Assessment] |
| 83275-8 | IRF-PAI - Quality indicators - discharge during assessment period [CMS Assessment] |
| 83276-6 | IRF-PAI - Functional abilities and goals - discharge [CMS Assessment] |
| 83277-4 | IRF-PAI - Mobility - discharge performance during 3 day assessment period [CMS Assessment] |
| 83278-2 | Does the patient walk - discharge performance during 3 day assessment period [CMS Assessment] |
| 83279-0 | IRF-PAI v3.0, LCDS v4.00, OASIS E - Health conditions - discharge or expired or transfer during assessment period [CMS Assessment] |
| 83280-8 | Has the patient had any falls since admission [CMS Assessment] |
| 83281-6 | IRF-PAI - Skin conditions - discharge during assessment period [CMS Assessment] |
| 83282-4 | Worsening in pressure injury status since admission during assessment period [CMS Assessment] |
| 83283-2 | Stage 2 pressure injuries not present or at a lesser stage on admission/reentry during assessment period [CMS Assessment] |
| 83284-0 | Stage 3 pressure injuries not present or at a lesser stage on admission/reentry during assessment period [CMS Assessment] |
| 83285-7 | Stage 4 pressure injuries not present or at a lesser stage on admission/reentry during assessment period [CMS Assessment] |
| 83286-5 | Unstageable pressure injuries due to non-removable dressing not present or at a lesser stage on admission/reentry during assessment period [CMS Assessment] |
| 83287-3 | Unstageable pressure injury due to slough/eschar not present or at a lesser stage on admission/reenty during assessment period [CMS Assessment] |
| 83288-1 | Unstageable pressure injury due to deep tissue injury not present or at a lesser stage on admission/reentry during assessment period [CMS Assessment] |
| 83322-8 | Home environment safety and stability [PCAM] |
| 83323-6 | Daily activities impact on well-being [PCAM] |
| 83324-4 | Social network [PCAM] |
| 83328-5 | Physical health needs that require further investigation [PCAM] |
| 83329-3 | Health and well-being panel [PCAM] |
| 83330-1 | Physical health impacting mental well-being [PCAM] |
| 83331-9 | Patient Centered Assessment Method panel [PCAM] |
| 83332-7 | Lifestyle behaviors impacting physical or mental well-being [PCAM] |
| 83333-5 | Other mental well-being concerns [PCAM] |
| 83334-3 | Social environmental panel [PCAM] |
| 83335-0 | Financial resources [PCAM] |
| 83336-8 | Health literacy and communication panel [PCAM] |
| 83337-6 | Understand health and well-being and what they need to do to manage their health [PCAM] |
| 83338-4 | Can engage in healthcare discussions [PCAM] |
| 83339-2 | Service coordination panel [PCAM] |
| 83340-0 | Do other services need to be involved to help this client [PCAM] |
| 83341-8 | Are current services involved with this client well-coordinated [PCAM] |
| 83342-6 | Barriers to action [PCAM] |
| 83343-4 | Who needs to be involved [PCAM] |
| 83344-2 | What action is required [PCAM] |
| 83345-9 | What action will be taken [PCAM] |
| 84772-3 | Total score [BSDS] |
| 84773-1 | Total score [MDQ] |
| 84775-6 | Positive Affect Survey - self-report - unadjusted scale score [NIH Toolbox] |
| 84777-2 | Positive Affect Survey - self-report - scale score fully adjusted [NIH Toolbox] |
| 84779-8 | Positive Affect Survey version 2.0 - ages 8-12 - T-score [NIH Toolbox] |
| 84781-4 | Positive Affect Survey - age 18+ - T-score [NIH Toolbox] |
| 84782-2 | Positive Affect Survey - self-report - scale score age adjusted [NIH Toolbox] |
| 84787-1 | Positive Affect Survey version 2.0 - ages 13-17 - T-score [NIH Toolbox] |
| 84788-9 | Positive Affect Survey - parent report - unadjusted scale score [NIH Toolbox] |
| 84789-7 | Positive Affect Survey - parent report - scale score fully adjusted [NIH Toolbox] |
| 84793-9 | Positive Affect Survey version 2.0 - parent report - ages 3-7 - T-score [NIH Toolbox] |
| 84794-7 | Positive Affect Survey - parent report - scale score age adjusted [NIH Toolbox] |
| 84795-4 | Positive Affect Survey - parent report - national percentile [NIH Toolbox] |
| 84796-2 | Positive Affect Survey - self-report - national percentile [NIH Toolbox] |
| 84798-8 | Perceived Stress Survey - parent report - fixed length form - ages 8-12 [NIH Toolbox] |
| 84799-6 | Positive Affect Survey - self report - CAT item bank - ages 18+ [NIH Toolbox] |
| 84800-2 | Positive Affect Survey - self report - fixed length form - ages 18+ [NI |