This is the ValueSet that contains all the codes in Screening and Assessment Survey Codes (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.13) and Treatment Intervention Preferences Grouping (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.9). E.g. what you have to deal with if you get resources containing codes in either of them
Generated Narrative: ValueSet ccd33c06-ba4f-486b-9afa-abf468e3f9bd-848
This value set includes codes based on the following rules:
http://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+ [NIH Toolbox] |
| 84801-0 | Positive Affect Survey version 2.0 - self report - CAT item bank - ages 13-17 [NIH Toolbox] |
| 84802-8 | Positive Affect Survey - parent report - fixed length form - ages 3-12 [NIH Toolbox] |
| 84910-9 | Positive Affect Survey - fixed length form - ages 13-17 [NIH Toolbox] |
| 84932-3 | Friendship Survey - fixed length form - ages 18+ [NIH Toolbox] |
| 84933-1 | Friendship Survey - fixed length form - ages 8-17 [NIH Toolbox] |
| 84956-2 | Instrumental Support Survey - fixed length form - ages 18+ [NIH Toolbox] |
| 84957-0 | Loneliness Survey - fixed length form - ages 18+ [NIH Toolbox] |
| 84958-8 | Loneliness Survey - fixed length form - ages 8-17 [NIH Toolbox] |
| 84962-0 | Friendship Survey - national percentile [NIH Toolbox] |
| 84963-8 | Friendship Survey - scale score age adjusted [NIH Toolbox] |
| 84964-6 | Friendship Survey - age 18+ - T-score [NIH Toolbox] |
| 84966-1 | Friendship Survey version 2.0 - ages 8-17 - T-score [NIH Toolbox] |
| 84968-7 | Friendship Survey - scale score fully adjusted [NIH Toolbox] |
| 84969-5 | Friendship Survey - unadjusted scale score [NIH Toolbox] |
| 84970-3 | Instrumental Support Survey - national percentile [NIH Toolbox] |
| 84971-1 | Instrumental Support Survey - scale score age adjusted [NIH Toolbox] |
| 84972-9 | Instrumental Support Survey - age 18+ - T-score [NIH Toolbox] |
| 84974-5 | Instrumental Support Survey - scale score fully adjusted [NIH Toolbox] |
| 84975-2 | Instrumental Support Survey - unadjusted scale score [NIH Toolbox] |
| 84976-0 | Loneliness Survey - national percentile [NIH Toolbox] |
| 84977-8 | Loneliness Survey - scale score age adjusted [NIH Toolbox] |
| 84978-6 | Loneliness Survey - age 18+ - T-score [NIH Toolbox] |
| 84980-2 | Loneliness Survey version 2.0 - ages 8-17 - T-score [NIH Toolbox] |
| 84982-8 | Loneliness Survey - scale score fully adjusted [NIH Toolbox] |
| 84983-6 | Loneliness Survey - unadjusted scale score [NIH Toolbox] |
| 85008-1 | General Life Satisfaction Survey - unadjusted scale score [NIH Toolbox] |
| 85009-9 | General Life Satisfaction Survey - parent report - fixed length form- ages 3-12 [NIH Toolbox] |
| 85011-5 | General Life Satisfaction Survey version 2.0 - parent report - ages 3-12 - T-score [NIH Toolbox] |
| 85012-3 | General Life Satisfaction Survey - scale score fully adjusted [NIH Toolbox] |
| 85013-1 | General Life Satisfaction Survey - fixed length form B - ages 18+ [NIH Toolbox] |
| 85016-4 | General Life Satisfaction Survey - fixed length form A - ages 18+ [NIH Toolbox] |
| 85019-8 | General Life Satisfaction Survey - CAT item bank - ages 8-12 [NIH Toolbox] |
| 85021-4 | General Life Satisfaction Survey version 2.0 - ages 8-12 - T-score [NIH Toolbox] |
| 85022-2 | General Life Satisfaction Survey - CAT item bank - ages 18+ [NIH Toolbox] |
| 85024-8 | General Life Satisfaction Survey - age 18+ - T-score [NIH Toolbox] |
| 85025-5 | General Life Satisfaction Survey - scale score age adjusted [NIH Toolbox] |
| 85026-3 | General Life Satisfaction Survey - national percentile [NIH Toolbox] |
| 85027-1 | Emotional Support Survey - unadjusted scale score [NIH Toolbox] |
| 85028-9 | Emotional Support Survey - scale score fully adjusted [NIH Toolbox] |
| 85029-7 | Emotional Support Survey - fixed length form - ages 8-17 [NIH Toolbox] |
| 85031-3 | Emotional Support Survey version 2.0 - ages 8-17 - T-score [NIH Toolbox] |
| 85032-1 | Emotional Support Survey - fixed length form - ages 18+ [NIH Toolbox] |
| 85034-7 | Emotional Support Survey - fixed length form - ages 18+ - raw score [NIH Toolbox] |
| 85035-4 | Emotional Support Survey - scale score age adjusted [NIH Toolbox] |
| 85036-2 | Emotional Support Survey - national percentile [NIH Toolbox] |
| 85054-5 | Self-care - discharge goal [CMS Assessment] |
| 85055-2 | IRF-PAI v3.0, LCDS v4.00 - Skin conditions - admission during assessment period [CMS Assessment] |
| 85056-0 | Mobility - discharge goal during 3 day assessment period [CMS Assessment] |
| 85057-8 | PCORnet Common Data Model set - version 3.0 [PCORnet] |
| 85070-1 | Prior functioning.self care during assessment period [CMS Assessment] |
| 85071-9 | Indoor mobility (Ambulation) during assessment period [CMS Assessment] |
| 85072-7 | Stairs during assessment period [CMS Assessment] |
| 85073-5 | Functional cognition during assessment period [CMS Assessment] |
| 85074-3 | General Life Satisfaction Survey - parent report - national percentile [NIH Toolbox] |
| 85075-0 | General Life Satisfaction Survey - parent report - scale score age adjusted [NIH Toolbox] |
| 85076-8 | General Life Satisfaction Survey - parent report - scale score fully adjusted [NIH Toolbox] |
| 85077-6 | General Life Satisfaction Survey - parent report - unadjusted scale score [NIH Toolbox] |
| 85102-2 | Mood Disorder Questionnaire [MDQ] |
| 85103-0 | Bipolar Spectrum Diagnostic Scale [BSDS] |
| 85105-5 | Anger-Affect Survey - CAT item bank - age 18+ [NIH Toolbox] |
| 85106-3 | Peer Rejection Survey version 2.0 - parent report - fixed length form - ages 3-12 [NIH Toolbox] |
| 85108-9 | Positive Peer Interaction Survey version 2.0 - parent report - ages 3-12 - T-score [NIH Toolbox] |
| 85109-7 | Positive Peer Interaction Survey version 2.0 - parent report - fixed length form - ages 3-12 [NIH Toolbox] |
| 85110-5 | Peer Rejection Survey version 2.0 - parent report - ages 3-12 - T-score [NIH Toolbox] |
| 85111-3 | Social Withdrawal Survey version 2.0 - parent report - ages 3-12 - T-score [NIH Toolbox] |
| 85112-1 | Social Withdrawal Survey version 2.0 - parent report - fixed length form - ages 3-12 [NIH Toolbox] |
| 85115-4 | Positive Affect Survey version 2.0 - parent report - CAT item bank - ages 3-7 [NIH Toolbox] |
| 85117-0 | Sadness Survey version 2.0 - parent report - ages 3-7 - T-score [NIH Toolbox] |
| 85118-8 | Sadness Survey version 2.0 - parent report - fixed length form - ages 3-7 [NIH Toolbox] |
| 85120-4 | Fear-Separation Anxiety Survey version 2.0 - parent report - ages 3-7 - T-score [NIH Toolbox] |
| 85121-2 | Fear-Separation Anxiety Survey version 2.0 - parent report - fixed length form - ages 3-7 [NIH Toolbox] |
| 85123-8 | Fear-Over Anxious Survey version 2.0 - parent report - ages 3-7 - T-score [NIH Toolbox] |
| 85124-6 | Fear-Over Anxious Survey version 2.0 - parent report - fixed length form - ages 3-7 [NIH Toolbox] |
| 85126-1 | Self-Efficacy Survey version 2.0 - ages 8-12 - T-score [NIH Toolbox] |
| 85127-9 | Self-Efficacy Survey version 2.0 - CAT item bank - ages 8-12 [NIH Toolbox] |
| 85129-5 | Self-Efficacy Survey version 2.0 - ages 13-17 - T-score [NIH Toolbox] |
| 85130-3 | Anger-Affect Survey - age 18+ - T-score [NIH Toolbox] |
| 85132-9 | General Life Satisfaction Survey version 2.0 - ages 13-17 - T-score [NIH Toolbox] |
| 85133-7 | General Life Satisfaction Survey version 2.0 - CAT item bank - ages 13-17 [NIH Toolbox] |
| 85135-2 | Positive Affect Survey version 2.0 - fixed length form - ages 8-12 [NIH Toolbox] |
| 85136-0 | Sadness Survey version 2.0 - fixed length form - ages 8-17 [NIH Toolbox] |
| 85137-8 | Sadness Survey version 2.0 - ages 8-17 - T-score [NIH Toolbox] |
| 85139-4 | Fear Survey version 2.0 - ages 8-17 - T-score [NIH Toolbox] |
| 85140-2 | Sadness Survey - CAT item bank - age 18+ [NIH Toolbox] |
| 85141-0 | Sadness Survey - age 18+ - T-score [NIH Toolbox] |
| 85143-6 | Fear Survey version 2.0 - fixed length form - ages 8-17 [NIH Toolbox] |
| 85145-1 | Meaning and Purpose Survey - age 18+ - T-score [NIH Toolbox] |
| 85146-9 | Meaning and Purpose Survey - CAT item bank - age 18+ [NIH Toolbox] |
| 85395-2 | IRF-PAI v3.0 - Identification information during assessment period [CMS Assessment] |
| 85396-0 | IRF-PAI - Facility information during assessment period [CMS Assessment] |
| 85397-8 | Inpatient rehabilitation facility admission during assessment period [CMS Assessment] |
| 85398-6 | Admitted from Facility |
| 85399-4 | Prior residence |
| 85400-0 | Prior living arrangement during assessment period [CMS Assessment] |
| 85401-8 | IRF-PAI - Payer information during assessment period [CMS Assessment] |
| 85402-6 | Primary payment source during assessment period [CMS Assessment] |
| 85403-4 | Secondary payment source during assessment period [CMS Assessment] |
| 85404-2 | IRF-PAI - Medical information during assessment period [CMS Assessment] |
| 85405-9 | IRF-PAI - Impairment group - admission during assessment period [CMS Assessment] |
| 85406-7 | IRF-PAI - Impairment group - discharge during assessment period [CMS Assessment] |
| 85407-5 | Arthritis conditions recorded during assessment period [CMS Assessment] |
| 85408-3 | Swallowing status - admission during assessment period [CMS Assessment] |
| 85409-1 | Swallowing status - discharge during assessment period [CMS Assessment] |
| 85410-9 | IRF-PAI - Discharge information during assessment period [CMS Assessment] |
| 85411-7 | Patient discharged against medical advice during assessment period [CMS Assessment] |
| 85412-5 | Program interruption(s) during assessment period [CMS Assessment] |
| 85413-3 | Program interruption date during assessment period [CMS Assessment] |
| 85414-1 | Program return date during assessment period [CMS Assessment] |
| 85415-8 | Patient discharged alive during assessment period [CMS Assessment] |
| 85417-4 | Discharge living arrangement during assessment period [CMS Assessment] |
| 85418-2 | Diagnosis for interruption or death during assessment period [CMS Assessment] |
| 85419-0 | Complications during rehabilitation stay during assessment period [CMS Assessment] |
| 85420-8 | IRF-PAI - Therapy information during assessment period [CMS Assessment] |
| 85446-3 | Health and well-being total [ePCAM] |
| 85447-1 | Health and well-being domain risk level [ePCAM] |
| 85448-9 | Social enviromental total [ePCAM] |
| 85449-7 | Social enviromental domain risk level [ePCAM] |
| 85450-5 | Health literacy and communication total [ePCAM] |
| 85451-3 | Health literacy and communication domain risk level [ePCAM] |
| 85452-1 | Service coordination total [ePCAM] |
| 85453-9 | Service coordination domain risk level [ePCAM] |
| 85454-7 | ePCAM Social Complexity [ePCAM] |
| 85455-4 | Health and well-being panel [ePCAM] |
| 85456-2 | Physical health needs that require further investigation - visual analog rating [ePCAM] |
| 85457-0 | Physical health impacting mental well-being - visual analog rating [ePCAM] |
| 85458-8 | Lifestyle behaviors impacting physical or mental well-being - visual analog rating [ePCAM] |
| 85459-6 | Other mental well-being concerns - visual analog rating [ePCAM] |
| 85460-4 | Social environmental panel [ePCAM] |
| 85461-2 | Home environment safety and stability - visual analog rating [ePCAM] |
| 85462-0 | Daily activities impact on well-being - visual analog rating [ePCAM] |
| 85463-8 | Social network - visual analog rating [ePCAM] |
| 85464-6 | Financial resources - visual analog rating [ePCAM] |
| 85465-3 | Health literacy and communication panel [ePCAM] |
| 85466-1 | Understand health and well-being and what they need to do to manage their health - visual analog rating [ePCAM] |
| 85467-9 | Can engage in healthcare discussions - visual analog rating [ePCAM] |
| 85468-7 | Do other services need to be involved to help this client - visual analog rating [ePCAM] |
| 85469-5 | Are current services involved with this client well-coordinated - visual analog rating [ePCAM] |
| 85483-6 | IRF-PAI v3.0, LCDS v3.00 - Program interruption dates during assessment period [CMS Assessment] |
| 85489-3 | Speech-language pathology services - co-treatment minutes--week 1 [CMS Assessment] |
| 85490-1 | Speech-language pathology services - group minutes--week 1 [CMS Assessment] |
| 85491-9 | Speech-language pathology services - concurrent minutes--week 1 [CMS Assessment] |
| 85492-7 | Speech-language pathology services - individual minutes--week 1 [CMS Assessment] |
| 85493-5 | IRF-PAI - Speech-language pathology services - week 1 [CMS Assessment] |
| 85494-3 | IRF-PAI - Therapy provided - week 1 [CMS Assessment] |
| 85495-0 | IRF-PAI - Therapy provided - week 2 [CMS Assessment] |
| 85523-9 | PROMIS short form - global - version 1.2 raw score |
| 85524-7 | PROMIS short form - global - version 1.2 |
| 85554-4 | Electronic Patient Centered Assessment Method panel [ePCAM] |
| 85555-1 | Service coordination panel [ePCAM] |
| 85557-7 | Physical therapy - individual minutes--week 1 [CMS Assessment] |
| 85558-5 | Physical therapy - concurrent minutes--week 1 [CMS Assessment] |
| 85559-3 | Physical therapy - group minutes--week 1 [CMS Assessment] |
| 85560-1 | Physical therapy - co-treatment minutes--week 1 [CMS Assessment] |
| 85561-9 | IRF-PAI - Occupational therapy - week 1 [CMS Assessment] |
| 85562-7 | Occupational therapy - individual minutes--week 1 [CMS Assessment] |
| 85563-5 | Occupational therapy - concurrent minutes--week 1 [CMS Assessment] |
| 85564-3 | Occupational therapy - group minutes--week 1 [CMS Assessment] |
| 85565-0 | Occupational therapy - co-treatment minutes--week 1 [CMS Assessment] |
| 85566-8 | IRF-PAI - Physical therapy - week 1 [CMS Assessment] |
| 85567-6 | Physical therapy - individual minutes--week 2 [CMS Assessment] |
| 85568-4 | Physical therapy - concurrent minutes--week 2 [CMS Assessment] |
| 85569-2 | Physical therapy - group minutes--week 2 [CMS Assessment] |
| 85570-0 | Physical therapy - co-treatment minutes--week 2 [CMS Assessment] |
| 85571-8 | Occupational therapy - individual minutes--week 2 [CMS Assessment] |
| 85572-6 | Occupational therapy - concurrent minutes--week 2 [CMS Assessment] |
| 85573-4 | Occupational therapy - group minutes--week 2 [CMS Assessment] |
| 85574-2 | Occupational therapy - co-treatment minutes--week 2 [CMS Assessment] |
| 85575-9 | Speech-language pathology services - individual minutes--week 2 [CMS Assessment] |
| 85576-7 | Speech-language pathology services - concurrent minutes--week 2 [CMS Assessment] |
| 85577-5 | Speech-language pathology services - group minutes--week 2 [CMS Assessment] |
| 85578-3 | Speech-language pathology services - co-treatment minutes--week 2 [CMS Assessment] |
| 85585-8 | Date of condition onset |
| 85589-0 | IRF-PAI - Physical therapy - week 2 [CMS Assessment] |
| 85590-8 | IRF-PAI - Occupational therapy - week 2 [CMS Assessment] |
| 85591-6 | IRF-PAI - Speech-language pathology services - week 2 [CMS Assessment] |
| 85598-1 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by causing swelling in your ankles or legs [MLHFQ] |
| 85599-9 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your walking about or climbing stairs difficult [MLHFQ] |
| 85600-5 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your working around the house or yard difficult [MLHFQ] |
| 85601-3 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your going places away from home difficult [MLHFQ] |
| 85602-1 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your sleeping well at night difficult [MLHFQ] |
| 85603-9 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your relating to or doing things with your friends or family difficult [MLHFQ] |
| 85604-7 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your working to earn a living difficult [MLHFQ] |
| 85605-4 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your recreational pastimes, sports or hobbies difficult [MLHFQ] |
| 85606-2 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making your sexual activities difficult [MLHFQ] |
| 85607-0 | Did your heart failure prevent you from living as you wanted during the past month (4weeks) by making you eat less of the foods you like [MLHFQ] |
| 85608-8 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you short of breath [MLHFQ] |
| 85609-6 | Emotional score [MLHFQ] |
| 85610-4 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you stay in a hospital [MLHFQ] |
| 85611-2 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by costing you money for medical care [MLHFQ] |
| 85612-0 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by giving you side effects from treatments [MLHFQ] |
| 85613-8 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you feel you are a burden to your family or friends [MLHFQ] |
| 85614-6 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you feel a loss of self-control in your life [MLHFQ] |
| 85615-3 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you worry [MLHFQ] |
| 85616-1 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making it difficult for you to concentrate or remember things [MLHFQ] |
| 85617-9 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you feel depressed [MLHFQ] |
| 85618-7 | Physical score [MLHFQ] |
| 85619-5 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you sit or lie down to rest during the day [MLHFQ] |
| 85620-3 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) by making you tired, fatigued or low on energy [MLHFQ] |
| 85629-4 | Comatose during 3 day assessment period [CMS Assessment] |
| 85630-2 | Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity during 3 day assessment period [CAM.CMS] |
| 85631-0 | Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said during 3 day assessment period [CAM.CMS] |
| 85632-8 | Facility type during assessment period [CMS Assessment] |
| 85633-6 | Indicate the patient's primary medical condition category during 3 day assessment period [CMS Assessment] |
| 85634-4 | Is there evidence of an acute change in mental status from the patient's baseline during 3 day assessment period [CAM.CMS] |
| 85635-1 | LCDS v3.00 - Active diagnoses [CMS Assessment] |
| 85636-9 | LCDS v4.00 - Administrative information - admission during assessment period [CMS Assessment] |
| 85637-7 | LCDS v3.00 - Assessment administration during assessment period [CMS Assessment] |
| 85638-5 | LCDS v3.00 - Cognitive patterns [CMS Assessment] |
| 85639-3 | LCDS v3.00 - Functional abilities and goals [CMS Assessment] |
| 85640-1 | LCDS v3.00 - Hearing, speech, and vision [CMS Assessment] |
| 85641-9 | LCDS v3.00 - Mobility - admission performance during 3 day assessment period [CMS Assessment] |
| 85642-7 | LCDS - Prior functioning: everyday activities during assessment period [CMS Assessment] |
| 85643-5 | LCDS v3.00 - Special treatments, procedures, and programs - admission during assessment period [CMS Assessment] |
| 85644-3 | LCDS v3.00 - Swallowing/nutritional status [CMS Assessment] |
| 85646-8 | Level of consciousness - Alert (normal) during 3 day assessment [CAM.CMS] |
| 85647-6 | Signature of person collecting or coordinating collection of assessment information Provider |
| 85648-4 | Signature of persons completing the assessment during assessment period [CMS Assessment] |
| 85649-2 | LCDS v3.00 - Signs and Symptoms of Delirium (from CAM) [CMS Assessment] |
| 85650-0 | Title of person collecting or coordinating collection of assessment information Provider |
| 85651-8 | Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject during 3 day assessment period [CAM.CMS] |
| 85652-6 | Wash upper body - functional ability during 3 day assessment period [CMS Assessment] |
| 85653-4 | Wash upper body - functional goal during 3 day assessment period [CMS Assessment] |
| 85655-9 | Level of consciousness - Vigilant or lethargic or stupor or coma during 3 day assessment [CAM.CMS] |
| 85660-9 | LCDS v3.00 - Mobility - discharge goal during 3D assessment period [CMS Assessment] |
| 85661-7 | LCDS v3.00 - Self-care - discharge goal [CMS Assessment] |
| 85663-3 | LCDS v3.00 - Administrative information - discharge during assessment period [CMS Assessment] |
| 85664-1 | LCDS v3.00 - Functional abilities and goals - planned discharge [CMS Assessment] |
| 85665-8 | LCDS v3.00 - Self-care - discharge performance [CMS Assessment] |
| 85666-6 | LCDS v3.00 - Bladder and bowel - planned discharge [CMS Assessment] |
| 85667-4 | LCDS v3.00 - Self-care - admission performance [CMS Assessment] |
| 85669-0 | Number of program interruptions during assessment period [CMS Assessment] |
| 85670-8 | LCDS v3.00 - Skin conditions - discharge during assessment period [CMS Assessment] |
| 85672-4 | LCDS v3.00 - Mobility - discharge performance during 3 day assessment period [CMS Assessment] |
| 85673-2 | LCDS v4.00 - Administrative information - expired during assessment period [CMS Assessment] |
| 85677-3 | Congenital rubella syndrome case classification |
| 85700-3 | Age and setting of exposure to illness verified |
| 85703-7 | Mothers Number of deliveries in the U.S. |
| 85811-8 | LCDS v3.00 - Altered level of consciousness [CMS Assessment] |
| 85812-6 | LCDS v3.00 - Acute onset and fluctuating course [CMS Assessment] |
| 85813-4 | IRF-PAI - Payment source during assessment period [CMS Assessment] |
| 85814-2 | IRF-PAI - Signature of persons completing the assessment during assessment period [CMS Assessment] |
| 85815-9 | LCDS - Pre-admission Service Use during assessment period [CMS Assessment] |
| 85816-7 | LCDS v4.00 - Patient demographic information - admission during assessment period [CMS Assessment] |
| 85817-5 | LCDS v4.00 - Patient demographic information - discharge and expired during assessment period [CMS Assessment] |
| 85845-6 | Impairment group during assessment period [CMS Assessment] |
| 85846-4 | Swallowing status during assessment period [CMS Assessment] |
| 85906-6 | Home health patient tracking sheet - resumption of care during assessment period [CMS Assessment] |
| 85908-2 | Home health patient tracking sheet - start of care during assessment period [CMS Assessment] |
| 85909-0 | OASIS C2 - Patient history and diagnoses - SOC or ROC during assessment period [CMS Assessment] |
| 85911-6 | Diagnoses, symptom control, and optional diagnoses during assessment period [CMS Assessment] |
| 85912-4 | Primary diagnosis during assessment period [CMS Assessment] |
| 85913-2 | Other diagnoses during assessment period [CMS Assessment] |
| 85914-0 | Underlying resolved condition ICD code during assessment period [CMS Assessment] |
| 85915-7 | Episode of care includes influenza vaccination season during assessment period [CMS Assessment] |
| 85917-3 | OASIS C2 - Integumentary status - SOC or ROC during assessment period [CMS Assessment] |
| 85918-1 | Unhealed pressure injury at stage 2 or higher or designated as unstageable during assessment period [CMS Assessment] |
| 85919-9 | OASIS C2 - Current number of unhealed pressure injuries at each stage - SOC or ROC during assessment period [CMS Assessment] |
| 85920-7 | Symptom control rating during assessment period [CMS Assessment] |
| 85921-5 | OASIS C2 - Respiratory status - SOC or ROC during assessment period [CMS Assessment] |
| 85922-3 | OASIS C2 - Elimination status - SOC or ROC [CMS Assessment] |
| 85923-1 | OASIS C2 - ADL and IADLs - SOC or ROC during assessment period [CMS Assessment] |
| 85924-9 | OASIS C2 - Functional abilities and goals - SOC or ROC during assessment period [CMS Assessment] |
| 85925-6 | OASIS C2 - Mobility during assessment period [CMS Assessment] |
| 85926-4 | Lying to sitting on side of bed - functional ability during assessment period [CMS Assessment] |
| 85927-2 | Lying to sitting on side of bed - functional goal during assessment period [CMS Assessment] |
| 85928-0 | OASIS C2 - Medications - SOC or ROC during assessment period [CMS Assessment] |
| 85950-4 | Living situation and availability of assistance during assessment period [CMS Assessment] |
| 85951-2 | Living arrangements during assessment period [CMS Assessment] |
| 86185-6 | Prior functioning.ambulation during assessment period [CMS Assessment] |
| 86186-4 | Prior functioning.transfer during assessment period [CMS Assessment] |
| 86187-2 | Prior functioning.household tasks during assessment period [CMS Assessment] |
| 86245-8 | OASIS E - Administrative Information - FU during assessment period [CMS Assessment] |
| 86246-6 | OASIS C2 - Patient history and diagnoses - follow-up during assessment period [CMS Assessment] |
| 86247-4 | Sensory status - follow-up during assessment period [CMS Assessment] |
| 86248-2 | OASIS C2 - Integumentary status - follow-up during assessment period [CMS Assessment] |
| 86249-0 | OASIS C2, D - Respiratory status - follow-up or discharge during assessment period [CMS Assessment] |
| 86250-8 | OASIS C2, D - Elimination status - follow-up [CMS Assessment] |
| 86251-6 | OASIS C2, D - ADL and IADLs - follow-up during assessment period [CMS Assessment] |
| 86252-4 | OASIS C2, D - Medications - follow-up during assessment period [CMS Assessment] |
| 86253-2 | Therapy need and plan of care - follow-up during assessment period [CMS Assessment] |
| 86254-0 | Underlying resolved condition.multiple coding ICD code during assessment period [CMS Assessment] |
| 86256-5 | Patient history and diagnoses - transfer or discharge from agency during assessment period [CMS Assessment] |
| 86257-3 | Clinical Record Items - transfer or discharge during assessment period [CMS Assessment] |
| 86258-1 | OASIS C2, D - Medications - transfer to inpatient facility during assessment period [CMS Assessment] |
| 86260-7 | Data items collected at inpatient facility admission or agency discharge only - transfer during assessment period [CMS Assessment] |
| 86262-3 | OASIS E - Medications - TRN during assessment period [CMS Assessment] |
| 86263-1 | Data items collected at inpatient facility admission or agency discharge only - discharge from agency - death at home during assessment period [CMS Assessment] |
| 86265-6 | OASIS C2 - Medications - discharge from agency during assessment period [CMS Assessment] |
| 86266-4 | Sensory status - discharge from agency during assessment period [CMS Assessment] |
| 86267-2 | OASIS C2 - Integumentary status - discharge from agency during assessment period [CMS Assessment] |
| 86268-0 | Worsening in pressure injury status since start or resumption of home care during assessment period [CMS Assessment] |
| 86269-8 | OASIS C2 - Elimination status - discharge from agency during assessment period [CMS Assessment] |
| 86270-6 | Current number of unhealed pressure injuries at each stage - follow-up or discharge during assessment period [CMS Assessment] |
| 86335-7 | Total interval score change [HOOSJR] |
| 86336-5 | Total interval score change [KOOSJR] |
| 86469-4 | Conditions prior to medical or treatment regimen change or inpatient stay that took place within past 14 days during assessment period [CMS Assessment] |
| 86470-2 | Most recent inpatient discharge date in the last 14 days [CMS Assessment] |
| 86471-0 | Ostomy for bowel elimination in the last 14 days [CMS Assessment] |
| 86472-8 | Shortness of breath limited your ability to do what you wanted over the past 2 weeks [KCCQ] |
| 86473-6 | Dressing yourself was limited by heart failure over the past 2 weeks [KCCQ] |
| 86474-4 | Walking 1 block on level ground was limited by heart failure over the past 2 weeks [KCCQ] |
| 86475-1 | Doing yardwork, housework or carrying groceries was limited by heart failure over the past 2 weeks [KCCQ] |
| 86476-9 | Climbing a flight of stairs without stopping was limited by heart failure over the past 2 weeks [KCCQ] |
| 86477-7 | Hurrying or jogging (as if to catch a bus) was limited by heart failure over the past 2 weeks [KCCQ] |
| 86478-5 | Change in symptoms of heart failure compared with 2 weeks ago [KCCQ] |
| 86479-3 | Swelling in your feet, ankles or legs when you woke up over the past 2 weeks [KCCQ] |
| 86480-1 | Bothered by swelling in your feet, ankles or legs over the past 2 weeks [KCCQ] |
| 86481-9 | Fatigue limited your ability to do what you wanted over the past 2 weeks [KCCQ] |
| 86482-7 | Bothered by fatigue over the past 2 weeks [KCCQ] |
| 86483-5 | Showering or bathing was limited by heart failure over the past 2 weeks [KCCQ] |
| 86484-3 | Bothered by shortness of breath over the past 2 weeks [KCCQ] |
| 86485-0 | Sleep sitting up in a chair or with at least 3 pillows to prop you up because of shortness of breath over the past 2 weeks [KCCQ] |
| 86486-8 | You know what to do, or whom to call, if your heart failure gets worse [KCCQ] |
| 86487-6 | Understand what things you are able to do to keep your heart failure symptoms from getting worse [KCCQ] |
| 86488-4 | Enjoyment of life limited by heart failure over the past 2 weeks [KCCQ] |
| 86489-2 | How would you feel if you had to spend the rest of your life with your heart failure the way it is right now [KCCQ] |
| 86490-0 | Felt discouraged or down in the dumps because of heart failure over the past 2 weeks [KCCQ] |
| 86491-8 | Participation in hobbies, recreational activities limited by heart failure over the past 2 weeks [KCCQ] |
| 86492-6 | Participation in working or doing household chores limited by heart failure over the past 2 weeks [KCCQ] |
| 86493-4 | Participation in visiting family or friends out of your home limited by heart failure over the past 2 weeks [KCCQ] |
| 86494-2 | Participation in intimate relationships with loved ones limited by heart failure over the past 2 weeks [KCCQ] |
| 86495-9 | When anxious within the last 14 days [CMS Assessment] |
| 86505-5 | Quest |
| 86506-3 | Favorite color |
| 86507-1 | Capital of Assyria |
| 86508-9 | Airspeed--unladen |
| 86523-8 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Identification information during assessment period [CMS Assessment] |
| 86524-6 | Type of assessment during assessment period [CMS Assessment] |
| 86525-3 | SNF Part A PPS discharge assessment during assessment period [CMS Assessment] |
| 86526-1 | Unit certification or licensure designation during assessment period [CMS Assessment] Facility |
| 86527-9 | Conditions related to intellectual disability and developmental disability status during assessment period [CMS Assessment] |
| 86528-7 | Most recent admission/entry or reentry into this facility during assessment period [CMS Assessment] |
| 86529-5 | MDS v3.0 - RAI v1.17.2 - Cognitive patterns during assessment period [CMS Assessment] |
| 86552-7 | Staff [#] who worked at facility at least one day from October 1 through March 31 |
| 86553-5 | Staff [#] who received influenza vaccination at the facility |
| 86554-3 | Staff [#] who provided documentation of influenza vaccine receipt |
| 86555-0 | Staff [#] who had a medical contraindication to the influenza vaccine |
| 86556-8 | Staff [#] who declined influenza vaccine |
| 86557-6 | Staff [#] with unknown influenza vaccination status |
| 86583-2 | Memory/recall ability in the last 7 days [CMS Assessment] |
| 86584-0 | Delirium during assessment period [CMS Assessment] |
| 86585-7 | MDS v3.0 - RAI v1.17.2, OASIS E - Signs and symptoms of delirium (from CAM) during assessment period [CMS Assessment] |
| 86595-6 | MDS v3.0 - RAI v1.16.1 - Staff assessment for mental status during assessment period [CMS Assessment] |
| 86596-4 | Behavior during assessment period [CMS Assessment] |
| 86597-2 | Potential indicators of psychosis during assessment period [CMS Assessment] |
| 86599-8 | Staff assessment of daily and activity preferences during assessment period [CMS Assessment] |
| 86600-4 | Preferences for customary routine and activities during assessment period [CMS Assessment] |
| 86601-2 | Functional status during assessment period [CMS Assessment] |
| 86602-0 | Mobility devices normally used during assessment period [CMS Assessment] |
| 86612-9 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Functional abilities and goals - admission [CMS Assessment] |
| 86613-7 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Self-care - admission performance [CMS Assessment] |
| 86614-5 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Mobility - admission performance during 3 day assessment period [CMS Assessment] |
| 86615-2 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Functional abilities and goals - discharge [CMS Assessment] |
| 86616-0 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Self-care - discharge performance [CMS Assessment] |
| 86617-8 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Mobility - discharge performance during 3 day assessment period [CMS Assessment] |
| 86618-6 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Self-care - discharge goal [CMS Assessment] |
| 86619-4 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Mobility - discharge goal during 3 day assessment period [CMS Assessment] |
| 86623-6 | MDS v3.0 - RAI v1.14.1 - Bladder and bowel during assessment period [CMS Assessment] |
| 86624-4 | Bladder and bowel appliances used during assessment period [CMS Assessment] |
| 86625-1 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Swallowing/nutritional status during assessment period [CMS Assessment] |
| 86631-9 | Pain panel [KOOSJR] |
| 86632-7 | Function and daily living panel [KOOSJR] |
| 86633-5 | Pain panel [HOOSJR] |
| 86634-3 | Function and daily living panel [HOOSJR] |
| 86636-8 | Family planning report - FPAR 2.0 set |
| 86638-4 | Patient demographic and administrative information panel [FPAR] |
| 86641-8 | Height, weight and blood pressure panel [FPAR] |
| 86642-6 | Pregnancy and contraception panel [FPAR] |
| 86644-2 | Pregnancy lab tests - FPAR 2.0 set |
| 86656-6 | Lab tests - FPAR 2.0 sets |
| 86657-4 | HIV 1 and 2 tests - FPAR 2.0 set |
| 86658-2 | HPV tests - FPAR 2.0 set |
| 86659-0 | Chlamydia sp tests - FPAR 2.0 set |
| 86660-8 | Neisseria gonorrhoeae tests - FPAR 2.0 set |
| 86661-6 | Chlamydia trachomatis+Neisseria gonorrhoeae tests - FPAR 2.0 set |
| 86662-4 | Pap smear tests - FPAR 2.0 set |
| 86663-2 | HIV referral information panel [FPAR] |
| 86670-7 | MDS v3.0 - RAI v1.17.2 - Active diagnoses - ND during assessment period [CMS Assessment] |
| 86671-5 | Active diagnoses during assessment period [CMS Assessment] |
| 86672-3 | Staff assessment for pain during assessment period [CMS Assessment] |
| 86673-1 | Indicators of pain or possible pain during assessment period [CMS Assessment] |
| 86674-9 | Other health conditions during assessment period [CMS Assessment] |
| 86675-6 | Shortness of breath during assessment period [CMS Assessment] |
| 86676-4 | Problem conditions during assessment period [CMS Assessment] |
| 86677-2 | Signs and symptoms of swallowing disorder during assessment period [CMS Assessment] |
| 86678-0 | Weight gain of 5% or more in the last month or gain of 10% or more in last 6 months [CMS Assessment] |
| 86679-8 | Percent intake by artificial route during assessment period [CMS Assessment] |
| 86680-6 | Proportion of total calories the resident received through parenteral or tube feeding in the 7 days - while not a resident [CMS Assessment] |
| 86681-4 | Proportion of total calories the resident received through parenteral or tube feeding in last 7 days - while a resident [CMS Assessment] |
| 86682-2 | Mean fluid intake per day by IV or tube feeding in last 7 days - while not a resident [CMS Assessment] |
| 86683-0 | Mean fluid intake per day by IV or tube feeding in last 7 days - while a resident [CMS Assessment] |
| 86684-8 | Mean fluid intake per day by IV or tube feeding during entire 7 days [CMS Assessment] |
| 86685-5 | Oral/dental status during assessment period [CMS Assessment] |
| 86686-3 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Health conditions during assessment period [CMS Assessment] |
| 86687-1 | Proportion of total calories the resident received through parenteral or tube feeding during entire 7 days [CMS Assessment] |
| 86706-9 | Dental problems during assessment period [CMS Assessment] |
| 86707-7 | MDS v3.00 - RAI v1.14.1 - Skin conditions during assessment period [CMS Assessment] |
| 86708-5 | Determination of pressure injury risk in last 7 days [CMS Assessment] |
| 86745-7 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Current number of unhealed pressure injuries at each stage during assessment period [CMS Assessment] |
| 86746-5 | Dimensions of unhealed stage 3 or 4 pressure injuries or eschar during assessment period [CMS Assessment] |
| 86748-1 | Skin and ulcer/injury treatments during assessment period [CMS Assessment] |
| 86749-9 | Medications during assessment period [CMS Assessment] |
| 86750-7 | Medications received during assessment period [CMS Assessment] |
| 86751-5 | Number of days antipsychotic received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86752-3 | Number of days antianxiety received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86753-1 | Number of days antidepressant received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86754-9 | Number of days hypnotic received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86755-6 | Number of days anticoagulant received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86756-4 | Number of days antibiotic received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86757-2 | Number of days diuretic received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 86758-0 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs during assessment period [CMS Assessment] |
| 86759-8 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Special treatments, procedures, and programs [CMS Assessment] |
| 86760-6 | Procedures performed during last 14 days - while not a resident [CMS Assessment] |
| 86761-4 | Procedures performed during last 14 days - while a resident [CMS Assessment] |
| 86762-2 | Therapies during assessment period [CMS Assessment] |
| 86763-0 | Speech-language pathology and audiology services during assessment period [CMS Assessment] |
| 86764-8 | Occupational therapy - co-treatment minutes during 7 day assessment period [CMS Assessment] |
| 86765-5 | Speech-language pathology and audiology services - co-treatment minutes during 7 day assessment period [CMS Assessment] |
| 86766-3 | Physical therapy - co-treatment minutes during 7 day assessment period [CMS Assessment] |
| 86767-1 | Occupational therapy during assessment period [CMS Assessment] |
| 86768-9 | Physical therapy during assessment period [CMS Assessment] |
| 86769-7 | Distinct calendar days of therapy in last 7 days [CMS Assessment] |
| 86770-5 | Resumption of therapy during assessment period [CMS Assessment] |
| 86771-3 | Date therapy regimen resumed during assessment period [CMS Assessment] |
| 86772-1 | Previous rehabilitation therapy regimen (speech, occupational, and/or physical therapy) ended, and regimen now resumed at exactly the same level for each discipline during assessment period [CMS Assessment] |
| 86773-9 | Restorative nursing programs during assessment period [CMS Assessment] |
| 86774-7 | Number of days of passive range of motion in last 7 calendar days [CMS Assessment] |
| 86775-4 | Number of days of active range of motion in last 7 calendar days [CMS Assessment] |
| 86776-2 | Number of days of splint or brace assistance in last 7 calendar days [CMS Assessment] |
| 86777-0 | Number of days of training and skill practice in bed mobility in last 7 calendar days [CMS Assessment] |
| 86778-8 | Number of days of training and skill practice in transfer in last 7 calendar days [CMS Assessment] |
| 86779-6 | Number of days of training and skill practice in walking in last 7 calendar days [CMS Assessment] |
| 86780-4 | Number of days of training and skill practice in dressing or grooming in last 7 calendar days [CMS Assessment] |
| 86781-2 | Number of days of training and skill practice in eating or swallowing in last 7 calendar days [CMS Assessment] |
| 86782-0 | Number of days of training and skill practice in amputation or prosthesis care in last 7 calendar days [CMS Assessment] |
| 86783-8 | Number of days of training and skill practice in communication in last 7 calendar days [CMS Assessment] |
| 86784-6 | Restraints [CMS Assessment] |
| 86785-3 | Physical restraints during assessment period [CMS Assessment] |
| 86786-1 | Physical restraints used in bed - bed rail used during assessment period [CMS Assessment] |
| 86787-9 | Physical restraints used in bed - trunk restraint used during assessment period [CMS Assessment] |
| 86788-7 | Physical restraints used in bed - limb restraint during assessment period [CMS Assessment] |
| 86789-5 | Other physical restraints used in bed during assessment period [CMS Assessment] |
| 86790-3 | Physical restraints used in chair or out of bed - trunk restraint used during assessment period [CMS Assessment] |
| 86791-1 | Physical restraints used in chair or out of bed - limb restraint used during assessment period [CMS Assessment] |
| 86792-9 | Physical restraints used in chair or out of bed - chair prevents rising used during assessment period [CMS Assessment] |
| 86793-7 | Other physical restraints used in chair or out of bed used during assessment period [CMS Assessment] |
| 86794-5 | MDS v3.0 - RAI v1.14.1 - Participation in assessment and goal setting [CMS Assessment] |
| 86795-2 | Clinical record documents a request that questions regarding possible return to the community be asked only on comprehensive assessments during assessment period [CMS Assessment] |
| 86796-0 | Resident's preference regarding being asked about returning to the community during assessment period [CMS Assessment] |
| 86797-8 | Resident (or legally authorized representative) wants to be asked about returning to the community on all assessments during assessment period [CMS Assessment] |
| 86798-6 | Information source for preference on return to community queries during assessment period [CMS Assessment] |
| 86809-1 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Identification information - NP, NQ during assessment period [CMS Assessment] |
| 86810-9 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Identification information - NS, SS during assessment period [CMS Assessment] |
| 86811-7 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Identification information - NO, NSD, ND, NOD, SP, SO, SSD, SD, SOD, NPE during assessment period [CMS Assessment] |
| 86812-5 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Identification information - NT, ST during assessment period [CMS Assessment] |
| 86813-3 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Hearing, speech, and vision - NO, NOD, SO, SOD during assessment period [CMS Assessment] |
| 86814-1 | MDS v3.0 - RAI v1.17.2 - Staff assessment for mental status - ND, SD, IPA, OSA during assessment period [CMS Assessment] |
| 86815-8 | MDS v3.0 - RAI v1.17.2 - Behavior - NP, NQ, ND, SD, SP, IPA, OSA during assessment period [CMS Assessment] |
| 86816-6 | MDS v3.0 - RAI v1.17.2 - Functional status - NP, NQ, SP during assessment period [CMS Assessment] |
| 86817-4 | MDS v3.0 - RAI v1.17.2 - Functional status - OSA during assessment period [CMS Assessment] |
| 86818-2 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Functional status - NSD, NOD, SSD, SOD during assessment period [CMS Assessment] |
| 86819-0 | MDS v3.0 - RAI v1.17.2 - Functional status - ND, SD during assessment period [CMS Assessment] |
| 86820-8 | MDS v3.0 - RAI v1.14.1 - Bladder and bowel - NP, NQ, NSD, NOD, SP, SSD, SOD during assessment period [CMS Assessment] |
| 86821-6 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Active diagnoses - NO, SO during assessment period [CMS Assessment] |
| 86822-4 | MDS v3.0 - RAI v1.17.2 - Health conditions - ND, SD during assessment period [CMS Assessment] |
| 86823-2 | MDS v3.0 - RAI v1.17.2 - Health Conditions - NPE during assessment period [CMS Assessment] |
| 86824-0 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Swallowing/nutritional status - NO, SO during assessment period [CMS Assessment] |
| 86825-7 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Swallowing/nutritional status - NSD, ND, SSD, SD during assessment period [CMS Assessment] |
| 86826-5 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Swallowing/nutritional status - NOD, SP, SOD during assessment period [CMS Assessment] |
| 86827-3 | MDS v3.0 - RAI v1.14.1 - Skin conditions - NO, SO during assessment period [CMS Assessment] |
| 86828-1 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Skin conditions - NSD, ND, SSD, SD during assessment period [CMS Assessment] |
| 86829-9 | MDS v3.0 - RAI v1.14.1 - Skin conditions - NOD, SOD during assessment period [CMS Assessment] |
| 86830-7 | MDS v3.0 - RAI v1.17.2 - Skin conditions - NPE during assessment period [CMS Assessment] |
| 86831-5 | MDS v3.0 - RAI v1.17.2 - Medications - OSA during assessment period [CMS Assessment] |
| 86832-3 | MDS v3.0 - RAI v1.14.1 - Medications - NSD, ND, SSD, SD during assessment period [CMS Assessment] |
| 86833-1 | Staff assessment of resident mood (PHQ-9-OV) - symptom presence in the last 2 weeks [CMS Assessment] |
| 86834-9 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - NP, NQ during assessment period [CMS Assessment] |
| 86835-6 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - NS, SS during assessment period [CMS Assessment] |
| 86836-4 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - NO, SO during assessment period [CMS Assessment] |
| 86837-2 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - NSD, SSD during assessment period [CMS Assessment] |
| 86838-0 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - ND, SD during assessment period [CMS Assessment] |
| 86839-8 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - NOD, SOD during assessment period [CMS Assessment] |
| 86840-6 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Special treatments, procedures, and programs - SP during assessment period [CMS Assessment] |
| 86841-4 | MDS v3.0 - RAI v1.17.2 - Therapies - NP, NQ during assessment period [CMS Assessment] |
| 86842-2 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Therapies - NS, NSD, SS, SSD during assessment period [CMS Assessment] |
| 86843-0 | Resident mood interview (PHQ-9) - symptom presence in the last 2 weeks [CMS Assessment] |
| 86844-8 | Resident mood interview (PHQ-9) - symptom frequency in the last 2 weeks [CMS Assessment] |
| 86845-5 | MDS v3.0 - RAI v1.17.2 - Therapies - ND during assessment period [CMS Assessment] |
| 86846-3 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Therapies - NOD, SOD during assessment period [CMS Assessment] |
| 86847-1 | MDS v3.0 - RAI v1.17.2 - Therapies - SP during assessment period [CMS Assessment] |
| 86848-9 | MDS v3.0 - RAI v1.17.2 - Occupational therapy - ND during assessment period [CMS Assessment] |
| 86849-7 | MDS v3.0 - RAI v1.17.2 - Respiratory therapy - NP, NQ, SP, IPA, OSA during assessment period [CMS Assessment] |
| 86850-5 | MDS v3.0 - RAI v1.17.2 - Psychological therapy - NP, NQ during assessment period [CMS Assessment] |
| 86851-3 | Invasive mechanical ventilator liberation status at discharge during assessment period [CMS Assessment] |
| 86852-1 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Participation in assessment and goal setting - NS, NO, SS, SO during assessment period [CMS Assessment] |
| 86853-9 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Participation in assessment and goal setting - NSD, NOD, SSD, SOD during assessment period [CMS Assessment] |
| 86854-7 | MDS v3.0 - RAI v1.17.2 - Participation in assessment and goal setting - ND, SD during assessment period [CMS Assessment] |
| 86855-4 | MDS v3.0 - RAI v1.17.2 - Speech-language pathology and audiology services - ND during assessment period [CMS Assessment] |
| 86866-1 | MDS v3.0 - RAI v1.17.2 - Urinary toileting program - NP, NQ, SP during assessment period [CMS Assessment] |
| 86867-9 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Health conditions - NP, NQ, SP during assessment period [CMS Assessment] |
| 86868-7 | MDS v3.0 - RAI v1.17.2 - Other health conditions - NP, NQ, SP during assessment period [CMS Assessment] |
| 86869-5 | MDS v3.0 - RAI v1.17.2 - Hearing, speech, and vision - ND, SD during assessment period [CMS Assessment] |
| 86878-6 | MDS v3.0 - RAI v1.14.1 - Bladder and bowel - NS, NO, SS, SO during assessment period [CMS Assessment] |
| 86879-4 | MDS v3.0 - RAI v1.16.1 - Bladder and bowel - ND, SD during assessment period [CMS Assessment] |
| 86880-2 | MDS v3.0 - RAI v1.17.2 - Activities of daily living (ADL) assistance - self-performance during assessment period [CMS Assessment] |
| 86881-0 | MDS v3.0 - RAI v1.17.2 - Activities of daily living (ADL) assistance - support provided during assessment period [CMS Assessment] |
| 86882-8 | MDS v3.0 - RAI v1.16.1 - Cognitive patterns - ND, SD during assessment period [CMS Assessment] |
| 86883-6 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Cognitive patterns - NO, SO during assessment period [CMS Assessment] |
| 86884-4 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Activities of daily living (ADL) assistance - support provided - NSD, NOD, SSD, SOD [CMS Assessment] |
| 86885-1 | MDS v3.0 - RAI v1.17.2 - Activities of daily living (ADL) assistance - self-performance - OSA during assessment period [CMS Assessment] |
| 86886-9 | MDS v3.0 - RAI v1.17.2 - Activities of daily living (ADL) assistance - support provided - OSA during assessment period [CMS Assessment] |
| 86887-7 | MDS v3.0 - RAI v1.17.2 - Bathing - ND, SD during assessment period [CMS Assessment] |
| 86888-5 | MDS v3.0 - RAI v1.17.2 - Health conditions - OSA during assessment period [CMS Assessment] |
| 86889-3 | MDS v3.0 - RAI v1.17.2 - Other health conditions - IPA, OSA during assessment period [CMS Assessment] |
| 86890-1 | MDS v3.0 - RAI v1.17.2 - Other health conditions - ND, SD during assessment period [CMS Assessment] |
| 86891-9 | Staff assessment of resident mood (PHQ-9-OV) - symptom frequency in the last 2 weeks [CMS Assessment] |
| 86892-7 | MDS v3.0 - RAI v1.17.2 - Current number of unhealed pressure injuries at each stage - IPA during assessment period [CMS Assessment] |
| 86893-5 | MDS v3.0 - RAI v1.17.2 - Physical therapy - ND, SD during assessment period [CMS Assessment] |
| 86901-6 | Length during assessment period [CMS Assessment] Pressure injury.largest stage 3 or 4 |
| 86902-4 | Width during assessment period [CMS Assessment] Pressure injury.largest stage 3 or 4 |
| 86903-2 | Tissue type during assessment period [CMS Assessment] Pressure injury.most advanced stage |
| 86923-0 | Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12] |
| 86924-8 | Overall summary score [KCCQ-12] |
| 86932-1 | I am confident that I can follow through on medical treatments I may need to do at home [PAM] |
| 86933-9 | Patient Activation Measure - 13 [PAM] |
| 86934-7 | I am confident I can figure out solutions when new problems arise with my health [PAM] |
| 86935-4 | I know how to prevent problems with my health [PAM] |
| 86936-2 | I have been able to maintain (keep up with) lifestyle changes, like eating right or exercising [PAM] |
| 86937-0 | I know what treatments are available for my health problems [PAM] |
| 86938-8 | Taking an active role in my own health care is the most important thing that affects my health [PAM] |
| 86939-6 | I am confident that I can maintain lifestyle changes, like eating right and exercising, even during times of stress [PAM] |
| 86940-4 | I am confident that I can tell a doctor concerns I have even when he or she does not ask [PAM] |
| 86941-2 | I am confident that I can tell whether I need to go to the doctor or whether I can take care of a health problem myself [PAM] |
| 86942-0 | I know what each of my prescribed medications do [PAM] |
| 86943-8 | I am confident I can help prevent or reduce problems associated with my health [PAM] |
| 86944-6 | When all is said and done, I am the person who is responsible for taking care of my health [PAM] |
| 86945-3 | I understand my health problems and what causes them [PAM] |
| 86946-1 | Patient Activation Measure - 10 [PAM] |
| 87207-7 | Care Area Assessment (CAA) Summary during assessment period [CMS Assessment] |
| 87208-5 | Items from the most recent prior OBRA or scheduled PPS Assessment during assessment period [CMS Assessment] |
| 87209-3 | Correction attestation section during assessment period [CMS Assessment] |
| 87210-1 | Care Area Assessment (CAA) and care planning during assessment period [CMS Assessment] |
| 87211-9 | Care Area Assessment (CAA) results during assessment period [CMS Assessment] |
| 87212-7 | Care area triggered during assessment period [CMS Assessment] |
| 87213-5 | Triggered care area included in care plan during assessment period [CMS Assessment] |
| 87214-3 | LCDS v4.0 - Special treatments, procedures, and programs - discharge during assessment period [CMS Assessment] |
| 87215-0 | LCDS v4.00 - Hearing, speech, and vision during assessment period [CMS Assessment] |
| 87216-8 | Date on existing record to be modified or inactivated during assessment period [CMS Assessment] |
| 87217-6 | Reasons for modification during assessment period [CMS Assessment] |
| 87218-4 | RN asessment coordinator attestation of completion during assessment period [CMS Assessment] |
| 87219-2 | Attesting individual first name during assessment period [CMS Assessment] Provider |
| 87220-0 | Attesting individual last name during assessment period [CMS Assessment] Provider |
| 87221-8 | Attesting individual title during assessment period [CMS Assessment] Provider |
| 87222-6 | Attestation date during assessment period [CMS Assessment] |
| 87223-4 | Assessment administration during assessment period [CMS Assessment] |
| 87224-2 | Correction request during assessment period [CMS Assessment] |
| 87225-9 | Reasons for inactivation during assessment period [CMS Assessment] |
| 87227-5 | Type of assessment on existing record to be modified or inactivated during assessment period [CMS Assessment] |
| 87228-3 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Assessment administration - NS, NO, NSD, NOD, SP, SS, SO, SSD, SOD during assessment period [CMS Assessment] |
| 87229-1 | MDS v3.0 - RAI v1.14.1, v1.15.1, v1.16.1 - Assessment administration - ND, SD during assessment period [CMS Assessment] |
| 87230-9 | LCDS v4.00 - Special treatments, procedures, and programs - admission during assessment period [CMS Assessment] |
| 87290-3 | Date of Social Security Number request |
| 87291-1 | Mothers Source of information |
| 87292-9 | Name not yet chosen |
| 87294-5 | Guardian or legally authorized representative signature for Social Security Number request |
| 87295-2 | Social Security Number was requested |
| 87296-0 | Age--at delivery Father |
| 87297-8 | Birth registration date |
| 87298-6 | Cigarettes smoked per day by Mother--1st trimester |
| 87299-4 | Cigarettes smoked per day by Mother--2nd trimester |
| 87300-0 | Highest level of education Father |
| 87301-8 | Mother was married at any time during pregnancy |
| 87302-6 | Paternity acknowledgment form signed Father |
| 87303-4 | Mother WIC food recipient |
| 87415-6 | IRF-PAI v3.0 - Medical Info during assessment period [CMS Assessment] |
| 87500-5 | LCDS v4.00 - Skin conditions - discharge during assessment period [CMS Assessment] |
| 87501-3 | LCDS v4.00 - Mobility - discharge performance during assessment period [CMS Assessment] |
| 87502-1 | LCDS v4.00 - Mobility - admission performance during assessment period [CMS Assessment] |
| 87503-9 | Understanding verbal and non-verbal content during 3 day assessment period [CMS Assessment] |
| 87504-7 | LCDS v4.00 - Administrative information - discharge during assessment period [CMS Assessment] |
| 87505-4 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 4.00 during assessment period [CMS Assessment] |
| 87506-2 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 during assessment period [CMS Assessment] |
| 87507-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 during assessment period [CMS Assessment] |
| 87508-8 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 during assessment period [CMS Assessment] |
| 87509-6 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 during assessment period [CMS Assessment] |
| 87521-1 | IRF-PAI v3.0, LCDS v4.00 - Medications - admission during assessment period [CMS Assessment] |
| 87522-9 | IRF-PAI v3.0, LCDS v4.00 - Medications - discharge and expired during assessment period [CMS Assessment] |
| 87537-7 | LCDS v4.00 - Spontaneous breathing trial during assessment period [CMS Assessment] |
| 87538-5 | Assessed for readiness for SBT by day 2 of stay during assessment period [CMS Assessment] |
| 87539-3 | Invasive mechanical ventilation support upon admission during assessment period [CMS Assessment] |
| 87540-1 | Deemed medically ready for SBT by day 2 of stay during assessment period [CMS Assessment] |
| 87541-9 | Is there documentation of reason(s) in the patient's medical record that the patient was deemed medically unready for SBT by day 2 of stay during assessment period [CMS Assessment] |
| 87542-7 | SBT performed by day 2 of stay during assessment period [CMS Assessment] |
| 87675-5 | Parent Patient Activation Measure - 13 [PAM] Parent |
| 87676-3 | When all is said and done, I am the person who is responsible for taking care of my child's health Parent [PAM] |
| 87677-1 | Taking an active role in my child's health care is the most important thing that affects his/her health Parent [PAM] |
| 87678-9 | I am confident I can help prevent or reduce problems associated with my child's health Parent [PAM] |
| 87679-7 | I know what each of my child's prescribed medications do Parent [PAM] |
| 87680-5 | I am confident that I can tell whether I need to go to the doctor or whether I can take care of my child's health problem myself Parent [PAM] |
| 87681-3 | I am confident that I can tell a doctor concerns I have abou my child's health even when he or she does not ask Parent [PAM] |
| 87682-1 | I am confident that I can follow through on medical treatments I need to do for my child at home Parent [PAM] |
| 87683-9 | I understand my child's health problems and what causes them Parent [PAM] |
| 87684-7 | I know what treatments are available for my child's health problems Parent [PAM] |
| 87685-4 | I have been able to help my child maintain (keep up with) lifestyle changes, like eating right or exercising Parent [PAM] |
| 87686-2 | I know how to prevent problems with my child's health Parent [PAM] |
| 87687-0 | I am confident I can figure out solutions when new problems arise with my child's health Parent [PAM] |
| 87688-8 | I am confident that I can help my child maintain lifestyle changes, like eating right and exercising, even during times of stress Parent [PAM] |
| 87689-6 | Parent Patient Activation Measure - 10 [PAM] Parent |
| 87690-4 | When all is said and done, I am responsible for seeing that this person's health is managed properly Caregiver [PAM] |
| 87691-2 | Taking an active role in this person's health care is one of the most important factors in determining her/his health and ability to function Caregiver [PAM] |
| 87692-0 | I am confident that I can take actions that will help prevent or minimize some symptoms or problems associated with this person's health Caregiver [PAM] |
| 87693-8 | I know what each of this person's prescribed medications do Caregiver [PAM] |
| 87694-6 | I am confident that I can tell when this person needs to get medical care and when I can handle the problem myself Caregiver [PAM] |
| 87695-3 | I am confident I can tell a doctor the concerns that I have about this person's health even when he or she does not ask Caregiver [PAM] |
| 87696-1 | I am confident that I can follow through on medical treatments I need to do for this person at home Caregiver [PAM] |
| 87697-9 | I understand the nature and causes of this person's health Caregiver [PAM] |
| 87698-7 | I know the different medical treatment options available for this person's health Caregiver [PAM] |
| 87699-5 | I am able to help this person maintain lifestyle changes (like eating right or exercising) for her/his condition Caregiver [PAM] |
| 87700-1 | I know how to prevent problems with this person's health Caregiver [PAM] |
| 87701-9 | I am confident I can figure out solutions when new situations or problems arise with this person's health Caregiver [PAM] |
| 87702-7 | I am confident I can help this person with lifestyle changes, like diet and exercise, even during times of stress Caregiver [PAM] |
| 87703-5 | Caregiver Patient Activation Measure - 13 [PAM] Caregiver |
| 87704-3 | Caregiver Patient Activation Measure - 10 [PAM] Caregiver |
| 88037-7 | How often have you had five or more drinks in one day during the past year [Reported] |
| 88117-7 | Mother's Tabulated ethnicity [CDC] |
| 88118-5 | Father's Tabulated ethnicity [CDC] |
| 88119-3 | Mother's Bridged race [CDC] |
| 88120-1 | Father's Bridged race [CDC] |
| 88121-9 | Hunger Vital Sign [HVS] |
| 88122-7 | Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS] |
| 88123-5 | Within the past 12 months the food we bought just didn't last and we didn't have money to get more [U.S. FSS] |
| 88124-3 | Food insecurity risk [HVS] |
| 88174-8 | Total score Parent [PAM] |
| 88175-5 | Total score [PAM] |
| 88176-3 | Total score Caregiver [PAM] |
| 88237-3 | LCDS v4.00 - Functional abilities and goals - planned discharge [CMS Assessment] |
| 88238-1 | LCDS v4.00 - Functional abilities and goals during assessment period [CMS Assessment] |
| 88241-5 | Fetal remains disposition method |
| 88289-4 | MDS v3.0 - RAI v1.15.1 - Medications during assessment period [CMS Assessment] |
| 88290-2 | MDS v3.0 - RAI v1.17.2 - Medications received during assessment period [CMS Assessment] |
| 88291-0 | Number of days opioid received in last 7 days or since admission/reentry if less than 7 days [CMS Assessment] |
| 88295-1 | Antipsychotic medication review during assessment period [CMS Assessment] |
| 88296-9 | Antipsychotic medications since admission/entry or reentry or the prior OBRA assessment, whichever is more recent during assessment period [CMS Assessment] |
| 88297-7 | Gradual dose reduction (GDR) attempted during assessment period [CMS Assessment] |
| 88298-5 | Date of last attempted gradual dose reduction during assessment period [CMS Assessment] |
| 88299-3 | Physician documented GDR as clinically contraindicated during assessment period [CMS Assessment] |
| 88300-9 | Date physician documented GDR as clinically contraindicated during assessment period [CMS Assessment] |
| 88307-4 | Restraints and alarms during assessment period [CMS Assessment] |
| 88308-2 | Other alarm used during assessment period [CMS Assessment] |
| 88309-0 | Alarms during assessment period [CMS Assessment] |
| 88310-8 | Bed alarm used during assessment period [CMS Assessment] |
| 88311-6 | Chair alarm used during assessment period [CMS Assessment] |
| 88312-4 | Floor mat alarm used during assessment period [CMS Assessment] |
| 88313-2 | Motion sensor alarm used during assessment period [CMS Assessment] |
| 88314-0 | Wander/elopement alarm used during assessment period [CMS Assessment] |
| 88328-0 | MDS v3.0 - RAI v1.17.2 - Restraints and alarms - NP, ND, SP, SD during assessment period [CMS Assessment] |
| 88330-6 | Mobility - admission performance during 3 day assessment period [CMS Assessment] |
| 88331-4 | Mobility - discharge performance during 3 day assessment period [CMS Assessment] |
| 88332-2 | IRF-PAI v3.0 - Skin conditions - discharge during assessment period [CMS Assessment] |
| 88333-0 | Memory/recall ability during 3 day assessment period [CMS Assessment] |
| 88367-8 | Outcome and assessment information set (OASIS) form - version D, D1 - Transfer to inpatient facility - patient discharged or not discharged during assessment period [CMS Assessment] |
| 88368-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Resumption of care during assessment period [CMS Assessment] |
| 88369-4 | Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up during assessment period [CMS Assessment] |
| 88370-2 | Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency - death at home during assessment period [CMS Assessment] |
| 88371-0 | Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency during assessment period [CMS Assessment] |
| 88372-8 | Outcome and assessment information set (OASIS) form - version D during assessment period [CMS Assessment] |
| 88373-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Start of care during assessment period [CMS Assessment] |
| 88379-3 | International Physical Activity Questionnaire self-administered long form [IPAQ] |
| 88380-1 | Job-related physical activity panel [IPAQ] |
| 88381-9 | Do you currently have a job or do any unpaid work outside your home [IPAQ] |
| 88382-7 | During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, digging, heavy construction, or climbing up stairs as part of your work for at least 10M at a time [IPAQ] |
| 88383-5 | How much time did you usually spend on one of those days doing vigorous physical activities as part of your work during the last 7 days [IPAQ] |
| 88384-3 | During the last 7 days, on how many days did you do moderate physical activities like carrying light loads as part of your work, not including walking, greater than 10 minutes at a time [IPAQ] |
| 88385-0 | How much time did you usually spend on one of those days doing moderate physical activities as part of your work during the last 7 days [IPAQ] |
| 88386-8 | During the last 7 days, on how many days did you walk for at least 10 minutes at a time as a part of your work, not counting any walking you did to travel to or from work [IPAQ] |
| 88387-6 | How much time did you usually spend on one of those days walking as part of your work during the last 7 days [IPAQ] |
| 88388-4 | Transportation physical activity panel [IPAQ] |
| 88389-2 | During the last 7 days, on how many days did you travel in a motor vehicle like a train, bus, car, or tram [IPAQ] |
| 88390-0 | How much time did you usually spend on one of those days traveling in a train, bus, car, tram, or other kind of motor vehicle during the last 7 days [IPAQ] |
| 88391-8 | During the last 7 days, on how many days did you bicycle for at least 10 minutes at a time to go from place to place [IPAQ] |
| 88392-6 | How much time did you usually spend on one of those days to bicycle from place to place during the last 7 days [IPAQ] |
| 88393-4 | During the last 7 days, on how many days did you walk for at least 10 minutes at a time to go from place to place [IPAQ] |
| 88394-2 | How much time did you usually spend on one of those days walking from place to place during the last 7 days [IPAQ] |
| 88395-9 | Housework, house maintenance, and caring for family panel [IPAQ] |
| 88396-7 | During the last 7 days, on how many days did you do vigorous physical activities like heavy lifting, chopping wood, shoveling snow, or digging in the garden or yard for at least 10 minutes at a time [IPAQ] |
| 88397-5 | How much time did you usually spend on one of those days doing vigorous physical activities in the garden or yard during the last 7 days [IPAQ] |
| 88398-3 | During the last 7 days, on how many days did you do moderate activities like carrying light loads, sweeping, washing windows, and raking in the garden or yard for at least 10 minutes at a time [IPAQ] |
| 88399-1 | How much time did you usually spend on one of those days doing moderate physical activities in the garden or yard during the last 7 days [IPAQ] |
| 88400-7 | During the last 7 days, on how many days did you do moderate activities like carrying light loads, washing windows, scrubbing floors and sweeping inside your home for at least 10 minutes at a time [IPAQ] |
| 88401-5 | How much time did you usually spend on one of those days doing moderate physical activities inside your home during the last 7 days [IPAQ] |
| 88402-3 | Recreation, sport, and leisure-time physical activity panel [IPAQ] |
| 88403-1 | Not counting any walking you have already mentioned, during the last 7 days, on how many days did you walk for at least 10 minutes at a time in your leisure time [IPAQ] |
| 88404-9 | How much time did you usually spend on one of those days walking in your leisure time during the last 7 days [IPAQ] |
| 88405-6 | During the last 7 days, on how many days did you do vigorous physical activities like aerobics, running, fast bicycling, or fast swimming in your leisure time for at least 10 minutes at a time [IPAQ] |
| 88406-4 | How much time did you usually spend on one of those days doing vigorous physical activities in your leisure time during the last 7 days [IPAQ] |
| 88407-2 | During the last 7 days, on how many days did you do moderate physical activities like bicycling at a regular pace, swimming at a regular pace, and doubles tennis in your leisure time for at least 10 minutes at a time [IPAQ] |
| 88408-0 | How much time did you usually spend on one of those days doing moderate physical activities in your leisure time during the last 7 days [IPAQ] |
| 88409-8 | Time spent sitting panel [IPAQ] |
| 88411-4 | During the last 7 days, how much time did you usually spend sitting on a weekend day [IPAQ] |
| 88412-2 | International Physical Activity Questionnaire telephone short form [IPAQ] |
| 88419-7 | Vigorous physical activity.work domain [IPAQ] |
| 88420-5 | Moderate physical activity.work domain [IPAQ] |
| 88421-3 | Walking physical activity.work domain [IPAQ] |
| 88422-1 | Total physical activity.work domain [IPAQ] |
| 88423-9 | Cycle physical activity.active transportation domain [IPAQ] |
| 88424-7 | Walking physical activity.active transportation domain [IPAQ] |
| 88425-4 | Total physical activity.active transportation domain [IPAQ] |
| 88426-2 | Vigorous physical activity.yard work [IPAQ] |
| 88427-0 | Moderate physical activity.yard work [IPAQ] |
| 88428-8 | Moderate physical activity.inside chores [IPAQ] |
| 88429-6 | Total physical activity.domestic and garden domain [IPAQ] |
| 88430-4 | Walking physical activity.leisure-time domain [IPAQ] |
| 88431-2 | Vigorous physical activity.leisure-time domain [IPAQ] |
| 88432-0 | Moderate physical activity.leisure-time domain [IPAQ] |
| 88433-8 | Total physical activity.leisure-time domain [IPAQ] |
| 88434-6 | International Physical Activity Questionnaire telephone long form [IPAQ] |
| 88463-5 | OASIS E - Skin Conditions - SOC, ROC during assessment period [CMS Assessment] |
| 88464-3 | OASIS D - Integumentary status - discharge from agency during assessment period [CMS Assessment] |
| 88465-0 | Types and sources of assistance - start of care or resumption of care during assessment period [CMS Assessment] |
| 88467-6 | Care management - discharge from agency during assessment period [CMS Assessment] |
| 88468-4 | Types and sources of assistance - discarge from agency during assessment period [CMS Assessment] |
| 88469-2 | How much has your chest pain, chest tightness or angina limited your enjoyment of life over the past 4 weeks [SAQ] |
| 88470-0 | Quality of life score [SAQ] |
| 88471-8 | Symptom frequency score [SAQ] |
| 88472-6 | Physical limitation score [SAQ] |
| 88473-4 | If you had to spend the rest of your life with your chest pain, chest tightness or angina the way it is right now, how would you feel about this [SAQ] |
| 88474-2 | Overall summary score [SAQ] |
| 88475-9 | How many times have you had to take nitroglycerin (nitroglycerin tablets or spray) for your chest pain, chest tightness or angina over the past 4 weeks [SAQ] |
| 88476-7 | How many times have you had chest pain, chest tightness or angina over the past 4 weeks [SAQ] |
| 88477-5 | Lifting or moving heavy objects limited by chest pain, chest tightness or angina over the past 4 weeks [SAQ] |
| 88478-3 | Gardening, vacuuming, or carrying groceries limited by chest pain, chest tightness or angina over the past 4 weeks [SAQ] |
| 88479-1 | Seattle Angina Questionnaire - 7 items [SAQ] |
| 88480-9 | Walking indoors on level ground limited by chest pain, chest tightness or angina over the past 4 weeks [SAQ] |
| 88481-7 | Activity limitations panel [SAQ] |
| 88482-5 | Functional abilities and goals - admission during assessment period [CMS Assessment] |
| 88483-3 | Functional abilities and goals - discharge [CMS Assessment] |
| 88484-1 | OASIS D - Functional abilities and goals - follow-up during assessment period [CMS Assessment] |
| 88485-8 | OASIS D - Self-care - follow-up performance during assessment period [CMS Assessment] |
| 88486-6 | OASIS D - Mobility - follow-up performance during assessment period [CMS Assessment] |
| 88487-4 | OASIS D - Patient history and diagnoses - SOC or ROC during assessment period [CMS Assessment] |
| 88488-2 | OASIS E - Diagnoses and symptom control during assessment period [CMS Assessment] |
| 88489-0 | OASIS E - Primary diagnosis during assessment period [CMS Assessment] |
| 88490-8 | OASIS E - Other diagnoses during assessment period [CMS Assessment] |
| 88491-6 | OASIS D - Patient history and diagnoses - follow-up during assessment period [CMS Assessment] |
| 88492-4 | OASIS D - Sensory status - SOC or ROC or follow-up during assessment period [CMS Assessment] |
| 88494-0 | OASIS E - Current number of unhealed pressure injuries at each stage - SOC, ROC, FU during assessment period [CMS Assessment] |
| 88495-7 | OASIS D - Respiratory status - SOC or ROC during assessment period [CMS Assessment] |
| 88496-5 | OASIS E - Bladder and Bowel - SOC, ROC during assessment period [CMS Assessment] |
| 88497-3 | OASIS E - Elimination status - discharge from agency during assessment period [CMS Assessment] |
| 88498-1 | OASIS D - Neuro and emotional and behavioral status - SOC or ROC during assessment period [CMS Assessment] |
| 88499-9 | OASIS D - ADL and IADLs - SOC or ROC during assessment period [CMS Assessment] |
| 88500-4 | OASIS D - ADL and IADLs - discharge from agency during assessment period [CMS Assessment] |
| 88501-2 | OASIS D - Medications - start of care or resumption of care during assessment period [CMS Assessment] |
| 88502-0 | OASIS E - Preferences for Customary Routine Activities - DC during assessment period [CMS Assessment] |
| 88503-8 | OASIS D - Therapy need and plan of care during assessment period [CMS Assessment] |
| 88504-6 | OASIS D - Data items collected at inpatient facility admission or agency discharge only - transfer during assessment period [CMS Assessment] |
| 88505-3 | OASIS D - Data items collected at inpatient facility admission or agency discharge only - discharge from agency - death at home during assessment period [CMS Assessment] |
| 88506-1 | OASIS D - Data items collected at inpatient facility admission or agency discharge only - discharge from agency during assessment period [CMS Assessment] |
| 88507-9 | OASIS D - Sensory status - discharge from agency during assessment period [CMS Assessment] |
| 88508-7 | OASIS D - Current number of unhealed pressure injuries at each stage - discharge from agency during assessment period [CMS Assessment] |
| 88520-2 | OASIS D - Medications - discharge from agency during assessment period [CMS Assessment] |
| 88521-0 | IRF-PAI v2.0 - Staff assessment for mental status [CMS Assessment] |
| 88522-8 | IRF-PAI v2.0 - Hearing, speech, and vision - admission during assessment period [CMS Assessment] |
| 88523-6 | IRF-PAI v2.0 - Quality indicators - admission during assessment period [CMS Assessment] |
| 88524-4 | IRF-PAI v2.0 - Cognitive patterns - admission during assessment period [CMS Assessment] |
| 88525-1 | IRF-PAI v2.0 - Quality indicators - discharge during assessment period [CMS Assessment] |
| 88695-2 | Used bowel toileting program during assessment period [CMS Assessment] |
| 88696-0 | Ulcers, wounds and skin problems in the last 7 days [CMS Assessment] |
| 88747-1 | Degree of difficulty experienced due to your hip while walking on uneven surface during the last week [HOOS] |
| 88748-9 | Degree of difficulty experienced due to your hip while twisting or pivoting on loaded leg during the last week [HOOS] |
| 88749-7 | Degree of difficulty experienced due to your hip while running during the last week [HOOS] |
| 88750-5 | Degree of difficulty experienced due to your hip while squatting during the last week [HOOS] |
| 88751-3 | How severe is your hip stiffness after sitting, lying or resting later in the day during the last week [HOOS] |
| 88752-1 | How severe is your hip joint stiffness after first wakening in the morning during the last week [HOOS] |
| 88753-9 | Difficulties to stride out when walking during the last week [HOOS] |
| 88754-7 | Difficulties spreading legs wide apart during the last week [HOOS] |
| 88755-4 | Do you feel grinding, hear clicking or any other type of noise from your hip during the last week [HOOS] |
| 88756-2 | In general, how much difficulty do you have with your hip [HOOS] |
| 88757-0 | How much are you troubled with lack of confidence in your hip [HOOS] |
| 88758-8 | Have you modified your life style to avoid activities potentially damaging to your hip [HOOS] |
| 88759-6 | How often are you aware of your hip problem [HOOS] |
| 88760-4 | Amount of hip pain experienced while walking of a hard surface (asphalt, concrete, etc.) in the last week [HOOS] |
| 88761-2 | Amount of hip pain experienced while standing upgright in the last week [HOOS] |
| 88762-0 | Degree of difficulty experienced due to your hip while sitting or lying during the last week [HOOS] |
| 88763-8 | Amount of hip pain experienced while at night while in bed in the last week [HOOS] |
| 88764-6 | Amount of hip pain experienced while walking on flat surface in the last week [HOOS] |
| 88765-3 | Amount of hip pain experienced while bending your hip fully in the last week [HOOS] |
| 88766-1 | Amount of hip pain experienced while straightening your hip fully in the last week [HOOS] |
| 88767-9 | How often is your hip painful [HOOS] |
| 88768-7 | Degree of difficulty experienced due to your hip while putting on socks or stockings in the last week [HOOS] |
| 88769-5 | Degree of difficulty experienced due to your hip while going shopping in the last week [HOOS] |
| 88770-3 | Degree of difficulty experienced due to your hip while getting in or out of car in the last week [HOOS] |
| 88771-1 | Degree of difficulty experienced due to your hip while walking on a flat surface in the last week [HOOS] |
| 88772-9 | Degree of difficulty experienced due to your hip while standing in the last week [HOOS] |
| 88773-7 | Degree of difficulty experienced due to your hip while ascending stairs in the last week [HOOS] |
| 88774-5 | Degree of difficulty experienced due to your hip while doing light domestic duties (cooking, dusting, etc) in the last week [HOOS] |
| 88775-2 | Degree of difficulty experienced due to your hip while doing heavy domestic duties (moving heavy boxes, scrubbing floors, etc) in the last week [HOOS] |
| 88776-0 | Degree of difficulty experienced due to your hip while getting on or off toilet in the last week [HOOS] |
| 88777-8 | Degree of difficulty experienced due to your hip while getting in or out of bath in the last week [HOOS] |
| 88778-6 | Degree of difficulty experienced due to your hip while taking off socks or stockings in the last week [HOOS] |
| 88779-4 | Degree of difficulty experienced due to your hip while rising from bed in the last week [HOOS] |
| 88780-2 | Degree of difficulty experienced due to your hip while descending stairs in the last week [HOOS] |
| 88781-0 | Quality of life panel [HOOS] |
| 88782-8 | Function, sports and recreational activities panel [HOOS] |
| 88783-6 | Pain panel [HOOS] |
| 88784-4 | Function and daily living panel [HOOS] |
| 88785-1 | Stiffness panel [HOOS] |
| 88786-9 | Symptoms panel [HOOS] |
| 88787-7 | Degree of difficulty experienced due to your knee while kneeling during the last week [KOOS] |
| 88788-5 | Degree of difficulty experienced due to your knee while twisting or pivoting on your injured knee during the last week [KOOS] |
| 88789-3 | Degree of difficulty experienced due to your knee while jumping during the last week [KOOS] |
| 88790-1 | Degree of difficulty experienced due to your knee while running during the last week [KOOS] |
| 88791-9 | Degree of difficulty experienced due to your knee while squatting during the last week [KOOS] |
| 88792-7 | How severe is your knee stiffness after sitting, lying or resting later in the day during the last week [KOOS] |
| 88793-5 | Can you bend your knee fully during the last week [KOOS] |
| 88794-3 | Can you straighten your knee fully during the last week [KOOS] |
| 88795-0 | Does your knee catch or hang up when moving during the last week [KOOS] |
| 88796-8 | Do you feel grinding, hear clicking or any other type of noise when your knee moves during the last week [KOOS] |
| 88797-6 | Do you have swelling in your knee during the last week [KOOS] |
| 88798-4 | In general, how much difficulty do you have with your knee [KOOS] |
| 88799-2 | How much are you troubled with lack of confidence in your knee [KOOS] |
| 88800-8 | Have you modified your life style to avoid activities potentially damaging to your knee [KOOS] |
| 88801-6 | How often are you aware of your knee problem [KOOS] |
| 88802-4 | Amount of knee pain experienced while sitting or lying in the last week [KOOS] |
| 88803-2 | Amount of knee pain experienced while at night while in bed in the last week [KOOS] |
| 88804-0 | Amount of knee pain experienced while walking on flat surface in the last week [KOOS] |
| 88805-7 | Amount of knee pain experienced while bending the knee fully in the last week [KOOS] |
| 88806-5 | How often do you experience knee pain [KOOS] |
| 88807-3 | Degree of difficulty experienced due to your knee while putting on socks or stockings in the last week [KOOS] |
| 88808-1 | Degree of difficulty experienced due to your knee while going shopping in the last week [KOOS] |
| 88809-9 | Degree of difficulty experienced due to your knee while getting in or out of car in the last week [KOOS] |
| 88810-7 | Degree of difficulty experienced due to your knee while walking on a flat surface in the last week [KOOS] |
| 88811-5 | Degree of difficulty experienced due to your knee while standing in the last week [KOOS] |
| 88812-3 | Degree of difficulty experienced due to your knee while ascending stairs in the last week [KOOS] |
| 88813-1 | Degree of difficulty experienced due to your knee while doing light domestic duties (cooking, dusting, etc) in the last week [KOOS] |
| 88814-9 | Degree of difficulty experienced due to your knee while doing heavy domestic duties (moving heavy boxes, scrubbing floors, etc) in the last week [KOOS] |
| 88815-6 | Degree of difficulty experienced due to your knee while getting on or off toilet in the last week [KOOS] |
| 88816-4 | Degree of difficulty experienced due to your knee while sitting in the last week [KOOS] |
| 88817-2 | Degree of difficulty experienced due to your knee while getting in or out of bath in the last week [KOOS] |
| 88818-0 | Degree of difficulty experienced due to your knee while lying in bed (turning over, maintaining hip position) in the last week [KOOS] |
| 88819-8 | Degree of difficulty experienced due to your knee while taking off socks or stockings in the last week [KOOS] |
| 88820-6 | Degree of difficulty experienced due to your knee while rising from bed in the last week [KOOS] |
| 88821-4 | Degree of difficulty experienced due to your knee while descending stairs in the last week [KOOS] |
| 88822-2 | Quality of life panel [KOOS] |
| 88823-0 | Function, sports and recreational activities panel [KOOS] |
| 88824-8 | Pain panel [KOOS] |
| 88825-5 | Function and daily living panel [KOOS] |
| 88826-3 | Stiffness panel [KOOS] |
| 88827-1 | Symptoms panel [KOOS] |
| 88851-1 | PROMIS cognitive function - abilities subset - version 1.0 T-score |
| 88852-9 | PROMIS item bank - applied cognition - abilities subset - version 1.0 |
| 88853-7 | I have been able to remember where I put things, like my keys or my wallet in past 7 days [PROMIS] |
| 88854-5 | I have been able to add and subtract numbers in my head without difficulty in past 7 days [PROMIS] |
| 88870-1 | Drug regimen review identified potential medication issues in the last 3 days [CMS Assessment] |
| 88871-9 | Medication follow-up in the last 3 days [CMS Assessment] |
| 88872-7 | IRF-PAI v2.0 - Medications - admission [CMS Assessment] |
| 88957-6 | MDS v3.0 - RAI v1.16.1 - Active diagnoses during assessment period [CMS Assessment] |
| 88958-4 | MDS v3.0 - RAI v1.16.1 - Health conditions during assessment period [CMS Assessment] |
| 88959-2 | MDS v3.0 - RAI v1.16.1 - Health conditions - NP, NQ, SP during assessment period [CMS Assessment] |
| 88960-0 | MDS v3.0 - RAI v1.17.2 - Skin conditions during assessment period [CMS Assessment] |
| 88961-8 | MDS v3.0 - RAI v1.17.2 - Current number of unhealed pressure injuries at each stage during assessment period [CMS Assessment] |
| 88962-6 | MDS v3.0 - RAI v1.17.2 - Medications during assessment period [CMS Assessment] |
| 88963-4 | MDS v3.0 - RAI v1.17.2 - Medications - ND, SD during assessment period [CMS Assessment] |
| 88964-2 | MDS v3.0 - RAI v1.16.1 - Medications - NOD, SOD during assessment period [CMS Assessment] |
| 88965-9 | MDS v3.0 - RAI v1.17.2 - Medications - NP, SP during assessment period [CMS Assessment] |
| 88980-8 | Swollen joint # |
| 88981-6 | Tender joint # |
| 88982-4 | Rheumatoid arthritis disease activity level [CDAI] |
| 88983-2 | Tender joint |
| 88984-0 | Swollen joint |
| 89046-7 | MDS v3.0 - RAI v1.17.2 - Skin conditions - ND, SD during assessment period [CMS Assessment] |
| 89047-5 | MDS v3.0 - RAI v1.16.1 - Skin conditions - NOD, SOD during assessment period [CMS Assessment] |
| 89048-3 | MDS v3.0 - RAI v1.16.1 - Bladder and bowel - NC during assessment period [CMS Assessment] |
| 89049-1 | MDS v3.0 - RAI v1.16.1 - Bladder and bowel - NP, NQ, SP during assessment period [CMS Assessment] |
| 89050-9 | MDS v3.0 - RAI v1.15.1, v1.16.1 - Bladder and bowel - NS, NO, SS, SO during assessment period [CMS Assessment] |
| 89051-7 | MDS v3.0 - RAI v1.17.2 - Skin conditions - IPA during assessment period [CMS Assessment] |
| 89052-5 | MDS v3.00 - RAI v1.15.1 - Skin conditions during assessment period [CMS Assessment] |
| 89053-3 | MDS v3.0 - RAI v1.15.1 - Skin conditions - NOD, SOD during assessment period [CMS Assessment] |
| 89070-7 | ADAPTABLE patient reported item set [ADAPTABLE] |
| 89071-5 | Enrollment item set [ADAPTABLE] |
| 89072-3 | Aspirin dose--post enrollment in ADAPTABLE study [ADAPTABLE] |
| 89073-1 | Reason for discontinuing aspirin use |
| 89074-9 | Aspirin usage--post enrollment in ADAPTABLE study [ADAPTABLE] |
| 89075-6 | Willing to change aspirin dose |
| 89076-4 | Aspirin usage--pre enrollment in ADAPTABLE study [ADAPTABLE] |
| 89077-2 | Adequacy of information on+time spent reading ADAPTABLE web site [ADAPTABLE] |
| 89078-0 | History of hospitalization--post enrollment in ADAPTABLE study [ADAPTABLE] |
| 89079-8 | Events--during hospitalization [ADAPTABLE] |
| 89080-6 | Satisfaction with using ADAPTABLE web site [ADAPTABLE] |
| 89081-4 | Aspirin dose--pre enrollment in ADAPTABLE study Dose [ADAPTABLE] |
| 89082-2 | Early visit item set [ADAPTABLE] |
| 89083-0 | Follow-up visit item set [ADAPTABLE] |
| 89084-8 | I have trouble doing all of my regular leisure activities with others in the past 7 days [ADAPTABLE] |
| 89090-5 | Everyday Cognition - Study Partner Report Form [ECog.Partner] |
| 89092-1 | Compared to 10 years ago, has there been any change in thinking things through before acting [ECog.Partner] |
| 89093-9 | Compared to 10 years ago, has there been any change in cooking or working and talking at the same time [ECog.Partner] |
| 89094-7 | Compared to 10 years ago, has there been any change in the ability to concentrate on a task without being distracted by external things in the environment [ECog.Partner] |
| 89095-4 | Compared to 10 years ago, has there been any change in returning to a task after being interrupted [ECog.Partner] |
| 89096-2 | Compared to 10 years ago, has there been any change in the ability to do two things at once [ECog.Partner] |
| 89097-0 | Compared to 10 years ago, has there been any change in using an organized strategy to manage a medication schedule involving multiple medications [ECog.Partner] |
| 89098-8 | Compared to 10 years ago, has there been any change in keeping mail and papers organized [ECog.Partner] |
| 89099-6 | Compared to 10 years ago, has there been any change in prioritizing tasks by importance [ECog.Partner] |
| 89100-2 | Compared to 10 years ago, has there been any change in keeping financial records organized [ECog.Partner] |
| 89101-0 | Compared to 10 years ago, has there been any change in balancing the checkbook without error [ECog.Partner] |
| 89102-8 | Compared to 10 years ago, has there been any change in keeping living and work space organized [ECog.Partner] |
| 89103-6 | Compared to 10 years ago, has there been any change in thinking ahead [ECog.Partner] |
| 89104-4 | Compared to 10 years ago, has there been any change in developing a schedule in advance of anticipated events [ECog.Partner] |
| 89105-1 | Compared to 10 years ago, has there been any change in the ability to anticipate weather changes and plan accordingly (i.e.bring a coat or umbrella) [ECog.Partner] |
| 89106-9 | Compared to 10 years ago, has there been any change in planning the sequence of stops on a shopping trip [ECog.Partner] |
| 89107-7 | Compared to 10 years ago, has there been any change in finding his or her way around a house visited many times [ECog.Partner] |
| 89108-5 | Compared to 10 years ago, has there been any change in finding his or her way around a familiar store [ECog.Partner] |
| 89109-3 | Compared to 10 years ago, has there been any change in remembering things that happened recently (such as recent outings, events in the news) [ECog.Partner] |
| 89110-1 | Compared to 10 years ago, has there been any change in finding the way back to a meeting spot in the mall or other location [ECog.Partner] |
| 89111-9 | Compared to 10 years ago, has there been any change in finding one's car in a parking lot [ECog.Partner] |
| 89112-7 | Compared to 10 years ago, has there been any change in reading a map and helping with directions when someone else is driving [ECog.Partner] |
| 89113-5 | Compared to 10 years ago, has there been any change in following a map to find a new location [ECog.Partner] |
| 89114-3 | Compared to 10 years ago, has there been any change in understanding spoken directions or instructions [ECog.Partner] |
| 89115-0 | Compared to 10 years ago, has there been any change in describing a program he or she has watched on TV [ECog.Partner] |
| 89116-8 | Compared to 10 years ago, has there been any change in remembering the meaning of common words [ECog.Partner] |
| 89117-6 | Compared to 10 years ago, has there been any change in understanding the point of what other people are trying to say [ECog.Partner] |
| 89118-4 | Compared to 10 years ago, has there been any change in following a story in a book or on TV [ECog.Partner] |
| 89119-2 | Compared to 10 years ago, has there been any change in communicating thoughts in a conversation [ECog.Partner] |
| 89120-0 | Compared to 10 years ago, has there been any change in finding the right words to use in a conversation [ECog.Partner] |
| 89121-8 | Compared to 10 years ago, has there been any change in verbally giving instructions to others [ECog.Partner] |
| 89122-6 | Compared to 10 years ago, has there been any change in forgetting the names of objects [ECog.Partner] |
| 89123-4 | Compared to 10 years ago, has there been any change in remembering appointments, meetings, or engagements [ECog.Partner] |
| 89124-2 | Compared to 10 years ago, has there been any change in remembering he or she has already told someone something [ECog.Partner] |
| 89125-9 | Compared to 10 years ago, has there been any change in remembering the current date or day of the week [ECog.Partner] |
| 89126-7 | Compared to 10 years ago, has there been any change in repeating stories AndOr questions [ECog.Partner] |
| 89127-5 | Compared to 10 years ago, has there been any change in remembering where he or she has placed objects [ECog.Partner] |
| 89128-3 | Compared to 10 years ago, has there been any change in recalling conversations a few days later [ECog.Partner] |
| 89129-1 | Compared to 10 years ago, has there been any change in remembering a few shopping items without a list [ECog.Partner] |
| 89130-9 | Compared to 10 years ago, has there been any change in finding his or her way around a familiar neighborhood [ECog.Partner] |
| 89133-3 | Everyday Cognition - Participant Self Report Form [ECog] |
| 89135-8 | Compared to 10 years ago, has there been any change in verbally giving instructions to others [ECog] |
| 89136-6 | Compared to 10 years ago, has there been any change in using an organized strategy to manage a medication schedule involving multiple medications [ECog] |
| 89137-4 | Compared to 10 years ago, has there been any change in understanding the point of what other people are trying to say [ECog] |
| 89138-2 | Compared to 10 years ago, has there been any change in understanding spoken directions or instructions [ECog] |
| 89139-0 | Compared to 10 years ago, has there been any change in thinking things through before acting [ECog] |
| 89140-8 | Compared to 10 years ago, has there been any change in thinking ahead [ECog] |
| 89141-6 | Compared to 10 years ago, has there been any change in the ability to do two things at once [ECog] |
| 89142-4 | Compared to 10 years ago, has there been any change in the ability to concentrate on a task without being distracted by external things in the environment [ECog] |
| 89143-2 | Compared to 10 years ago, has there been any change in the ability to anticipate weather changes and plan accordingly (i.e. bring a coat or umbrella) [ECog] |
| 89144-0 | Compared to 10 years ago, has there been any change in returning to a task after being interrupted [ECog] |
| 89145-7 | Compared to 10 years ago, has there been any change in repeating stories AndOr questions [ECog] |
| 89146-5 | Compared to 10 years ago, has there been any change in remembering where I have placed objects [ECog] |
| 89147-3 | Compared to 10 years ago, has there been any change in remembering things that happened recently (such as recent outings, events in the news) [ECog] |
| 89148-1 | Compared to 10 years ago, has there been any change in remembering the meaning of common words [ECog] |
| 89149-9 | Compared to 10 years ago, has there been any change in remembering the current date or day of the week [ECog] |
| 89150-7 | Compared to 10 years ago, has there been any change in remembering I have already told someone something [ECog] |
| 89151-5 | Compared to 10 years ago, has there been any change in remembering appointments, meetings, or engagements [ECog] |
| 89152-3 | Compared to 10 years ago, has there been any change in remembering a few shopping items without a list [ECog] |
| 89153-1 | Compared to 10 years ago, has there been any change in recalling conversations a few days later [ECog] |
| 89154-9 | Compared to 10 years ago, has there been any change in reading a map and helping with directions when someone else is driving [ECog] |
| 89155-6 | Compared to 10 years ago, has there been any change in prioritizing tasks by importance [ECog] |
| 89156-4 | Compared to 10 years ago, has there been any change in planning a sequence of stops on a shopping trip [ECog] |
| 89157-2 | Compared to 10 years ago, has there been any change in keeping mail and papers organized [ECog] |
| 89158-0 | Compared to 10 years ago, has there been any change in keeping living and work space organized [ECog] |
| 89159-8 | Compared to 10 years ago, has there been any change in keeping financial records organized [ECog] |
| 89160-6 | Compared to 10 years ago, has there been any change in forgetting the names of objects [ECog] |
| 89161-4 | Compared to 10 years ago, has there been any change in following a story in a book or on TV [ECog] |
| 89162-2 | Compared to 10 years ago, has there been any change in following a map to find a new location [ECog] |
| 89163-0 | Compared to 10 years ago, has there been any change in finding the right words to use in a conversation [ECog] |
| 89164-8 | Compared to 10 years ago, has there been any change in finding my way back to a meeting spot in the mall or other location [ECog] |
| 89165-5 | Compared to 10 years ago, has there been any change in finding my way around a house visited many times [ECog] |
| 89166-3 | Compared to 10 years ago, has there been any change in finding my way around a familiar store [ECog] |
| 89167-1 | Compared to 10 years ago, has there been any change in finding my way around a familiar neighborhood [ECog] |
| 89168-9 | Compared to 10 years ago, has there been any change in finding my car in a parking lot [ECog] |
| 89169-7 | Compared to 10 years ago, has there been any change in developing a schedule in advance of anticipated events [ECog] |
| 89170-5 | Compared to 10 years ago, has there been any change in describing a program I have watched on TV [ECog] |
| 89171-3 | Compared to 10 years ago, has there been any change in cooking or working and talking at the same time [ECog] |
| 89172-1 | Compared to 10 years ago, has there been any change in communicating thoughts in a conversation [ECog] |
| 89173-9 | Compared to 10 years ago, has there been any change in balancing the checkbook without error [ECog] |
| 89174-7 | Are you concerned that you have a memory or other thinking problem [ECog] |
| 89190-3 | Performance-based measure name |
| 89191-1 | Performance-based measure score |
| 89192-9 | Performance-based measure score interpretation |
| 89193-7 | Patient reported outcome measure score interpretation |
| 89194-5 | Patient reported outcome measure score |
| 89195-2 | Patient reported outcome measure name |
| 89196-0 | Patient reported outcome measure panel |
| 89197-8 | Performance-based measure panel |
| 89198-6 | Mean score [ECog] |
| 89199-4 | Mean score [ECog.Partner] |
| 89204-2 | Patient Health Questionnaire-9: Modified for Teens total score [Reported.PHQ.Teen] |
| 89205-9 | Center for Epidemiologic Studies Depression Scale-Revised total score [CESD-R] |
| 89206-7 | Patient Health Questionnaire-9: Modified for Teens [Reported.PHQ.Teen] |
| 89207-5 | Center for Epidemiologic Studies Depression Scale-Revised [CESD-R] |
| 89208-3 | Beck Depression Inventory Fast Screen total score [BDI] |
| 89209-1 | Beck Depression Inventory II total score [BDI] |
| 89210-9 | Beck Depression Inventory II [BDI] |
| 89211-7 | Beck Depression Inventory Fast Screen [BDI] |
| 89285-1 | Executive functioning: divided attention panel [ECog] |
| 89286-9 | Memory panel [ECog] |
| 89287-7 | Language panel [ECog] |
| 89288-5 | Visual-spatial and perceptual abilities panel [ECog] |
| 89289-3 | Executive functioning: planning panel [ECog] |
| 89290-1 | Executive functioning: organization panel [ECog] |
| 89293-5 | Executive functioning: organization panel [ECog.Partner] |
| 89294-3 | Executive functioning: planning panel [ECog.Partner] |
| 89295-0 | Visual-spatial and perceptual abilities panel [ECog.Partner] |
| 89296-8 | Language panel [ECog.Partner] |
| 89297-6 | Memory panel [ECog.Partner] |
| 89298-4 | Executive functioning: divided attention panel [ECog.Partner] |
| 89375-0 | Wheel 50 feet with two turns - functional goal during assessment period [CMS Assessment] |
| 89376-8 | Wheel 50 feet with two turns - functional ability during assessment period [CMS Assessment] |
| 89377-6 | Wheel 150 feet - functional goal during assessment period [CMS Assessment] |
| 89378-4 | Wheel 150 feet - functional ability during assessment period [CMS Assessment] |
| 89379-2 | Walking 10 feet on uneven surfaces - functional goal during assessment period [CMS Assessment] |
| 89380-0 | Walking 10 feet on uneven surfaces - functional ability during assessment period [CMS Assessment] |
| 89381-8 | Walk 50 feet with two turns - functional goal during assessment period [CMS Assessment] |
| 89382-6 | Walk 50 feet with two turns - functional ability during assessment period [CMS Assessment] |
| 89383-4 | Walk 150 feet - functional goal during assessment period [CMS Assessment] |
| 89384-2 | Walk 150 feet - functional ability during assessment period [CMS Assessment] |
| 89385-9 | Walk 10 feet - functional goal during assessment period [CMS Assessment] |
| 89386-7 | Walk 10 feet - functional ability during assessment period [CMS Assessment] |
| 89387-5 | Upper body dressing - functional goal during assessment period [CMS Assessment] |
| 89388-3 | Upper body dressing - functional ability during assessment period [CMS Assessment] |
| 89389-1 | Toileting hygiene - functional goal during assessment period [CMS Assessment] |
| 89390-9 | Toilet transfer - functional goal during assessment period [CMS Assessment] |
| 89391-7 | OASIS E - Functional abilities and goals - DC during assessment period [CMS Assessment] |
| 89392-5 | Sit to stand - functional goal during assessment period [CMS Assessment] |
| 89393-3 | Sit to stand - functional ability during assessment period [CMS Assessment] |
| 89394-1 | Sit to lying - functional goal during assessment period [CMS Assessment] |
| 89395-8 | Sit to lying - functional ability during assessment period [CMS Assessment] |
| 89396-6 | Shower/bathe self - functional goal during assessment period [CMS Assessment] |
| 89397-4 | Shower/bathe self - functional ability during assessment period [CMS Assessment] |
| 89398-2 | Roll left and right - functional goal during assessment period [CMS Assessment] |
| 89399-0 | Roll left and right - functional ability during assessment period [CMS Assessment] |
| 89400-6 | Putting on and taking off footwear - functional goal during assessment period [CMS Assessment] |
| 89401-4 | Putting on and taking off footwear - functional ability during assessment period [CMS Assessment] |
| 89402-2 | Picking up object - functional goal during assessment period [CMS Assessment] |
| 89403-0 | Picking up object - functional ability during assessment period [CMS Assessment] |
| 89404-8 | Oral hygiene - functional goal during assessment period [CMS Assessment] |
| 89405-5 | Oral hygiene - functional ability during assessment period [CMS Assessment] |
| 89406-3 | Lower body dressing - functional goal during assessment period [CMS Assessment] |
| 89407-1 | Lower body dressing - functional ability during assessment period [CMS Assessment] |
| 89409-7 | Eating - functional goal during assessment period [CMS Assessment] |
| 89410-5 | Eating - functional ability during assessment period [CMS Assessment] |
| 89412-1 | Car transfer - functional goal during assessment period [CMS Assessment] |
| 89413-9 | Car transfer - functional ability during assessment period [CMS Assessment] |
| 89414-7 | Chair/bed-to-chair transfer - functional goal during assessment period [CMS Assessment] |
| 89415-4 | Bed-to-chair transfer - functional ability during assessment period [CMS Assessment] |
| 89416-2 | Go up and down 4 steps - functional goal during assessment period [CMS Assessment] |
| 89417-0 | 4 steps - functional ability during assessment period [CMS Assessment] |
| 89418-8 | Go up and down 12 steps - functional goal during assessment period [CMS Assessment] |
| 89419-6 | 12 steps - functional ability during assessment period [CMS Assessment] |
| 89420-4 | Go up and down a curb/step - functional goal during assessment period [CMS Assessment] |
| 89421-2 | 1 step (curb) - functional ability during assessment period [CMS Assessment] |
| 89435-2 | Disabled from walking by any condition other than heart or lung disease [Rose Dyspnea Scale] |
| 89436-0 | Total score [Rose Dyspnea Scale] |
| 89437-8 | Are you short of breath on washing or dressing [Rose Dyspnea Scale] |
| 89438-6 | Do you have to stop for breath when walking at your own pace on level ground [Rose Dyspnea Scale] |
| 89439-4 | Do you get short of breath walking with other people of your own age on level ground [Rose Dyspnea Scale] |
| 89440-2 | Rose Dyspnea Scale |
| 89474-1 | OASIS E - Mobility - discharge performance during assessment period [CMS Assessment] |
| 89475-8 | OASIS E - Self-care - discharge performance during assessment period [CMS Assessment] |
| 89476-6 | Mobility - discharge goal during assessment period [CMS Assessment] |
| 89477-4 | OASIS E - Mobility - SOC and ROC performance during assessment period [CMS Assessment] |
| 89478-2 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2, OASIS E - Self-care - discharge goal during assessment period [CMS Assessment] |
| 89479-0 | OASIS E - Self-care - SOC and ROC performance during assessment period [CMS Assessment] |
| 89555-7 | How many days per week did you engage in moderate to strenuous physical activity in the last 30 days |
| 89556-5 | Comprehensive Universal Behavior Health Screen [CUBS] |
| 89557-3 | Depression symptoms score [CUBS] |
| 89558-1 | Anxiety symptoms score [CUBS] |
| 89559-9 | Lifetime suicide risk score [CUBS] |
| 89560-7 | Suicide risk score [CUBS] |
| 89561-5 | Trauma symptoms score [CUBS] |
| 89562-3 | Substance abuse symptoms score [CUBS] |
| 89563-1 | Eating disorder symptoms score [CUBS] |
| 89564-9 | Employment status [CUBS] |
| 89565-6 | Housing status [CUBS] |
| 89566-4 | Income status [CUBS] |
| 89567-2 | Food insecurity status [CUBS] |
| 89568-0 | Child care availability status [CUBS] |
| 89569-8 | Access to transportation/mobility status [CUBS] |
| 89570-6 | Involvement with criminal justice [CUBS] |
| 89571-4 | Disability status [CUBS] |
| 89572-2 | OASIS E - Functional abilities and goals - SOC, ROC during assessment period [CMS Assessment] |
| 89573-0 | MDS v3.0 - RAI v1.16.1 - Cognitive patterns - NO, SO during assessment period [CMS Assessment] |
| 89574-8 | Exercise Vital Sign (EVS) |
| 89663-9 | I felt irritable in past 7 days [PROMIS] |
| 89664-7 | I felt lonely even when I was with other people in past 7 days [PROMIS] |
| 89665-4 | I had mood swings in past 7 days [PROMIS] |
| 89666-2 | I felt like crying in past 7 days [PROMIS] |
| 89667-0 | I felt unloved in past 7 days [PROMIS] |
| 89668-8 | I felt like I needed help for my depression in past 7 days [PROMIS] |
| 89669-6 | PROMIS cancer emotional distress - depression - version 1.0 T-score |
| 89670-4 | PROMIS cancer item bank - emotional distress - depression - version 1.0 |
| 89671-2 | How much did pain interfere with your ability to pay attention in past 7 days [PROMIS] |
| 89672-0 | How often did pain make it hard for you to walk more than 5 minutes at a time in past 7 days [PROMIS] |
| 89673-8 | How much did you worry about pain in past 7 days [PROMIS] |
| 89674-6 | PROMIS cancer item bank - pain interference - version 1.1 |
| 89675-3 | PROMIS cancer pain interference - version 1.1 T-score |
| 89676-1 | PROMIS cancer fatigue - version 1.0 T-score |
| 89677-9 | PROMIS cancer item bank - fatigue - version 1.0 |
| 89678-7 | I had unpleasant thoughts that wouldn't leave my mind in past 7 days [PROMIS] |
| 89679-5 | PROMIS cancer item bank - emotional distress - anxiety - version 1.0 |
| 89680-3 | PROMIS cancer emotional distress - anxiety - version 1.0 T-score |
| 89681-1 | Does your health now limit you in exercising regularly [PROMIS] |
| 89682-9 | Are you able to climb several flights of stairs [PROMIS] |
| 89683-7 | Are you able to do two hours of physical labor [PROMIS] |
| 89684-5 | Are you able to run on uneven ground [PROMIS] |
| 89685-2 | Does your health now limit you in doing housework or jobs around the house [PROMIS] |
| 89686-0 | Does your health now limit you in doing recreational activities which require little exertion (e.g., card playing, knitting, etc.) [PROMIS] |
| 89687-8 | Does your health now limit you in pursuing your hobbies or other leisure activities [PROMIS] |
| 89688-6 | Does your health now limit you in traveling out of town for an overnight stay [PROMIS] |
| 89689-4 | PROMIS cancer item bank - physical function - version 1.1 |
| 89690-2 | PROMIS cancer physical function - version 1.1 T-score |
| 89724-9 | Minimum Data Set (MDS) for Public Health Emergency Operations Centers (EOC) [CDC Emergency Operations Centers] |
| 89725-6 | Managing and commanding [CDC Emergency Operations Centers] |
| 89726-4 | Operating [CDC Emergency Operations Centers] |
| 89727-2 | Planning and intelligence [CDC Emergency Operations Centers] |
| 89728-0 | Logistics [CDC Emergency Operations Centers] |
| 89729-8 | Finance and administration [CDC Emergency Operations Centers] |
| 89730-6 | Decisions and approvals [CDC Emergency Operations Centers] |
| 89731-4 | Coordination [CDC Emergency Operations Centers] |
| 89732-2 | Communication [CDC Emergency Operations Centers] |
| 89733-0 | Leadership assigned [CDC Emergency Operations Centers] |
| 89734-8 | Response status and response team [CDC Emergency Operations Centers] |
| 89735-5 | Activate and deactivate decision [CDC Emergency Operations Centers] |
| 89736-3 | Plan approval [CDC Emergency Operations Centers] |
| 89737-1 | Partners list [CDC Emergency Operations Centers] |
| 89738-9 | Partner tasking [CDC Emergency Operations Centers] |
| 89739-7 | Public communication [CDC Emergency Operations Centers] |
| 89740-5 | Inter-agency communication [CDC Emergency Operations Centers] |
| 89741-3 | Intra-agency communication [CDC Emergency Operations Centers] |
| 89742-1 | Incident commander information [CDC Emergency Operations Centers] |
| 89743-9 | Response section information [CDC Emergency Operations Centers] |
| 89744-7 | Response plan [CDC Emergency Operations Centers] |
| 89745-4 | Daily schedule [CDC Emergency Operations Centers] |
| 89746-2 | Start and terminate response [CDC Emergency Operations Centers] |
| 89747-0 | Response team [CDC Emergency Operations Centers] |
| 89748-8 | Reporting to leadership [CDC Emergency Operations Centers] |
| 89749-6 | Standard operating procedures inventory [CDC Emergency Operations Centers] |
| 89750-4 | Task tracing [CDC Emergency Operations Centers] |
| 89751-2 | Event investigation [CDC Emergency Operations Centers] |
| 89752-0 | Controlling [CDC Emergency Operations Centers] |
| 89753-8 | Task information [CDC Emergency Operations Centers] |
| 89754-6 | Event status [CDC Emergency Operations Centers] |
| 89755-3 | Risk assessments [CDC Emergency Operations Centers] |
| 89756-1 | Laboratory operations report [CDC Emergency Operations Centers] |
| 89757-9 | Countermeasures operations [CDC Emergency Operations Centers] |
| 89758-7 | Situation analysis [CDC Emergency Operations Centers] |
| 89759-5 | Planning [CDC Emergency Operations Centers] |
| 89760-3 | After action review [CDC Emergency Operations Centers] |
| 89761-1 | Information management [CDC Emergency Operations Centers] |
| 89762-9 | Infectious diseases reporting and surveillance [CDC Emergency Operations Centers] |
| 89763-7 | Laboratory reporting [CDC Emergency Operations Centers] |
| 89764-5 | Public health emergency event surveillance [CDC Emergency Operations Centers] |
| 89765-2 | Rumors surveillance [CDC Emergency Operations Centers] |
| 89766-0 | Daily watch-keeping record [CDC Emergency Operations Centers] |
| 89767-8 | Risk assessment and consultation [CDC Emergency Operations Centers] |
| 89768-6 | Situational report [CDC Emergency Operations Centers] |
| 89769-4 | Plan development [CDC Emergency Operations Centers] |
| 89770-2 | Authority to plan [CDC Emergency Operations Centers] |
| 89771-0 | Plan components [CDC Emergency Operations Centers] |
| 89772-8 | After action report [CDC Emergency Operations Centers] |
| 89773-6 | Improvement plan [CDC Emergency Operations Centers] |
| 89774-4 | Document management [CDC Emergency Operations Centers] |
| 89775-1 | Resources management [CDC Emergency Operations Centers] |
| 89776-9 | Information and communications technology support [CDC Emergency Operations Centers] |
| 89777-7 | Health agencies [CDC Emergency Operations Centers] |
| 89778-5 | Experts and staff [CDC Emergency Operations Centers] |
| 89779-3 | Rapid response team [CDC Emergency Operations Centers] |
| 89780-1 | Volunteers [CDC Emergency Operations Centers] |
| 89781-9 | Reserves of emergency supplies [CDC Emergency Operations Centers] |
| 89782-7 | Shelters [CDC Emergency Operations Centers] |
| 89783-5 | Technology assessment [CDC Emergency Operations Centers] |
| 89784-3 | Budget management [CDC Emergency Operations Centers] |
| 89785-0 | Purchase and dispatch [CDC Emergency Operations Centers] |
| 89786-8 | Human resources management [CDC Emergency Operations Centers] |
| 89787-6 | Budget [CDC Emergency Operations Centers] |
| 89788-4 | Donor [CDC Emergency Operations Centers] |
| 89789-2 | Human resources [CDC Emergency Operations Centers] |
| 89790-0 | Purchase [CDC Emergency Operations Centers] |
| 89791-8 | Dispatch [CDC Emergency Operations Centers] |
| 89792-6 | Event activation or deactivation |
| 89793-4 | Event description |
| 89862-7 | Patient-Oriented Eczema Measure [POEM] |
| 89863-5 | Over the last week, on how many days has your or your child's skin been itchy because of eczema [POEM] |
| 89864-3 | Over the last week, on how many nights has your or your child's sleep been disturbed because of the eczema [POEM] |
| 89865-0 | Over the last week, on how many days has your or your child's skin been bleeding because of the eczema [POEM] |
| 89866-8 | Over the last week, on how many days has your or your child's skin been weeping or oozing clear fluid because of the eczema [POEM] |
| 89867-6 | Over the last week, on how many days has your or your child's skin been cracked because of the eczema [POEM] |
| 89868-4 | Over the last week, on how many days has your or your child's skin been flaking off because of the eczema [POEM] |
| 89869-2 | Over the last week, on how many days has your or your child's skin felt dry or rough because of the eczema [POEM] |
| 89870-0 | Total score [POEM] |
| 89904-7 | Total score [CRQ-SAS] |
| 89905-4 | Chronic Respiratory Questionnaire Self-Administered Standardized Format [CRQ-SAS] |
| 89906-2 | Chronic Respiratory Questionnaire Self-Administered Individualized Format [CRQ-SAI] |
| 89907-0 | Total score [CRQ-SAI] |
| 89911-2 | Emergency management plan name |
| 89912-0 | Emergency management plan purpose |
| 89913-8 | Event identifier |
| 89914-6 | Condition triggering EOC response activation |
| 89915-3 | Condition triggering EOC response termination |
| 89916-1 | Emergency management plan approved date |
| 89917-9 | Emergency management plan estimated fulfillment date |
| 89918-7 | Emergency management plan approver name |
| 89919-5 | Organization Emergency response capabilities |
| 89920-3 | PROMIS item bank - anger - version 1.1 |
| 89921-1 | PROMIS anger - version 1.1 T-score |
| 89922-9 | I worried about dying in past 7 days [PROMIS] |
| 89923-7 | PROMIS item bank - pain interference - version 1.1 |
| 89924-5 | PROMIS pain interference - version 1.1 Tscore |
| 89934-4 | I had so much pain I had to stop what I was doing in past 7 days [PROMIS.PEDS] |
| 89935-1 | PROMIS pediatric item bank - pain interference - version 2.0 |
| 89936-9 | PROMIS pediatric pain interference - version 2.0 Tscore |
| 89937-7 | It was hard for my child to walk one block when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89938-5 | My child had trouble doing schoolwork when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89939-3 | It was hard for my child to run when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89940-1 | It was hard for my child to pay attention when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89941-9 | It was hard for my child to have fun when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89942-7 | My child hurt all over his or her body in past 7 days [PROMIS.PARENTPROXY] |
| 89943-5 | My child felt angry when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89944-3 | My child hurt a lot in past 7 days [PROMIS.PARENTPROXY] |
| 89945-0 | It was hard for my child to remember things when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89946-8 | It was hard for my child to get along with other people when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89947-6 | My child missed school when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89948-4 | It was hard for my child to stay standing when he or she had pain in past 7 days [PROMIS.PARENTPROXY] |
| 89949-2 | PROMIS parent proxy item bank - pain interference - version 2.0 |
| 89950-0 | PROMIS parent proxy pain interference - version 2.0 T-score |
| 89963-3 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 during assessment period [CMS Assessment] |
| 90016-7 | IRF-PAI v3.0 - Quality indicators - discharge during assessment period [CMS Assessment] |
| 90018-3 | Psoriasis care satisfaction questionnaire [PsoSat] |
| 90019-1 | My current treatment meets my expectations [PsoSat] |
| 90020-9 | I am satisfied with the treatment |
| 90021-7 | I wish for a better treatment [PsoSat] |
| 90022-5 | There has been no progress in my treatment for quite some time [PsoSat] |
| 90023-3 | The side effects are causing me discomfort [PsoSat] |
| 90024-1 | The current treatment has been going on for too long without success [PsoSat] |
| 90025-8 | The treatment itself is putting a great strain on me [PsoSat] |
| 90026-6 | I am dependent on other people's assistance for my treatment [PsoSat] |
| 90027-4 | Total score [PsoSat] |
| 90028-2 | Routine Assessment of Patient Index Data 3 [RAPID3] |
| 90030-8 | Over the past week, are you able to get in and out of a car, bus, train, or airplane [HAQ] |
| 90031-6 | Over the past week, are you able to walk two miles or three kilometers, if you wish [HAQ] |
| 90032-4 | Over the past week, are you able to participate in recreational activities and sports as you would like, if you wish [HAQ] |
| 90033-2 | Over the past week, are you able to get a good night's sleep [HAQ] |
| 90034-0 | Over the past week, are you able to deal with feelings of anxiety or being nervous [HAQ] |
| 90035-7 | Over the past week, are you able to deal with feelings of depression or feeling blue [HAQ] |
| 90036-5 | Pain severity in the past week- 0-10 (0.5 increments) numeric rating [Reported] |
| 90037-3 | Assessment of global health - 0-10 (0.5 increments) numeric rating [Reported] |
| 90038-1 | Weighted score [RAPID3] |
| 90094-4 | Rheumatoid arthritis disease severity level [RAPID3] |
| 90095-1 | Event managing group at lead department or agency Organization |
| 90096-9 | Event managing group at co-lead department or agency Organization |
| 90112-4 | Response section or team responsibility |
| 90120-7 | Date and time of event response status |
| 90121-5 | Event response description |
| 90122-3 | Response team participation status |
| 90127-2 | It is hard for your child to find his or her way to a place that he or she has visited several times before in past 4 weeks [PROMIS.PARENTPROXY] |
| 90128-0 | Your child has trouble remembering where he or she put things, like his or her watch or his or her homework in past 4 weeks [PROMIS.PARENTPROXY] |
| 90130-6 | It is hard for your child to take notes in class in past 4 weeks [PROMIS.PARENTPROXY] |
| 90131-4 | It is hard for your child to learn new things in past 4 weeks [PROMIS.PARENTPROXY] |
| 90132-2 | It is hard for your child to understand pictures that show how to make something in past 4 weeks [PROMIS.PARENTPROXY] |
| 90133-0 | It is hard for your child to pay attention to something boring he or she has to do in past 4 weeks [PROMIS.PARENTPROXY] |
| 90134-8 | It is hard for your child to pay attention to one thing for more than 5-10 minutes in past 4 weeks [PROMIS.PARENTPROXY] |
| 90135-5 | Your child has trouble remembering the names of people he or she has just met in past 4 weeks [PROMIS.PARENTPROXY] |
| 90136-3 | Your child has trouble keeping track of what he or she is doing if he or she gets interrupted in past 4 weeks [PROMIS.PARENTPROXY] |
| 90137-1 | It is hard for your child to do more than one thing at a time in past 4 weeks [PROMIS.PARENTPROXY] |
| 90138-9 | Your child forgets what his or her parents or teachers ask him or her to do in past 4 weeks [PROMIS.PARENTPROXY] |
| 90139-7 | Your child walks into a room and forgets what he or she wanted to get or do in past 4 weeks [PROMIS.PARENTPROXY] |
| 90140-5 | Your child has trouble remembering the names of people he or she knows in past 4 weeks [PROMIS.PARENTPROXY] |
| 90141-3 | It is hard for your child to add or subtract numbers in his or her head in past 4 weeks [PROMIS.PARENTPROXY] |
| 90142-1 | Your child has trouble remembering the date or day of the week in past 4 weeks [PROMIS.PARENTPROXY] |
| 90143-9 | When your child has a big project to do, he or she has trouble deciding where to start in past 4 weeks [PROMIS.PARENTPROXY] |
| 90144-7 | Your child has to read things several times to understand them in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90145-4 | Your child has to read things several times to understand them in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90146-2 | Your child reacts slower than most people his or her age when he or she plays games in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90147-0 | Your child reacts slower than most people his or her age when he or she plays games in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90148-8 | It is hard for your child to find the right words to say what he or she means in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90149-6 | It is hard for your child to find the right words to say what he or she means in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90150-4 | Your child forgets things easily in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90151-2 | Your child forgets things easily in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90152-0 | It is hard for your child to concentrate in school in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90153-8 | It is hard for your child to concentrate in school in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90154-6 | Your child has a hard time keeping track of his or her homework in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90155-3 | Your child has a hard time keeping track of his or her homework in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90156-1 | Your child forgets to bring things to and from school that he or she needs for homework in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90157-9 | Your child forgets to bring things to and from school that he or she needs for homework in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90158-7 | Your child forgets what he or she is going to say in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90159-5 | Your child forgets what he or she is going to say in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90160-3 | It takes your child longer than other people to get his or her school work done in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90161-1 | It takes your child longer than other people to get his or her school work done in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90162-9 | Your child has to use written lists more often than other people his or her age so he or she will not forget things in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90163-7 | Your child has to use written lists more often than other people his or her age so he or she will not forget things in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90164-5 | Your child has trouble remembering to do things like school projects or chores in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90165-2 | Your child has trouble remembering to do things like school projects or chores in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90166-0 | Your child has trouble paying attention to the teacher in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90167-8 | Your child has trouble paying attention to the teacher in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90168-6 | Your child has to work really hard to pay attention or he or she makes mistakes in past 4 weeks - frequency [PROMIS.PARENTPROXY] |
| 90169-4 | Your child has to work really hard to pay attention or he or she makes mistakes in past 4 weeks - severity [PROMIS.PARENTPROXY] |
| 90170-2 | PROMIS parent proxy item bank - cognitive function - version 1.0 |
| 90171-0 | PROMIS parent proxy cognitive function - version 1.0 T-score |
| 90172-8 | PROMIS parent proxy cognitive function - frequency - version 1.0 |
| 90173-6 | PROMIS parent proxy cognitive function - severity - version 1.0 |
| 90174-4 | It is hard for me to find my way to a place that I have visited several times before in past 4 weeks [PROMIS.PEDS] |
| 90175-1 | I have trouble remembering where I put things, like my watch or my homework in past 4 weeks [PROMIS.PEDS] |
| 90176-9 | I have trouble remembering the names of people I have just met in past 4 weeks [PROMIS.PEDS] |
| 90177-7 | It is hard for me to take notes in class in past 4 weeks [PROMIS.PEDS] |
| 90178-5 | It is hard for me to learn new things in past 4 weeks [PROMIS.PEDS] |
| 90179-3 | It is hard for me to understand pictures that show how to make something in past 4 weeks [PROMIS.PEDS] |
| 90180-1 | It is hard for me to pay attention to something boring I have to do in past 4 weeks [PROMIS.PEDS] |
| 90181-9 | It is hard for me to pay attention to one thing for more than 5-10 minutes in past 4 weeks [PROMIS.PEDS] |
| 90182-7 | I have trouble recalling the names of things in past 4 weeks [PROMIS.PEDS] |
| 90183-5 | I have trouble keeping track of what I am doing if I get interrupted in past 4 weeks [PROMIS.PEDS] |
| 90184-3 | It is hard for me to do more than one thing at a time in past 4 weeks [PROMIS.PEDS] |
| 90185-0 | I forget what my parents or teachers ask me to do in past 4 weeks [PROMIS.PEDS] |
| 90186-8 | I walk into a room and forget what I wanted to get or do in past 4 weeks [PROMIS.PEDS] |
| 90187-6 | I have trouble remembering the names of people I know in past 4 weeks [PROMIS.PEDS] |
| 90188-4 | It is hard for me to add or subtract numbers in my head in past 4 weeks [PROMIS.PEDS] |
| 90189-2 | I have trouble remembering the date or day of the week in past 4 weeks [PROMIS.PEDS] |
| 90190-0 | When I have a big project to do, I have trouble deciding where to start in past 4 weeks [PROMIS.PEDS] |
| 90191-8 | I have to read things several times to understand them in past 4 weeks - frequency [PROMIS.PEDS] |
| 90192-6 | I have to read things several times to understand them in past 4 weeks - severity [PROMIS.PEDS] |
| 90193-4 | I react slower than most people my age when I play games in past 4 weeks - frequency [PROMIS.PEDS] |
| 90194-2 | I react slower than most people my age when I play games in past 4 weeks - severity [PROMIS.PEDS] |
| 90195-9 | It is hard for me to find the right words to say what I mean in past 4 weeks - frequency [PROMIS.PEDS] |
| 90196-7 | It is hard for me to find the right words to say what I mean in past 4 weeks - severity [PROMIS.PEDS] |
| 90197-5 | I forget things easily in past 4 weeks - frequency [PROMIS.PEDS] |
| 90198-3 | I forget things easily in past 4 weeks - severity [PROMIS.PEDS] |
| 90199-1 | It is hard for me to concentrate in school in past 4 weeks - frequency [PROMIS.PEDS] |
| 90200-7 | It is hard for me to concentrate in school in past 4 weeks - severity [PROMIS.PEDS] |
| 90201-5 | I have a hard time keeping track of my homework in past 4 weeks - frequency [PROMIS.PEDS] |
| 90202-3 | I have a hard time keeping track of my homework in past 4 weeks - severity [PROMIS.PEDS] |
| 90203-1 | I forget to bring things to and from school that I need for homework in past 4 weeks - frequency [PROMIS.PEDS] |
| 90204-9 | I forget to bring things to and from school that I need for homework in past 4 weeks - severity [PROMIS.PEDS] |
| 90205-6 | I forget what I am going to say in past 4 weeks - frequency [PROMIS.PEDS] |
| 90206-4 | I forget what I am going to say in past 4 weeks - severity [PROMIS.PEDS] |
| 90207-2 | It takes me longer than other people to get my school work done in past 4 weeks - frequency [PROMIS.PEDS] |
| 90208-0 | It takes me longer than other people to get my school work done in past 4 weeks - severity [PROMIS.PEDS] |
| 90209-8 | I have to use written lists more often than other people my age so I will not forget things in past 4 weeks - frequency [PROMIS.PEDS] |
| 90210-6 | I have to use written lists more often than other people my age so I will not forget things in past 4 weeks - severity [PROMIS.PEDS] |
| 90211-4 | I have trouble remembering to do things like school projects or chores in past 4 weeks - frequency [PROMIS.PEDS] |
| 90212-2 | I have trouble remembering to do things like school projects or chores in past 4 weeks - severity [PROMIS.PEDS] |
| 90213-0 | I have trouble paying attention to the teacher in past 4 weeks - frequency [PROMIS.PEDS] |
| 90214-8 | I have trouble paying attention to the teacher in past 4 weeks - severity [PROMIS.PEDS] |
| 90215-5 | I have to work really hard to pay attention or I make mistakes in past 4 weeks - frequency [PROMIS.PEDS] |
| 90216-3 | I have to work really hard to pay attention or I make mistakes in past 4 weeks - severity [PROMIS.PEDS] |
| 90217-1 | PROMIS pediatric item bank - cognitive function - version 1.0 |
| 90218-9 | PROMIS pediatric cognitive function - version 1.0 T-score |
| 90219-7 | PROMIS pediatric cognitive function - frequency - version 1.0 |
| 90220-5 | PROMIS pediatric cognitive function - severity - version 1.0 |
| 90221-3 | Total score [CUDOS] |
| 90222-1 | Clinically Useful Depression Outcome Scale [CUDOS] |
| 90376-5 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when dressing yourself without help [PROMIS] |
| 90377-3 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking 50 steps/paces on flat ground at a normal speed without stopping [PROMIS] |
| 90378-1 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking up 20 stairs (2 flights) without stopping [PROMIS] |
| 90379-9 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when preparing meals [PROMIS] |
| 90380-7 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when washing dishes [PROMIS] |
| 90381-5 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when sweeping or mopping [PROMIS] |
| 90382-3 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when making a bed [PROMIS] |
| 90383-1 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when lifting something weighing 10-20 lbs (about 4.5-9 kg, like a large bag of groceries) [PROMIS] |
| 90384-9 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when carrying something weighing 10-20 lbs (about 4.5-9 kg, like a large bag of groceries) from one room to another [PROMIS] |
| 90385-6 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking (faster than your usual speed) for 1/2 mile (almost 1 km) without stopping [PROMIS] |
| 90386-4 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when taking a bath without help [PROMIS] |
| 90387-2 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when taking a shower [PROMIS] |
| 90388-0 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when putting on socks or stockings [PROMIS] |
| 90389-8 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when standing for at least 5 minutes [PROMIS] |
| 90390-6 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking 10 steps/paces on flat ground at a normal speed without stopping [PROMIS] |
| 90391-4 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking 1/2 mile (almost 1 km) on flat ground at a normal speed without stopping [PROMIS] |
| 90392-2 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking up 5 stairs without stopping [PROMIS] |
| 90393-0 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking up 10 stairs (1 flight) without stopping [PROMIS] |
| 90394-8 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking up 30 stairs (3 flights) without stopping [PROMIS] |
| 90395-5 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when scrubbing the floor or counter [PROMIS] |
| 90396-3 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when lifting something weighing less than 5 lbs (about 2 kg, like a houseplant) [PROMIS] |
| 90397-1 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when lifting something weighing 5-10 lbs (about 2-4.5 kg, like a basket of clothes) [PROMIS] |
| 90398-9 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when lifting something weighing more than 20 lbs (about 9 kg, like a medium-sized suitcase) [PROMIS] |
| 90399-7 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when carrying something weighing less than 5 lbs (about 2 kg, like a houseplant) from one room to another [PROMIS] |
| 90400-3 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when carrying something weighing 5-10 lbs (about 2-4.5 kg, like a basket of clothes) from one room to another [PROMIS] |
| 90401-1 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when getting in or out of a car [PROMIS] |
| 90402-9 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when dining out [PROMIS] |
| 90403-7 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when low-intensity leisure activity (gardening, etc.) [PROMIS] |
| 90404-5 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when moderate-intensity leisure activity (bicycling on level terrain, etc.) [PROMIS] |
| 90405-2 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking (faster than your usual speed) for 50 steps without stopping [PROMIS] |
| 90406-0 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when walking (faster than your usual speed) for at least 1 mile (a little more than 1.5 km) without stopping [PROMIS] |
| 90407-8 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had singing or humming [PROMIS] |
| 90408-6 | Considering your shortness of breath over the past 7 days, rate the amount of difficulty you had when talking while walking [PROMIS] |
| 90409-4 | PROMIS item bank - dyspnea functional limitations - version 1.0 |
| 90410-2 | PROMIS dyspnea functional limitations - version 1.0 T score |
| 90411-0 | Words I wanted to use have seemed to be on the tip of my tongue in past 7 days [PROMIS] |
| 90412-8 | I have had trouble finding the right words to express myself in past 7 days [PROMIS] |
| 90472-2 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.17.1, 1.17.2 during assessment period [CMS Assessment] |
| 90473-0 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 90474-8 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 90475-5 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 90476-3 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 90477-1 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 90478-9 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 90479-7 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home and Swing bed tracking (NT and ST) item set during assessment period [CMS Assessment] |
| 90480-5 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 90481-3 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Optional State Assessment (OSA) item set during assessment period [CMS Assessment] |
| 90482-1 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Mood during assessment period [CMS Assessment] |
| 90483-9 | MDS v3.0 - RAI v1.17.2 - Swallowing/nutritional status during assessment period [CMS Assessment] |
| 90484-7 | MDS v3.0 - RAI v1.17.2 - Swallowing/nutritional status - ND, SD during assessment period [CMS Assessment] |
| 90485-4 | MDS v3.0 - RAI v1.17.2 - Active diagnoses during assessment period [CMS Assessment] |
| 90486-2 | MDS v3.0 - RAI v1.17.2 - Health conditions during assessment period [CMS Assessment] |
| 90487-0 | MDS v3.0 - RAI v1.17.2 - Health conditions - NP, NQ, SP during assessment period [CMS Assessment] |
| 90488-8 | MDS v3.0 - RAI v1.17.2 - Health conditions - IPA during assessment period [CMS Assessment] |
| 90489-6 | MDS v3.0 - RAI v1.17.2 - Type of assessment during assessment period [CMS Assessment] |
| 90490-4 | MDS v3.0 - RAI v1.17.2 - Correction request during assessment period [CMS Assessment] |
| 90491-2 | MDS v3.0 - RAI v1.17.2 - Correction request - OSA during assessment period [CMS Assessment] |
| 90492-0 | MDS v3.0 - RAI v1.17.2 - Type of assessment on existing record to be modified or inactivated during assessment period [CMS Assessment] |
| 90493-8 | MDS v3.0 - RAI v1.17.2 - Assessment administration - SP during assessment period [CMS Assessment] |
| 90494-6 | MDS v3.0 - RAI v1.17.2 - Medicare stay - OSA during assessment period [CMS Assessment] |
| 90495-3 | MDS v3.0 - RAI v1.17.2 - Assessment administration - IPA during assessment period [CMS Assessment] |
| 90496-1 | MDS v3.0 - RAI v1.17.2 - Assessment administration - OSA during assessment period [CMS Assessment] |
| 90497-9 | MDS v3.0 - RAI v1.17.2 - Assessment administration during assessment period [CMS Assessment] |
| 90498-7 | MDS v3.0 - RAI v1.17.2 - Medicare part A billing during assessment period [CMS Assessment] |
| 90499-5 | MDS v3.0 - RAI v1.17.2 - Identification information during assessment period [CMS Assessment] |
| 90500-0 | MDS v3.0 - RAI v1.17.2 - Identification information - NP, NQ during assessment period [CMS Assessment] |
| 90501-8 | MDS v3.0 - RAI v1.17.2 - Identification information - SD, SP during assessment period [CMS Assessment] |
| 90502-6 | MDS v3.0 - RAI v1.17.2 - Identification information - NT, ST during assessment period [CMS Assessment] |
| 90503-4 | MDS v3.0 - RAI v1.17.2 - Identification information - IPA during assessment period [CMS Assessment] |
| 90504-2 | MDS v3.0 - RAI v1.17.2 - Identification information - OSA during assessment period [CMS Assessment] |
| 90505-9 | MDS v3.0 - RAI v1.17.2 - Hearing, speech, and vision - IPA, OSA during assessment period [CMS Assessment] |
| 90506-7 | MDS v3.0 - RAI v1.17.2 - Bladder and bowel - OSA during assessment period [CMS Assessment] |
| 90507-5 | MDS v3.0 - RAI v1.17.2 - Bladder and bowel - IPA during assessment period [CMS Assessment] |
| 90508-3 | MDS v3.0 - RAI v1.17.2 - Active diagnoses - OSA during assessment period [CMS Assessment] |
| 90509-1 | MDS v3.0 - RAI v1.17.2 - Swallowing/nutritional status - IPA during assessment period [CMS Assessment] |
| 90510-9 | MDS v3.0 - RAI v1.17.2 - Swallowing/nutritional status - OSA during assessment period [CMS Assessment] |
| 90511-7 | MDS v3.0 - RAI v1.17.2 - Current number of unhealed pressure injuries at each stage - OSA during assessment period [CMS Assessment] |
| 90512-5 | MDS v3.0 - RAI v1.17.2 - Skin conditions - OSA during assessment period [CMS Assessment] |
| 90513-3 | MDS v3.0 - RAI v1.17.2 - Medications - IPA during assessment period [CMS Assessment] |
| 90514-1 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs during assessment period [CMS Assessment] |
| 90515-8 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - NP, NQ during assessment period [CMS Assessment] |
| 90516-6 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - ND during assessment period [CMS Assessment] |
| 90517-4 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - NPE during assessment period [CMS Assessment] |
| 90518-2 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - OSA during assessment period [CMS Assessment] |
| 90519-0 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - IPA during assessment period [CMS Assessment] |
| 90520-8 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - SP during assessment period [CMS Assessment] |
| 90521-6 | Optional state assessment during assessment period [CMS Assessment] |
| 90522-4 | Assessment for state payment during assessment period [CMS Assessment] |
| 90523-2 | MDS v3.0 - RAI v1.17.2 - Optional state assessment during assessment period [CMS Assessment] |
| 90524-0 | Type of assessment for state payment during assessment period [CMS Assessment] |
| 90525-7 | SNF Part A Interrupted Stay during assessment period [CMS Assessment] |
| 90526-5 | Functional abilities and goals - IPA during assessment period [CMS Assessment] |
| 90527-3 | Occupational therapy - concurrent minutes during assessment period [CMS Assessment] |
| 90528-1 | Occupational therapy - co-treatment minutes during assessment period [CMS Assessment] |
| 90529-9 | Occupational therapy - group minutes during assessment period [CMS Assessment] |
| 90530-7 | Number of days with at least 15 minutes of occupational therapy during assessment period [CMS Assessment] |
| 90531-5 | Occupational therapy - individual minutes during assessment period [CMS Assessment] |
| 90532-3 | Physical therapy - concurrent minutes during assessment period [CMS Assessment] |
| 90533-1 | Physical therapy - co-treatment minutes during assessment period [CMS Assessment] |
| 90534-9 | Physical therapy - group minutes during assessment period [CMS Assessment] |
| 90535-6 | Physical therapy - individual minutes during assessment period [CMS Assessment] |
| 90536-4 | Speech-language pathology and audiology services - concurrent minutes during assessment period [CMS Assessment] |
| 90537-2 | Speech-language pathology and audiology services - co-treatment minutes during assessment period [CMS Assessment] |
| 90538-0 | Speech-language pathology and audiology services - group minutes during assessment period [CMS Assessment] |
| 90539-8 | Speech-language pathology and audiology services - individual minutes during assessment period [CMS Assessment] |
| 90540-6 | MDS v1.17.1, 1.17.2 - Self-care - interim performance - IPA during assessment period [CMS Assessment] |
| 90541-4 | Mobility - interim performance during assessment period [CMS Assessment] |
| 90542-2 | Did the resident have a major surgical procedure during the prior inpatient hospital stay that requires active care during the SNF stay [CMS Assessment] |
| 90543-0 | Percent intake by artificial route while a resident and during the last 7 days during assessment period [CMS Assessment] |
| 90544-8 | Therapies during Part A Medicare stay [CMS Assessment] |
| 90545-5 | Speech-language pathology and audiology services since the start date of the resident's most recent Medicare Part A stay [CMS Assessment] |
| 90546-3 | Occupational therapy since the start date of the resident's most recent Medicare Part A stay [CMS Assessment] |
| 90547-1 | Physical therapy since the start date of the resident's most recent Medicare Part A stay [CMS Assessment] |
| 90548-9 | Distinct calendar days of therapy during assessment period [CMS Assessment] |
| 90549-7 | Short stay assessment during assessment period [CMS Assessment] |
| 90550-5 | Number of days with at least 15 minutes of physical therapy during assessment period [CMS Assessment] |
| 90551-3 | Number of days with at least 15 minutes of speech language pathology and audiology services during assessment period [CMS Assessment] |
| 90569-5 | MDS v3.0 - RAI v1.17.2 - Identification information - NPE during assessment period [CMS Assessment] |
| 90570-3 | MDS v3.0 - RAI v1.17.2 - Type of assessment - NT, NPE, ST during assessment period [CMS Assessment] |
| 90571-1 | MDS v3.0 - RAI v1.17.2 - Type of assessment - IPA during assessment period [CMS Assessment] |
| 90572-9 | PROMIS parent proxy life satisfaction - version 1.0 T-Score |
| 90573-7 | Thinking about the past 4 weeks, my child's life was ideal [PROMIS.PARENTPROXY] |
| 90574-5 | Thinking about the past 4 weeks, my child was satisfied with his/her life in general [PROMIS.PARENTPROXY] |
| 90575-2 | Thinking about the past 4 weeks, my child felt he/she lived his/her life well [PROMIS.PARENTPROXY] |
| 90576-0 | Thinking about the past 4 weeks, my child's life went well [PROMIS.PARENTPROXY] |
| 90577-8 | Thinking about the past 4 weeks, my child's life was worthwhile [PROMIS.PARENTPROXY] |
| 90578-6 | Thinking about the past 4 weeks, my child liked the way he/she lived his/her life [PROMIS.PARENTPROXY] |
| 90579-4 | Thinking about the past 4 weeks, my child enjoyed his/her life [PROMIS.PARENTPROXY] |
| 90580-2 | Thinking about the past 4 weeks, my child had a lot of fun [PROMIS.PARENTPROXY] |
| 90581-0 | Thinking about the past 4 weeks, my child had fun [PROMIS.PARENTPROXY] |
| 90582-8 | Thinking about the past 4 weeks, my child felt positive about his/her life [PROMIS.PARENTPROXY] |
| 90583-6 | Thinking about the past 4 weeks, my child had a good life [PROMIS.PARENTPROXY] |
| 90584-4 | Thinking about the past 4 weeks, my child felt good about his/her life [PROMIS.PARENTPROXY] |
| 90585-1 | Thinking about the past 4 weeks, my child felt very good about his/her life [PROMIS.PARENTPROXY] |
| 90586-9 | Thinking about the past 4 weeks, my child was happy with his/her life [PROMIS.PARENTPROXY] |
| 90587-7 | Thinking about the past 4 weeks, my child felt extremely positive about his/her life [PROMIS.PARENTPROXY] |
| 90588-5 | Thinking about the past 4 weeks, my child was satisfied with his/her life [PROMIS.PARENTPROXY] |
| 90589-3 | Thinking about the past 4 weeks, my child was satisfied with his/her skills and talents [PROMIS.PARENTPROXY] |
| 90590-1 | Thinking about the past 4 weeks, my child was satisfied with his/her free time [PROMIS.PARENTPROXY] |
| 90591-9 | Thinking about the past 4 weeks, my child was happy with life in his/her community [PROMIS.PARENTPROXY] |
| 90592-7 | Thinking about the past 4 weeks, my child was happy with life in his/her neighborhood [PROMIS.PARENTPROXY] |
| 90593-5 | Thinking about the past 4 weeks, my child was happy with his/her life at home [PROMIS.PARENTPROXY] |
| 90594-3 | Thinking about the past 4 weeks, my child was happy with his/her life at school [PROMIS.PARENTPROXY] |
| 90595-0 | Thinking about the past 4 weeks, my child was happy with his/her family life [PROMIS.PARENTPROXY] |
| 90596-8 | Thinking about the past 4 weeks, my child was happy with his/her social life [PROMIS.PARENTPROXY] |
| 90597-6 | Thinking about the past 4 weeks, my child was satisfied with the friends he/she has [PROMIS.PARENTPROXY] |
| 90598-4 | Thinking about the past 4 weeks, my child's life was as good as most kids' lives [PROMIS.PARENTPROXY] |
| 90599-2 | Thinking about the past 4 weeks, my child felt he/she lived as well as other kids [PROMIS.PARENTPROXY] |
| 90600-8 | Thinking about the past 4 weeks, my child enjoyed his/her life more than most kids enjoyed their lives [PROMIS.PARENTPROXY] |
| 90601-6 | Thinking about the past 4 weeks, my child felt that his/her life was better than most kids' lives [PROMIS.PARENTPROXY] |
| 90602-4 | Thinking about the past 4 weeks, my child got the things he/she wanted in life [PROMIS.PARENTPROXY] |
| 90603-2 | Thinking about the past 4 weeks, my child had what he/she needed in life [PROMIS.PARENTPROXY] |
| 90604-0 | Thinking about the past 4 weeks, my child had what he/she wanted in life [PROMIS.PARENTPROXY] |
| 90605-7 | Thinking about the past 4 weeks, my child was happy with the way things were [PROMIS.PARENTPROXY] |
| 90606-5 | Thinking about the past 4 weeks, my child's life situation was excellent [PROMIS.PARENTPROXY] |
| 90607-3 | Thinking about the past 4 weeks, the conditions of my child's life were excellent [PROMIS.PARENTPROXY] |
| 90608-1 | Thinking about the past 4 weeks, my child's life was just right [PROMIS.PARENTPROXY] |
| 90609-9 | Thinking about the past 4 weeks, my child's life was going very well [PROMIS.PARENTPROXY] |
| 90610-7 | Thinking about the past 4 weeks, my child's life was good [PROMIS.PARENTPROXY] |
| 90611-5 | Thinking about the past 4 weeks, my child's life was great [PROMIS.PARENTPROXY] |
| 90612-3 | Thinking about the past 4 weeks, my child's life was excellent [PROMIS.PARENTPROXY] |
| 90613-1 | Thinking about the past 4 weeks, my child's life was outstanding [PROMIS.PARENTPROXY] |
| 90614-9 | Thinking about the past 4 weeks, my child's life was the best [PROMIS.PARENTPROXY] |
| 90615-6 | PROMIS parent proxy item bank - life satisfaction - version 1.0 |
| 90616-4 | PROMIS pediatric item bank - life satisfaction - version 1.0 |
| 90617-2 | PROMIS pediatric life satisfaction - version 1.0 T-Score |
| 90618-0 | Thinking about the past 4 weeks, my life was ideal [PROMIS] |
| 90619-8 | Thinking about the past 4 weeks, I was satisfied with my life in general [PROMIS] |
| 90620-6 | Thinking about the past 4 weeks, I lived my life well [PROMIS] |
| 90621-4 | Thinking about the past 4 weeks, my life went well [PROMIS] |
| 90622-2 | Thinking about the past 4 weeks, my life was worthwhile [PROMIS] |
| 90623-0 | Thinking about the past 4 weeks, I liked the way I lived my life [PROMIS] |
| 90624-8 | Thinking about the past 4 weeks, I enjoyed my life [PROMIS] |
| 90625-5 | Thinking about the past 4 weeks, I had a lot of fun [PROMIS] |
| 90626-3 | Thinking about the past 4 weeks, I had fun [PROMIS] |
| 90627-1 | Thinking about the past 4 weeks, I felt positive about my life [PROMIS] |
| 90628-9 | Thinking about the past 4 weeks, I had a good life [PROMIS] |
| 90629-7 | Thinking about the past 4 weeks, I felt good about my life [PROMIS] |
| 90630-5 | Thinking about the past 4 weeks, I felt very good about my life [PROMIS] |
| 90631-3 | Thinking about the past 4 weeks, I was happy with my life [PROMIS] |
| 90632-1 | Thinking about the past 4 weeks, I felt extremely positive about my life [PROMIS] |
| 90633-9 | Thinking about the past 4 weeks, I was satisfied with my life [PROMIS] |
| 90634-7 | Thinking about the past 4 weeks, I was satisfied with my skills and talents [PROMIS] |
| 90635-4 | Thinking about the past 4 weeks, I was satified with my free time [PROMIS] |
| 90636-2 | Thinking about the past 4 weeks, I was happy with my life in my community [PROMIS] |
| 90637-0 | Thinking about the past 4 weeks, I was happy with my life in my neighborhood [PROMIS] |
| 90638-8 | Thinking about the past 4 weeks, I was happy with my life at home [PROMIS] |
| 90639-6 | Thinking about the past 4 weeks, I was happy with my life at school [PROMIS] |
| 90640-4 | Thinking about the past 4 weeks, I was happy with my family life [PROMIS] |
| 90641-2 | Thinking about the past 4 weeks, I was happy with my social life [PROMIS] |
| 90642-0 | Thinking about the past 4 weeks, I was satisfied with the friends I have [PROMIS] |
| 90643-8 | Thinking about the past 4 weeks, my life was as good as most kids' lives [PROMIS] |
| 90644-6 | Thinking about the past 4 weeks, I lived as well as other kids [PROMIS] |
| 90645-3 | Thinking about the past 4 weeks, I enjoyed my life more than most kids enjoyed their lives [PROMIS] |
| 90646-1 | Thinking about the past 4 weeks, my life was better than most kids' lives [PROMIS] |
| 90647-9 | Thinking about the past 4 weeks, I got the things I wanted in life [PROMIS] |
| 90648-7 | Thinking about the past 4 weeks, I had what I needed in life [PROMIS] |
| 90649-5 | Thinking about the past 4 weeks, I had what I wanted in life [PROMIS] |
| 90650-3 | Thinking about the past 4 weeks, I was happy with the way things were [PROMIS] |
| 90651-1 | Thinking about the past 4 weeks, my life situation was excellent [PROMIS] |
| 90652-9 | Thinking about the past 4 weeks, the conditions of my life were excellent [PROMIS] |
| 90653-7 | Thinking about the past 4 weeks, my life was just right [PROMIS] |
| 90654-5 | Thinking about the past 4 weeks, my life was going very well [PROMIS] |
| 90655-2 | Thinking about the past 4 weeks, my life was good [PROMIS] |
| 90656-0 | Thinking about the past 4 weeks, my life was great [PROMIS] |
| 90657-8 | Thinking about the past 4 weeks, my life was excellent [PROMIS] |
| 90658-6 | Thinking about the past 4 weeks, my life was outstanding [PROMIS] |
| 90659-4 | Thinking about the past 4 weeks, my life was the best [PROMIS] |
| 90664-4 | Other kids wanted to be my child's friend in past 7 days [PROMIS.PARENTPROXY] |
| 90665-1 | My child felt good about his/her friendships in past 7 days [PROMIS.PARENTPROXY] |
| 90666-9 | My child was able to have fun with his/her friends in past 7 days [PROMIS.PARENTPROXY] |
| 90667-7 | My child shared with other kids (food, games, pens, etc.) in past 7 days [PROMIS.PARENTPROXY] |
| 90668-5 | My child was a good friend in past 7 days [PROMIS.PARENTPROXY] |
| 90669-3 | Other kids wanted to talk to my child in past 7 days [PROMIS.PARENTPROXY] |
| 90670-1 | My child and his/her friends helped each other out in past 7 days [PROMIS.PARENTPROXY] |
| 90671-9 | My child was good at making friends in past 7 days [PROMIS.PARENTPROXY] |
| 90672-7 | My child felt accepted by other kids his/her age in past 7 days [PROMIS.PARENTPROXY] |
| 90673-5 | Other kids wanted to be with my child in past 7 days [PROMIS.PARENTPROXY] |
| 90674-3 | My child was able to talk about everything with his or her friends in past 7 days [PROMIS.PARENTPROXY] |
| 90675-0 | My child was able to count on his/her friends in past 7 days [PROMIS.PARENTPROXY] |
| 90676-8 | My child played alone and kept to himself/herself in past 7 days [PROMIS.PARENTPROXY] |
| 90677-6 | My child liked being around other kids his/her age in past 7 days [PROMIS.PARENTPROXY] |
| 90678-4 | My child spent time with his/her friends in past 7 days [PROMIS.PARENTPROXY] |
| 90679-2 | PROMIS parent proxy item bank - peer relationships - version 2.0 |
| 90680-0 | PROMIS parent proxy peer relationships - version 2.0 T-score |
| 90681-8 | My child has been physically able to do the activities he/she enjoys most in past 7 days [PROMIS.PARENTPROXY] |
| 90682-6 | My child could ride a bike in past 7 days [PROMIS.PARENTPROXY] |
| 90683-4 | My child could do sports and exercise that other kids his/her age could do in past 7 days [PROMIS.PARENTPROXY] |
| 90684-2 | My child could get down on his/her knees without holding on to something in past 7 days [PROMIS.PARENTPROXY] |
| 90685-9 | My child could go up one step in past 7 days [PROMIS.PARENTPROXY] |
| 90686-7 | My child could run a mile in past 7 days [PROMIS.PARENTPROXY] |
| 90687-5 | My child could walk up stairs without holding on to anything in past 7 days [PROMIS.PARENTPROXY] |
| 90688-3 | My child could get up from a regular toilet in past 7 days [PROMIS.PARENTPROXY] |
| 90689-1 | My child could stand up on his/her tiptoes in past 7 days [PROMIS.PARENTPROXY] |
| 90690-9 | My child could turn his/her head all the way to the side in past 7 days [PROMIS.PARENTPROXY] |
| 90691-7 | My child could walk across the room in past 7 days [PROMIS.PARENTPROXY] |
| 90692-5 | My child could get into bed by himself/herself in past 7 days [PROMIS.PARENTPROXY] |
| 90693-3 | My child could stand up without help in past 7 days [PROMIS.PARENTPROXY] |
| 90694-1 | My child used a walker, cane or crutches to get around in past 7 days [PROMIS.PARENTPROXY] |
| 90695-8 | My child could move his/her legs in past 7 days [PROMIS.PARENTPROXY] |
| 90696-6 | My child could get up from the floor in past 7 days [PROMIS.PARENTPROXY] |
| 90697-4 | My child could bend over to pick something up in past 7 days [PROMIS.PARENTPROXY] |
| 90698-2 | My child could get in and out of a car in past 7 days [PROMIS.PARENTPROXY] |
| 90699-0 | My child could walk more than one block in past 7 days [PROMIS.PARENTPROXY] |
| 90700-6 | My child could keep up when he/she played with other kids in past 7 days [PROMIS.PARENTPROXY] |
| 90701-4 | My child could get out of bed by himself/herself in past 7 days [PROMIS.PARENTPROXY] |
| 90702-2 | My child used a wheelchair to get around in past 7 days [PROMIS.PARENTPROXY] |
| 90703-0 | My child could carry his/her books in a backpack in past 7 days [PROMIS.PARENTPROXY] |
| 90704-8 | PROMIS parent proxy item bank - mobility - version 2.0 |
| 90705-5 | PROMIS parent proxy mobility - version 2.0 T-score |
| 90706-3 | PROMIS pediatric item bank - peer relationships - version 2.0 |
| 90707-1 | PROMIS pediatric peer relationships - version 2.0 T-score |
| 90718-8 | During the past month, how often did you eat hot or cold cereals |
| 90719-6 | During the past month, how often did you drink regular soda or pop that contains sugar |
| 90720-4 | During the past month, how often did you drink coffee or tea that had sugar or honey added to it |
| 90721-2 | During the past month, how often did you eat a green leafy or lettuce salad, with or without other vegetables |
| 90722-0 | During the past month, how often did you eat any kind of fried potatoes, including french fries, home fries, or hash brown potatoes |
| 90723-8 | During the past month, how often did you eat any other kind of potatoes, such as baked, boiled, mashed potatoes, sweet potatoes, or potato salad |
| 90724-6 | During the past month, how often did you eat refried beans, baked beans, beans in soup, pork and beans or any other type of cooked dried beans |
| 90725-3 | During the past month, how often did you eat brown rice or other cooked whole grains, such as bulgur, cracked wheat, or millet |
| 90726-1 | During the past month, how often did you eat pizza |
| 90727-9 | During the past month, how often did you eat any kind of cheese |
| 90728-7 | During the past month, how often did you eat red meat, such as beef, pork, ham, or sausage |
| 90729-5 | During the past month, how often did you eat ice cream or other frozen desserts |
| 90744-4 | Youth Risk Behavior Survey - body weight panel [CDC] |
| 90745-1 | Surgical procedures requiring active SNF care during assessment period [CMS Assessment] |
| 90761-8 | PROMIS item bank - applied cognitive - general concerns - version 1.0 |
| 90762-6 | PROMIS applied cognitive - general concerns - version 1.0 T-score |
| 90775-8 | Disease severity level [Reported] |
| 90853-3 | Final score [DUKE-AD] |
| 90854-1 | Duke Anxiety Depression Scale [DUKE-AD] |
| 90883-0 | PROMIS pediatric item bank - mobility - version 2.0 |
| 90884-8 | PROMIS pediatric mobility - version 2.0 T-score |
| 90933-3 | PROMIS pediatric short form - cognitive function 7a - version 1.0 |
| 90934-1 | PROMIS parent proxy short form - cognitive function 7a - version 1.0 |
| 90935-8 | PROMIS parent proxy short form - cognitive function 7a - version 1.0 raw score |
| 90936-6 | PROMIS parent proxy short form - life satisfaction 4a - version 1.0 |
| 90937-4 | PROMIS parent proxy short form - life satisfaction 4a - version 1.0 raw score |
| 90938-2 | PROMIS parent proxy short form - life satisfaction 8a - version 1.0 |
| 90939-0 | PROMIS parent proxy short form - life satisfaction 8a - version 1.0 raw score |
| 90940-8 | PROMIS parent proxy short form - mobility 8a - version 2.0 |
| 90941-6 | PROMIS parent proxy short form - mobility 8a - version 2.0 raw score |
| 90942-4 | PROMIS parent proxy short form - pain interference 8a - version 2.0 |
| 90943-2 | PROMIS parent proxy short form - pain interference 8a - version 2.0 raw score |
| 90944-0 | PROMIS parent proxy short form - peer relationship 7a - version 2.0 |
| 90945-7 | PROMIS parent proxy short form - peer relationship 7a - version 2.0 raw score |
| 90948-1 | PROMIS pediatric short form - cognitive function 7a - version 1.0 raw score |
| 90949-9 | PROMIS pediatric short form - depressive symptoms 8a - version 2.0 |
| 90950-7 | PROMIS pediatric short form - depressive symptoms 8a - version 2.0 raw score |
| 90951-5 | PROMIS pediatric short form - life satisfaction 4a - version 1.0 |
| 90952-3 | PROMIS pediatric short form - life satisfaction 4a - version 1.0 raw score |
| 90953-1 | PROMIS pediatric short form - life satisfaction 8a - version 1.0 |
| 90954-9 | PROMIS pediatric short form - life satisfaction 8a - version 1.0 raw score |
| 90955-6 | PROMIS pediatric short form - mobility 8a - version 2.0 |
| 90956-4 | PROMIS pediatric short form - mobility 8a - version 2.0 raw score |
| 90957-2 | PROMIS pediatric short form - pain interference 8a - version 2.0 |
| 90958-0 | PROMIS pediatric short form - pain interference 8a - version 2.0 raw score |
| 90959-8 | PROMIS pediatric short form - peer relationships 8a - version 2.0 |
| 90960-6 | PROMIS pediatric short form - peer relationships 8a - version 2.0 raw score |
| 90961-4 | PROMIS short form - applied cognition - general concerns 4a - version 1.0 |
| 90962-2 | PROMIS short form - applied cognition - general concerns 4a - version 1.0 raw score |
| 90963-0 | PROMIS short form - applied cognition - general concerns 6a - version 1.0 |
| 90964-8 | PROMIS short form - applied cognition - general concerns 6a - version 1.0 raw score |
| 90965-5 | PROMIS short form - applied cognition - general concerns 8a - version 1.0 |
| 90966-3 | PROMIS short form - applied cognition - general concerns 8a - version 1.0 raw score |
| 90967-1 | PROMIS short form - dyspnea functional limitations 10a - version 1.0 |
| 90968-9 | PROMIS short form - dyspnea functional limitations 10a - version 1.0 raw score |
| 90969-7 | PROMIS short form - emotional distress - anger 5a - version 1.1 |
| 90970-5 | PROMIS short form - emotional distress - anger 5a - version 1.1 raw score |
| 90971-3 | PROMIS short form - pain interference 4a - version 1.0 |
| 90972-1 | PROMIS short form - pain interference 4a - version 1.0 raw score |
| 90973-9 | PROMIS short form - pain interference 6a - version 1.0 |
| 90974-7 | PROMIS short form - pain interference 6a - version 1.0 raw score |
| 90981-2 | Pressure Injury Scale for Healing Tool 3.0 total score [PUSH] |
| 90982-0 | Pressure Injury Scale for Healing Tool 3.0 [PUSH] |
| 90998-6 | Analysis of information sources |
| 90999-4 | Analysis of emergency department visits |
| 91018-2 | Status of regional dialysis centers |
| 91019-0 | Status of regional human shelters |
| 91020-8 | Status of critical regional infrastructure |
| 91025-7 | Lead department or agency name Organization |
| 91145-3 | What number best describes how pain has interfered with your enjoyment of life during the past week |
| 91146-1 | What number best describes how pain has interfered with your general activity during the past week |
| 91147-9 | Mean score [PEG] |
| 91148-7 | Pain intensity, Enjoyment of life, General activity scale [PEG] |
| 91152-9 | When my child was in pain he or she tried not to move in past 7 days [PROMIS.PARENTPROXY] |
| 91153-7 | When my child was in pain his or her face looked sad in past 7 days [PROMIS.PARENTPROXY] |
| 91154-5 | When my child was in pain he or she asked for help with doing things in past 7 days [PROMIS.PARENTPROXY] |
| 91155-2 | When my child was in pain he or she asked people to let him or her be by himself or herself in past 7 days [PROMIS.PARENTPROXY] |
| 91156-0 | When my child was in pain he or she moved stiffly in past 7 days [PROMIS.PARENTPROXY] |
| 91157-8 | When my child was in pain he or she yelled for someone to help him or her in past 7 days [PROMIS.PARENTPROXY] |
| 91158-6 | When my child was in pain he or she cried in past 7 days [PROMIS.PARENTPROXY] |
| 91159-4 | When my child was in pain he or she used something for support (cane, crutches, wheelchair) to move from place to place in past 7 days [PROMIS.PARENTPROXY] |
| 91160-2 | When my child was in pain he or she limped in past 7 days [PROMIS.PARENTPROXY] |
| 91161-0 | When my child was in pain he or she became quiet in past 7 days [PROMIS.PARENTPROXY] |
| 91162-8 | When my child was in pain he or she asked for help getting around in past 7 days [PROMIS.PARENTPROXY] |
| 91163-6 | When my child was in pain he or she groaned in past 7 days [PROMIS.PARENTPROXY] |
| 91164-4 | When my child was in pain he or she stayed away from other people in past 7 days [PROMIS.PARENTPROXY] |
| 91165-1 | When my child was in pain he or she asked for medicine in past 7 days [PROMIS.PARENTPROXY] |
| 91166-9 | When my child was in pain he or she screamed in past 7 days [PROMIS.PARENTPROXY] |
| 91167-7 | When my child was in pain he or she protected the part of his or her body that hurt in past 7 days [PROMIS.PARENTPROXY] |
| 91168-5 | When my child was in pain he or she tightened his or her jaw in past 7 days [PROMIS.PARENTPROXY] |
| 91169-3 | When my child was in pain he or she talked about his or her pain in past 7 days [PROMIS.PARENTPROXY] |
| 91170-1 | When my child was in pain he or she didn't let anyone touch him or her in past 7 days [PROMIS.PARENTPROXY] |
| 91171-9 | When my child was in pain he or she rubbed his or her body where it hurt in past 7 days [PROMIS.PARENTPROXY] |
| 91172-7 | When my child was in pain he or she moved slower in past 7 days [PROMIS.PARENTPROXY] |
| 91173-5 | When my child was in pain he or she got angry at people in past 7 days [PROMIS.PARENTPROXY] |
| 91174-3 | When my child was in pain he or she didn't want anyone to touch him or her in past 7 days [PROMIS.PARENTPROXY] |
| 91175-0 | When my child was in pain he or she avoided standing in past 7 days [PROMIS.PARENTPROXY] |
| 91176-8 | When my child was in pain he or she asked people to bring him or her things (food, games) in past 7 days [PROMIS.PARENTPROXY] |
| 91177-6 | When my child was in pain he or she couldn't stay still in past 7 days [PROMIS.PARENTPROXY] |
| 91178-4 | When my child was in pain he or she was restless in past 7 days [PROMIS.PARENTPROXY] |
| 91179-2 | When my child was in pain he or she tried to think of something nice or fun in past 7 days [PROMIS.PARENTPROXY] |
| 91180-0 | When my child was in pain he or she went to sleep in past 7 days [PROMIS.PARENTPROXY] |
| 91181-8 | When my child was in pain he or she had to stop what he or she was doing in past 7 days [PROMIS.PARENTPROXY] |
| 91182-6 | When my child was in pain he or she avoided lifting or carrying heavy things in past 7 days [PROMIS.PARENTPROXY] |
| 91183-4 | When my child was in pain he or she stayed near to someone who cares about him or her in past 7 days [PROMIS.PARENTPROXY] |
| 91184-2 | When my child was in pain he or she tried to rest or relax in past 7 days [PROMIS.PARENTPROXY] |
| 91185-9 | When my child was in pain he or she complained in past 7 days [PROMIS.PARENTPROXY] |
| 91186-7 | When my child was in pain he or she asked to see a doctor in past 7 days [PROMIS.PARENTPROXY] |
| 91187-5 | When my child was in pain he or she pulled away if someone touched him or her where it hurt in past 7 days [PROMIS.PARENTPROXY] |
| 91188-3 | When my child was in pain he or she argued with people in past 7 days [PROMIS.PARENTPROXY] |
| 91189-1 | When my child was in pain he or she avoided using the part of his or her body that hurt in past 7 days [PROMIS.PARENTPROXY] |
| 91190-9 | When my child was in pain he or she said mean words to people in past 7 days [PROMIS.PARENTPROXY] |
| 91191-7 | When my child was in pain he or she got mad and threw or hit something in past 7 days [PROMIS.PARENTPROXY] |
| 91192-5 | When my child was in pain he or she had a fixed or dazed expression in past 7 days [PROMIS.PARENTPROXY] |
| 91193-3 | When my child was in pain he or she had tears in his or her eyes in past 7 days [PROMIS.PARENTPROXY] |
| 91194-1 | When my child was in pain he or she had circles under his or her eyes in past 7 days [PROMIS.PARENTPROXY] |
| 91195-8 | When my child was in pain he or she sighed in past 7 days [PROMIS.PARENTPROXY] |
| 91196-6 | When my child was in pain he or she took breaks from what he or she was doing in past 7 days [PROMIS.PARENTPROXY] |
| 91197-4 | When my child was in pain he or she told people he or she couldn't do his or her usual chores in past 7 days [PROMIS.PARENTPROXY] |
| 91198-2 | When my child was in pain it showed on his or her face in past 7 days [PROMIS.PARENTPROXY] |
| 91199-0 | When my child was in pain he or she told people he or she couldn't do things with them in past 7 days [PROMIS.PARENTPROXY] |
| 91200-6 | When my child was in pain he or she asked for someone to help him or her in past 7 days [PROMIS.PARENTPROXY] |
| 91201-4 | When my child was in pain he or she lay down in past 7 days [PROMIS.PARENTPROXY] |
| 91202-2 | When my child was in pain he or she felt his or her body get tense in past 7 days [PROMIS.PARENTPROXY] |
| 91203-0 | PROMIS parent proxy pain behavior - version 1.0 T-score |
| 91204-8 | PROMIS parent proxy item bank - pain behavior - version 1.0 |
| 91205-5 | How many days did your child run for 10 minutes or more in past 7 days [PROMIS.PARENTPROXY] |
| 91206-3 | How many days was your child physically active for 10 minutes or more in past 7 days [PROMIS.PARENTPROXY] |
| 91207-1 | How many days did your child exercise really hard for 10 minutes or more in past 7 days [PROMIS.PARENTPROXY] |
| 91208-9 | On a usual day, how physically active was your child in past 7 days [PROMIS.PARENTPROXY] |
| 91209-7 | How many days did your child exercise or play so hard that he or she felt tired in past 7 days [PROMIS.PARENTPROXY] |
| 91210-5 | How many days did your child exercise or play so hard that his or her muscles burned in past 7 days [PROMIS.PARENTPROXY] |
| 91211-3 | How many days did your child exercise or play so hard that his or her body got tired in past 7 days [PROMIS.PARENTPROXY] |
| 91212-1 | How many days was your child so physically active that he or she sweated in past 7 days [PROMIS.PARENTPROXY] |
| 91213-9 | How many days did your child play sports for 10 minutes or more in past 7 days [PROMIS.PARENTPROXY] |
| 91214-7 | How many days did your child exercise so much that he or she breathed hard in past 7 days [PROMIS.PARENTPROXY] |
| 91215-4 | PROMIS parent proxy item bank - physical activity - version 1.0 |
| 91216-2 | PROMIS parent proxy physical activity - version 1.0 T-score |
| 91217-0 | How many days did you run for 10 minutes or more in past 7 days [PROMIS.PEDS] |
| 91218-8 | How many days were you physically active for 10 minutes or more in past 7 days [PROMIS.PEDS] |
| 91219-6 | How many days did you exercise really hard for 10 minutes or more in past 7 days [PROMIS.PEDS] |
| 91220-4 | On a usual day, how physically active were you in past 7 days [PROMIS.PEDS] |
| 91221-2 | How many days did you exercise or play so hard that you felt tired in past 7 days [PROMIS.PEDS] |
| 91222-0 | How many days did you exercise or play so hard that your muscles burned in past 7 days [PROMIS.PEDS] |
| 91223-8 | How many days did you exercise or play so hard that your body got tired in past 7 days [PROMIS.PEDS] |
| 91224-6 | How many days were you so physically active that you sweated in past 7 days [PROMIS.PEDS] |
| 91225-3 | How many days did you play sports for 10 minutes or more in past 7 days [PROMIS.PEDS] |
| 91226-1 | How many days did you exercise so much that you breathed hard in past 7 days [PROMIS.PEDS] |
| 91227-9 | PROMIS pediatric physical activity - version 1.0 T-score |
| 91228-7 | PROMIS pediatric item bank - physical activity - version 1.0 |
| 91229-5 | I felt healthy in past 7 days [PROMIS.PEDS] |
| 91230-3 | I felt strong in past 7 days [PROMIS.PEDS] |
| 91231-1 | I felt full of pep in past 7 days [PROMIS.PEDS] |
| 91232-9 | I felt active in past 7 days [PROMIS.PEDS] |
| 91233-7 | I felt refreshed in past 7 days [PROMIS.PEDS] |
| 91234-5 | I felt wide awake in past 7 days [PROMIS.PEDS] |
| 91235-2 | I had a lot of energy in past 7 days [PROMIS.PEDS] |
| 91236-0 | I felt energetic in past 7 days [PROMIS.PEDS] |
| 91237-8 | I felt enthusiastic in past 7 days [PROMIS.PEDS] |
| 91238-6 | I felt blissful in past 7 days [PROMIS.PEDS] |
| 91239-4 | I felt good in past 7 days [PROMIS.PEDS] |
| 91240-2 | I was in good spirits in past 7 days [PROMIS.PEDS] |
| 91241-0 | I was in a good mood in past 7 days [PROMIS.PEDS] |
| 91242-8 | I was merry in past 7 days [PROMIS.PEDS] |
| 91243-6 | I laughed a lot in past 7 days [PROMIS.PEDS] |
| 91244-4 | I smiled a lot in past 7 days [PROMIS.PEDS] |
| 91245-1 | My life was pleasurable in past 7 days [PROMIS.PEDS] |
| 91246-9 | I felt delighted in past 7 days [PROMIS.PEDS] |
| 91247-7 | I felt joyful in past 7 days [PROMIS.PEDS] |
| 91248-5 | I had very strong happy feelings in past 7 days [PROMIS.PEDS] |
| 91249-3 | I felt happy in past 7 days [PROMIS.PEDS] |
| 91250-1 | I felt cheerful in past 7 days [PROMIS.PEDS] |
| 91251-9 | I felt great in past 7 days [PROMIS.PEDS] |
| 91252-7 | I felt pleased in past 7 days [PROMIS.PEDS] |
| 91253-5 | I had much to be proud about in past 7 days [PROMIS.PEDS] |
| 91254-3 | I felt proud in past 7 days [PROMIS.PEDS] |
| 91255-0 | I felt appreciated in past 7 days [PROMIS.PEDS] |
| 91256-8 | I felt respected in past 7 days [PROMIS.PEDS] |
| 91257-6 | I felt fulfilled in past 7 days [PROMIS.PEDS] |
| 91258-4 | I felt comfortable in past 7 days [PROMIS.PEDS] |
| 91259-2 | I felt relaxed in past 7 days [PROMIS.PEDS] |
| 91260-0 | I felt carefree in past 7 days [PROMIS.PEDS] |
| 91261-8 | I felt positive in past 7 days [PROMIS.PEDS] |
| 91262-6 | I felt thankful in past 7 days [PROMIS.PEDS] |
| 91263-4 | I felt grateful in past 7 days [PROMIS.PEDS] |
| 91264-2 | I felt content in past 7 days [PROMIS.PEDS] |
| 91265-9 | I felt satisfied in past 7 days [PROMIS.PEDS] |
| 91266-7 | I felt peaceful in past 7 days [PROMIS.PEDS] |
| 91267-5 | My child felt healthy in past 7 days [PROMIS.PARENTPROXY] |
| 91268-3 | My child felt strong in past 7 days [PROMIS.PARENTPROXY] |
| 91269-1 | My child felt full of pep in past 7 days [PROMIS.PARENTPROXY] |
| 91270-9 | My child felt active in past 7 days [PROMIS.PARENTPROXY] |
| 91271-7 | My child felt refreshed in past 7 days [PROMIS.PARENTPROXY] |
| 91272-5 | My child felt wide awake in past 7 days [PROMIS.PARENTPROXY] |
| 91273-3 | My child had a lot of energy in past 7 days [PROMIS.PARENTPROXY] |
| 91274-1 | My child felt energetic in past 7 days [PROMIS.PARENTPROXY] |
| 91275-8 | My child felt enthusiastic in past 7 days [PROMIS.PARENTPROXY] |
| 91276-6 | My child felt blissful in past 7 days [PROMIS.PARENTPROXY] |
| 91277-4 | My child felt good in past 7 days [PROMIS.PARENTPROXY] |
| 91278-2 | My child was in good spirits in past 7 days [PROMIS.PARENTPROXY] |
| 91279-0 | My child was in a good mood in past 7 days [PROMIS.PARENTPROXY] |
| 91280-8 | My child felt merry in past 7 days [PROMIS.PARENTPROXY] |
| 91281-6 | My child laughed a lot in past 7 days [PROMIS.PARENTPROXY] |
| 91282-4 | My child smiled a lot in past 7 days [PROMIS.PARENTPROXY] |
| 91283-2 | My child felt his or her life was pleasurable in past 7 days [PROMIS.PARENTPROXY] |
| 91284-0 | My child felt delighted in past 7 days [PROMIS.PARENTPROXY] |
| 91285-7 | My child felt joyful in past 7 days [PROMIS.PARENTPROXY] |
| 91286-5 | My child had very strong happy feelings in past 7 days [PROMIS.PARENTPROXY] |
| 91287-3 | My child felt happy in past 7 days [PROMIS.PARENTPROXY] |
| 91288-1 | My child felt cheerful in past 7 days [PROMIS.PARENTPROXY] |
| 91289-9 | My child felt great in past 7 days [PROMIS.PARENTPROXY] |
| 91290-7 | My child felt pleased in past 7 days [PROMIS.PARENTPROXY] |
| 91291-5 | My child felt he or she had much to be proud about in past 7 days [PROMIS.PARENTPROXY] |
| 91292-3 | My child felt proud in past 7 days [PROMIS.PARENTPROXY] |
| 91293-1 | My child felt appreciated in past 7 days [PROMIS.PARENTPROXY] |
| 91294-9 | My child felt respected in past 7 days [PROMIS.PARENTPROXY] |
| 91295-6 | My child felt fulfilled in past 7 days [PROMIS.PARENTPROXY] |
| 91296-4 | My child felt comfortable in past 7 days [PROMIS.PARENTPROXY] |
| 91297-2 | My child felt relaxed in past 7 days [PROMIS.PARENTPROXY] |
| 91298-0 | My child felt carefree in past 7 days [PROMIS.PARENTPROXY] |
| 91299-8 | My child felt positive in past 7 days [PROMIS.PARENTPROXY] |
| 91300-4 | My child felt thankful in past 7 days [PROMIS.PARENTPROXY] |
| 91301-2 | My child felt grateful in past 7 days [PROMIS.PARENTPROXY] |
| 91302-0 | My child felt content in past 7 days [PROMIS.PARENTPROXY] |
| 91303-8 | My child felt satisfied in past 7 days [PROMIS.PARENTPROXY] |
| 91304-6 | My child felt peaceful in past 7 days [PROMIS.PARENTPROXY] |
| 91305-3 | My child felt calm in past 7 days [PROMIS.PARENTPROXY] |
| 91306-1 | PROMIS parent proxy positive affect - version 1.0 T-score |
| 91307-9 | PROMIS parent proxy item bank - positive affect - version 1.0 |
| 91308-7 | I felt I had too much going on in past 7 days [PROMIS.PEDS] |
| 91309-5 | I felt unable to manage things in my life in past 7 days [PROMIS.PEDS] |
| 91310-3 | I felt unable to react to something that bothered me in past 7 days [PROMIS.PEDS] |
| 91311-1 | I was slow to react to things in past 7 days [PROMIS.PEDS] |
| 91312-9 | My thoughts went very fast in past 7 days [PROMIS.PEDS] |
| 91313-7 | I had trouble concentrating in past 7 days [PROMIS.PEDS] |
| 91314-5 | I felt so upset that I could not remember what happened or what I did in past 7 days [PROMIS.PEDS] |
| 91315-2 | I felt unable to remember answers, even for questions I knew the answer to in past 7 days [PROMIS.PEDS] |
| 91316-0 | I felt like my thinking was slower than usual in past 7 days [PROMIS.PEDS] |
| 91317-8 | I forgot things in past 7 days [PROMIS.PEDS] |
| 91318-6 | I felt overwhelmed in past 7 days [PROMIS.PEDS] |
| 91319-4 | I felt that my problems kept piling up in past 7 days [PROMIS.PEDS] |
| 91320-2 | I felt under pressure in past 7 days [PROMIS.PEDS] |
| 91321-0 | Everything bothered me in past 7 days [PROMIS.PEDS] |
| 91322-8 | Small things upset me in past 7 days [PROMIS.PEDS] |
| 91323-6 | I felt concerned about what was going on in my life in past 7 days [PROMIS.PEDS] |
| 91324-4 | PROMIS pediatric item bank - psychological stress experiences - version 1.0 |
| 91325-1 | PROMIS pediatric psychological stress experiences - version 1.0 T-score |
| 91326-9 | How many days was your child strong enough to lift heavy things over his or her head in past 7 days [PROMIS.PARENTPROXY] |
| 91327-7 | How many days was your child strong enough to get down on the floor in past 7 days [PROMIS.PARENTPROXY] |
| 91328-5 | How many days was your child strong enough to carry his or her school books in past 7 days [PROMIS.PARENTPROXY] |
| 91329-3 | How many days was your child strong enough to open a jar by himself or herself in past 7 days [PROMIS.PARENTPROXY] |
| 91330-1 | How many days was your child strong enough to pour a drink from a full pitcher or carton in past 7 days [PROMIS.PARENTPROXY] |
| 91331-9 | How many days was your child strong enough to jump up and down in past 7 days [PROMIS.PARENTPROXY] |
| 91332-7 | How many days was your child strong enough to get out of bed and stand without help in past 7 days [PROMIS.PARENTPROXY] |
| 91333-5 | How many days was your child strong enough to hold a full plate or tray of food in past 7 days [PROMIS.PARENTPROXY] |
| 91334-3 | How many days was your child strong enough to open a heavy door in past 7 days [PROMIS.PARENTPROXY] |
| 91335-0 | How many days was your child strong enough to reach above his or her head to get heavy things in past 7 days [PROMIS.PARENTPROXY] |
| 91336-8 | How many days was your child strong enough to go up and down stairs in past 7 days [PROMIS.PARENTPROXY] |
| 91337-6 | How many days was your child strong enough to carry heavy things with his or her hands in past 7 days [PROMIS.PARENTPROXY] |
| 91338-4 | PROMIS parent proxy item bank - strength impact - version 1.0 |
| 91339-2 | PROMIS parent proxy strength impact - version 1.0 T-score |
| 91340-0 | My back pain has spread down my leg(s) at some time in the last 2 weeks [STarT Back] |
| 91341-8 | I have had pain in the shoulder or neck at some time in the last 2 weeks [STarT Back] |
| 91342-6 | I have only walked short distances because of my back pain in the last 2 weeks [STarT Back] |
| 91343-4 | I have dressed more slowly than usual because of back pain in the last 2 weeks [STarT Back] |
| 91344-2 | Thinking about the last 2 weeks, it's not really safe for a person with a condition like mine to be physically active [STarT Back] |
| 91345-9 | Worrying thoughts have been going through my mind a lot of the time in the last 2 weeks [STarT Back] |
| 91346-7 | Thinking about the last 2 weeks, I feel that my back pain is terrible and it's never going to get any better [STarT Back] |
| 91347-5 | Thinking about the last 2 weeks, in general I have not enjoyed all the things I used to enjoy [STarT Back] |
| 91348-3 | Overall, how bothersome has your back pain been in the last 2 weeks [STarT Back] |
| 91349-1 | STarT Back Screening Tool panel |
| 91350-9 | Distress subscore [STarT Back] |
| 91351-7 | Total score [STarT Back] |
| 91352-5 | STarT Back Screening risk level |
| 91353-3 | I felt calm in past 7 days [PROMIS.PEDS] |
| 91354-1 | PROMIS pediatric positive affect - version 1.0 T-score |
| 91355-8 | PROMIS pediatric item bank - positive affect - version 1.0 |
| 91356-6 | My child felt concerned about what was going on in his or her life in past 7 days [PROMIS.PARENTPROXY] |
| 91357-4 | Small things upset my child in past 7 days [PROMIS.PARENTPROXY] |
| 91358-2 | Everything bothered my child in past 7 days [PROMIS.PARENTPROXY] |
| 91359-0 | My child felt under pressure in past 7 days [PROMIS.PARENTPROXY] |
| 91360-8 | My child felt that his or her problems kept piling up in past 7 days [PROMIS.PARENTPROXY] |
| 91361-6 | My child felt overwhelmed in past 7 days [PROMIS.PARENTPROXY] |
| 91362-4 | My child felt so upset that he or she could not remember what happened or what he or she did in past 7 days [PROMIS.PARENTPROXY] |
| 91363-2 | My child had trouble concentrating in past 7 days [PROMIS.PARENTPROXY] |
| 91364-0 | My child's thoughts went very fast in past 7 days [PROMIS.PARENTPROXY] |
| 91365-7 | My child felt unable to manage things in his or her life in past 7 days [PROMIS.PARENTPROXY] |
| 91366-5 | My child felt he or she had too much going on in past 7 days [PROMIS.PARENTPROXY] |
| 91367-3 | PROMIS parent proxy item bank - psychological stress experiences - version 1.0 |
| 91368-1 | PROMIS parent proxy psychological stress experiences - version 1.0 T-score |
| 91369-9 | I had trouble controlling my thoughts in past 7 days [PROMIS.PEDS] |
| 91394-7 | It was hard for my child to do school work because he or she felt sad in past 7 days [PROMIS.PARENTPROXY] |
| 91395-4 | It was hard for my child to have fun in past 7 days [PROMIS.PARENTPROXY] |
| 91396-2 | My child could not stop feeling sad in past 7 days [PROMIS.PARENTPROXY] |
| 91397-0 | My child didn't care about anything in past 7 days [PROMIS.PARENTPROXY] |
| 91398-8 | My child felt alone in past 7 days [PROMIS.PARENTPROXY] |
| 91399-6 | My child felt everything in his or her life went wrong in past 7 days [PROMIS.PARENTPROXY] |
| 91400-2 | My child felt like he or she couldn't do anything right in past 7 days [PROMIS.PARENTPROXY] |
| 91401-0 | My child felt lonely in past 7 days [PROMIS.PARENTPROXY] |
| 91402-8 | My child felt sad in past 7 days [PROMIS.PARENTPROXY] |
| 91403-6 | My child felt too sad to eat in past 7 days [PROMIS.PARENTPROXY] |
| 91404-4 | My child felt unhappy in past 7 days [PROMIS.PARENTPROXY] |
| 91405-1 | My child wanted to be by himself or herself in past 7 days [PROMIS.PARENTPROXY] |
| 91406-9 | PROMIS parent proxy depressive symptoms - version 2.0 T-score |
| 91407-7 | PROMIS parent proxy item bank - depressive symptoms - version 2.0 |
| 91408-5 | It was hard for my child to play sports or exercise because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91409-3 | It was hard for my child to play with pets because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91410-1 | It was hard for my child to take a deep breath because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91411-9 | My child coughed because of his or her asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91412-7 | My child felt scared that he or she might have trouble breathing because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91413-5 | My child felt wheezy because of his or her asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91414-3 | My child got tired easily because of his or her asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91415-0 | My child had asthma attacks in past 7 days [PROMIS.PARENTPROXY] |
| 91416-8 | My child had trouble breathing because of his or her asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91417-6 | My child had trouble sleeping at night because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91418-4 | My child had trouble walking because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91419-2 | My child missed school because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91420-0 | My child was bothered by asthma when he or she was with friends in past 7 days [PROMIS.PARENTPROXY] |
| 91421-8 | My child was bothered by the amount of time he or she spent wheezing in past 7 days [PROMIS.PARENTPROXY] |
| 91422-6 | My child's asthma bothered him or her in past 7 days [PROMIS.PARENTPROXY] |
| 91423-4 | My child's body felt bad when he or she was out of breath in past 7 days [PROMIS.PARENTPROXY] |
| 91424-2 | My child's chest felt tight because of asthma in past 7 days [PROMIS.PARENTPROXY] |
| 91425-9 | PROMIS parent proxy asthma impact - version 2.0 T-score |
| 91426-7 | PROMIS parent proxy item bank - asthma impact - version 2.0 |
| 91427-5 | A sudden noise made me jump in past 7 days [PROMIS.PEDS] |
| 91428-3 | I could not stay still for long in past 7 days [PROMIS.PEDS] |
| 91429-1 | I felt as if I needed to move my legs a lot in past 7 days [PROMIS.PEDS] |
| 91430-9 | I felt dizzy in past 7 days [PROMIS.PEDS] |
| 91431-7 | I felt some food coming up into my throat in past 7 days [PROMIS.PEDS] |
| 91432-5 | I had a bad stomach ache in past 7 days [PROMIS.PEDS] |
| 91433-3 | I had a headache in past 7 days [PROMIS.PEDS] |
| 91434-1 | I had pain that really bothered me in past 7 days [PROMIS.PEDS] |
| 91435-8 | I had trouble breathing, even when I was not exercising or playing hard in past 7 days [PROMIS.PEDS] |
| 91436-6 | I threw up in past 7 days [PROMIS.PEDS] |
| 91437-4 | I was sweaty, even when I was not exercising or playing hard in past 7 days [PROMIS.PEDS] |
| 91438-2 | My appetite changed in past 7 days [PROMIS.PEDS] |
| 91439-0 | My back hurt in past 7 days [PROMIS.PEDS] |
| 91440-8 | My body shook in past 7 days [PROMIS.PEDS] |
| 91441-6 | My breathing was fast in past 7 days [PROMIS.PEDS] |
| 91442-4 | My breathing was fast, even when I was not exercising or playing hard in past 7 days [PROMIS.PEDS] |
| 91443-2 | My hands shook in past 7 days [PROMIS.PEDS] |
| 91444-0 | My heart beat faster than usual, even when I was not exercising or playing hard in past 7 days [PROMIS.PEDS] |
| 91445-7 | My heart pounded, even when I was not exercising or playing hard in past 7 days [PROMIS.PEDS] |
| 91446-5 | My legs shook in past 7 days [PROMIS.PEDS] |
| 91447-3 | My mouth was dry in past 7 days [PROMIS.PEDS] |
| 91448-1 | My muscles felt tight in past 7 days [PROMIS.PEDS] |
| 91449-9 | My neck felt tight in past 7 days [PROMIS.PEDS] |
| 91450-7 | My neck hurt in past 7 days [PROMIS.PEDS] |
| 91451-5 | My palms were sweaty in past 7 days [PROMIS.PEDS] |
| 91452-3 | PROMIS pediatric item bank - physical stress experiences - version 1.0 |
| 91453-1 | PROMIS pediatric physical stress experiences - version 1.0 T-score |
| 91454-9 | PROMIS pediatric item bank - meaning and purpose - version 1.0 |
| 91455-6 | PROMIS pediatric meaning and purpose - version 1.0 T-score |
| 91456-4 | Thinking about my life, I always have hope [PROMIS.PEDS] |
| 91457-2 | Thinking about my life, I am full of hope [PROMIS.PEDS] |
| 91458-0 | Thinking about my life, I am positive about my future [PROMIS.PEDS] |
| 91459-8 | Thinking about my life, I am satisfied with my purpose in life [PROMIS.PEDS] |
| 91460-6 | Thinking about my life, I can do almost anything if I have enough faith in myself [PROMIS.PEDS] |
| 91461-4 | Thinking about my life, I can reach my goals in life [PROMIS.PEDS] |
| 91462-2 | Thinking about my life, I expect amazing things to happen to me [PROMIS.PEDS] |
| 91463-0 | Thinking about my life, I expect things to work out for the best [PROMIS.PEDS] |
| 91464-8 | Thinking about my life, I expect to achieve my goals [PROMIS.PEDS] |
| 91465-5 | Thinking about my life, I expect to achieve what I want in life [PROMIS.PEDS] |
| 91466-3 | Thinking about my life, I expect to be successful in the future [PROMIS.PEDS] |
| 91467-1 | Thinking about my life, I expect to enjoy my future life [PROMIS.PEDS] |
| 91468-9 | Thinking about my life, I expect to have a family in the future [PROMIS.PEDS] |
| 91469-7 | Thinking about my life, I expect to have a job in the future [PROMIS.PEDS] |
| 91470-5 | Thinking about my life, I expect to have a long life [PROMIS.PEDS] |
| 91471-3 | Thinking about my life, I expect to have success in the future [PROMIS.PEDS] |
| 91472-1 | Thinking about my life, I expect to succeed at what I try to do [PROMIS.PEDS] |
| 91473-9 | Thinking about my life, I feel hopeful about my future [PROMIS.PEDS] |
| 91474-7 | Thinking about my life, I feel hopeful about my plans for the future [PROMIS.PEDS] |
| 91475-4 | Thinking about my life, I have a clear purpose in life [PROMIS.PEDS] |
| 91476-2 | Thinking about my life, I have a reason for living [PROMIS.PEDS] |
| 91477-0 | Thinking about my life, I have goals for myself [PROMIS.PEDS] |
| 91478-8 | Thinking about my life, I have hope [PROMIS.PEDS] |
| 91479-6 | Thinking about my life, I have things I need to do in life [PROMIS.PEDS] |
| 91480-4 | Thinking about my life, I have things I want to accomplish in life [PROMIS.PEDS] |
| 91481-2 | Thinking about my life, I have things I want to do in life [PROMIS.PEDS] |
| 91482-0 | Thinking about my life, I know what makes my life meaningful [PROMIS.PEDS] |
| 91483-8 | Thinking about my life, I know where I am going in life [PROMIS.PEDS] |
| 91484-6 | Thinking about my life, I look forward to what will happen in the future [PROMIS.PEDS] |
| 91485-3 | Thinking about my life, I make plans for my future [PROMIS.PEDS] |
| 91486-1 | Thinking about my life, I try to find meaning in life [PROMIS.PEDS] |
| 91487-9 | Thinking about my life, I try to find purpose in life [PROMIS.PEDS] |
| 91488-7 | Thinking about my life, I want to do what is important [PROMIS.PEDS] |
| 91489-5 | Thinking about my life, I want to make the most out of my life [PROMIS.PEDS] |
| 91490-3 | Thinking about my life, my life has meaning [PROMIS.PEDS] |
| 91491-1 | Thinking about my life, my life has purpose [PROMIS.PEDS] |
| 91492-9 | Thinking about my life, my life is filled with important things [PROMIS.PEDS] |
| 91493-7 | Thinking about my life, my life is filled with meaning [PROMIS.PEDS] |
| 91494-5 | Thinking about my life, my life is filled with purpose [PROMIS.PEDS] |
| 91495-2 | Thinking about my life, my life is filled with things that interest me [PROMIS.PEDS] |
| 91496-0 | Thinking about my life, my life is important [PROMIS.PEDS] |
| 91497-8 | Thinking about my life, people will remember me when I die [PROMIS.PEDS] |
| 91498-6 | Thinking about my life, the things I have done in the past will help me in the future [PROMIS.PEDS] |
| 91499-4 | Thinking about my life, when bad things happen, I expect them to get better [PROMIS.PEDS] |
| 91500-9 | How many days were you strong enough to carry heavy things with your hands in past 7 days [PROMIS.PEDS] |
| 91501-7 | How many days were you strong enough to carry your school books in past 7 days [PROMIS.PEDS] |
| 91502-5 | How many days were you strong enough to get down on the floor in past 7 days [PROMIS.PEDS] |
| 91503-3 | How many days were you strong enough to get out of bed and stand without help in past 7 days [PROMIS.PEDS] |
| 91504-1 | How many days were you strong enough to go up and down stairs in past 7 days [PROMIS.PEDS] |
| 91505-8 | How many days were you strong enough to hold a full plate or tray of food in past 7 days [PROMIS.PEDS] |
| 91506-6 | How many days were you strong enough to jump up and down in past 7 days [PROMIS.PEDS] |
| 91507-4 | How many days were you strong enough to lift heavy things over your head in past 7 days [PROMIS.PEDS] |
| 91508-2 | How many days were you strong enough to open a heavy door in past 7 days [PROMIS.PEDS] |
| 91509-0 | How many days were you strong enough to open a jar by yourself in past 7 days [PROMIS.PEDS] |
| 91510-8 | How many days were you strong enough to pour a drink from a full pitcher or carton in past 7 days [PROMIS.PEDS] |
| 91511-6 | How many days were you strong enough to reach above your head to get heavy things in past 7 days [PROMIS.PEDS] |
| 91512-4 | PROMIS pediatric item bank - strength impact - version 1.0 |
| 91513-2 | PROMIS pediatric strength impact - version 1.0 T-score |
| 91526-4 | Fear-Affect Survey - age 18+ - T-score [NIH Toolbox] |
| 91527-2 | Perceived Stress Survey - age 18+ - T-score [NIH Toolbox] |
| 91528-0 | Perceived Stress Survey - fixed length form - age 18+ [NIH Toolbox] |
| 91529-8 | Fear-Affect Survey - CAT item bank - age 18+ [NIH Toolbox] |
| 91530-6 | Self-Efficacy Survey version 2.0 - CAT item bank - ages 13-17 [NIH Toolbox] |
| 91533-0 | PROMIS pediatric fatigue - version 2.0 T-score |
| 91534-8 | PROMIS pediatric item bank - fatigue - version 2.0 |
| 91535-5 | PROMIS pediatric depressive symptoms - version 2.0 T-score |
| 91536-3 | PROMIS pediatric item bank - depressive symptoms - version 2.0 |
| 91537-1 | PROMIS pediatric asthma impact - version 2.0 T-score |
| 91538-9 | PROMIS pediatric item bank - asthma impact - version 2.0 |
| 91539-7 | PROMIS pediatric anxiety - version 2.0 T-score |
| 91540-5 | PROMIS pediatric item bank - anxiety - version 2.0 |
| 91552-0 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed discharge (SD) item set during assessment period [CMS Assessment] |
| 91554-6 | MDS v3.0 - RAI v1.17.2 - Identification information - ND during assessment period [CMS Assessment] |
| 91555-3 | Percent intake by artificial route during the last 7 days [CMS Assessment] |
| 91567-8 | MDS v3.0 - RAI v1.17.2 - Special treatments, procedures, and programs - SD during assessment period [CMS Assessment] |
| 91577-7 | MDS v3.0 - RAI v1.17.2 - Therapies - OSA during assessment period [CMS Assessment] |
| 91578-5 | Probability of an event occurring |
| 91579-3 | MDS v3.0 - RAI v1.17.2 - Correction request - IPA during assessment period [CMS Assessment] |
| 91580-1 | MDS v3.0 - RAI v1.17.2 - Type of assessment on existing record to be modified or inactivated - IPA during assessment period [CMS Assessment] |
| 91581-9 | MDS v3.0 - RAI v1.17.2 - State Medicaid billing - OSA during assessment period [CMS Assessment] |
| 91607-2 | Does your health now limit you in opening a previously opened jar [PROMIS] |
| 91608-0 | Are you able to pass a 20-pound (10 kg) turkey or ham to other people at the table [PROMIS] |
| 91609-8 | Are you able to continuously swing a baseball bat or tennis racket back and forth for 5 minutes [PROMIS] |
| 91610-6 | Are you able to lift a heavy painting or picture to hang on your wall above eye-level [PROMIS] |
| 91611-4 | PROMIS item bank - upper extremity - version 2.0 |
| 91612-2 | PROMIS upper extremity version 2.0 T-score |
| 91613-0 | PROMIS item bank - mobility - version 2.0 |
| 91614-8 | PROMIS mobility - version 2.0 T-score |
| 91615-5 | How depressed or cheerful have you been during the past month [NHANES] |
| 91616-3 | How much energy, pep, and vitality have you felt during the past month [NHANES] |
| 91617-1 | How relaxed or tense have you been during the past month [NHANES] |
| 91618-9 | How concerned or worried about your health have you been during the past month [NHANES] |
| 91619-7 | Have you felt tired, worn out, used-up, or exhausted during the past month [NHANES] |
| 91620-5 | Have you been feeling emotionally stable and sure of yourself during the past month [NHANES] |
| 91621-3 | Has your daily life been full of things that were interesting to you during the past month [NHANES] |
| 91622-1 | Have you been waking up fresh and rested during the past month [NHANES] |
| 91623-9 | Have you had any reason to wonder if you were losing your mind, or losing control over the way you act, talk, think, feel, or of your memory during the past month [NHANES] |
| 91624-7 | How happy, satisfied, or pleased have you been with your personal life during the past month [NHANES] |
| 91625-4 | Have you felt so sad, discouraged, hopeless, or had so many problems that you wondered if anything was worthwhile during the past month [NHANES] |
| 91626-2 | Have you been in firm control of your behavior, thoughts, emotions, or feelings during the past month [NHANES] |
| 91627-0 | Have you been bothered by nervousness or your nerves during the past month [NHANES] |
| 91628-8 | How have you been feeling in general during the past month [NHANES] |
| 91629-6 | General Well-Being Schedule - 18 item [NHANES] |
| 91630-4 | Have you felt down-hearted and blue during the past month [NHANES] |
| 91631-2 | Have you been bothered by any illness, bodily disorder, pains, or fears about your health during the past month [NHANES] |
| 91632-0 | Have you been anxious, worried, or upset during the past month [NHANES] |
| 91633-8 | Have you been under or felt you were under any strain, stress, or pressure during the past month [NHANES] |
| 91634-6 | How often is the following kind of support available to you if you need it - someone you can count on to listen to you when you need to talk [MOS Social Support Survey] |
| 91635-3 | How often is the following kind of support available to you if you need it - someone to give you good advice about a crisis [MOS Social Support Survey] |
| 91636-1 | How often is the following kind of support available to you if you need it - someone who shows you love and affection [MOS Social Support Survey] |
| 91637-9 | How often is the following kind of support available to you if you need it - someone to confide in or talk to about yourself or your problems [MOS Social Support Survey] |
| 91638-7 | How often is the following kind of support available to you if you need it - someone whose advice you really want [MOS Social Support Survey] |
| 91639-5 | How often is the following kind of support available to you if you need it - someone to help with daily chores if you were sick [MOS Social Support Survey] |
| 91640-3 | How often is the following kind of support available to you if you need it - someone to share your most private worries and fears with [MOS Social Support Survey] |
| 91641-1 | How often is the following kind of support available to you if you need it - someone to love and make you feel wanted [MOS Social Support Survey] |
| 91642-9 | Medical Outcomes Study Social Support Survey panel [MOS Social Support Survey] |
| 91643-7 | Emotional/informational support [MOS Social Support Survey] |
| 91644-5 | Tangible support [MOS Social Support Survey] |
| 91645-2 | Affectionate support [MOS Social Support Survey] |
| 91646-0 | Positive social interaction [MOS Social Support Survey] |
| 91647-8 | Emotional/informational support score [MOS Social Support Survey] |
| 91648-6 | Tangible support score [MOS Social Support Survey] |
| 91649-4 | Affectionate support score [MOS Social Support Survey] |
| 91650-2 | Positive social interaction score [MOS Social Support Survey] |
| 91651-0 | General Well-Being Schedule - 18 item - total score [NHANES] |
| 91652-8 | How often is the following kind of support available to you if you need it - someone to help you if you were confined to bed [MOS Social Support Survey] |
| 91653-6 | How often is the following kind of support available to you if you need it - someone to take you to the doctor if you needed it [MOS Social Support Survey] |
| 91654-4 | How often is the following kind of support available to you if you need it - someone to have a good time with [MOS Social Support Survey] |
| 91655-1 | How often is the following kind of support available to you if you need it - someone to give you information to help you understand a situation [MOS Social Support Survey] |
| 91656-9 | How often is the following kind of support available to you if you need it - someone who hugs you [MOS Social Support Survey] |
| 91657-7 | How often is the following kind of support available to you if you need it - someone to get together with for relaxation [MOS Social Support Survey] |
| 91658-5 | How often is the following kind of support available to you if you need it - someone to prepare your meals if you were unable to do it yourself [MOS Social Support Survey] |
| 91659-3 | How often is the following kind of support available to you if you need it - someone to do things with to help get your mind off things [MOS Social Support Survey] |
| 91660-1 | How often is the following kind of support available to you if you need it - someone to turn to for suggestions about how to deal with a personal problem [MOS Social Support Survey] |
| 91661-9 | How often is the following kind of support available to you if you need it - someone to do something enjoyable with [MOS Social Support Survey] |
| 91662-7 | How often is the following kind of support available to you if you need it - someone who understands your problems [MOS Social Support Survey] |
| 91663-5 | Social support index [MOS Social Support Survey] |
| 91686-6 | Adult self-report long short form total score [MFQ] |
| 91687-4 | Adult self-report long form total score [MFQ] |
| 91688-2 | Mood and Feelings Questionnaire [MFQ] Adult self-report long form |
| 91689-0 | Mood and Feelings Questionnaire [MFQ] Adult self-report short form |
| 91721-1 | PROMIS physical function - version 2.0 T-score |
| 91722-9 | PROMIS item bank - physical function - version 2.0 |
| 91723-7 | Are you able to rake leaves or sweep for 1 hour without stopping to rest [PROMIS] |
| 91724-5 | Are you able to complete 5 push-ups without stopping [PROMIS] |
| 91725-2 | Are you able to hand wash and wax a car for 2 hours without stopping to rest [PROMIS] |
| 91726-0 | Are you able to dance energetically for 1 hour [PROMIS] |
| 91727-8 | Are you able to swim laps for 30 minutes at a moderate pace [PROMIS] |
| 91728-6 | Are you able to stand up from a push-up position five times quickly [PROMIS] |
| 91729-4 | Are you able to pull a sled or a wagon with two children (total 100 lbs or 50 kg) for 100 yards (100 m) [PROMIS] |
| 91730-2 | Are you able to carry a 50 lb (25 kg) bag of sand 25 yards (25 m) [PROMIS] |
| 91731-0 | Are you able to push an empty refrigerator forward 1 yard (1 m) [PROMIS] |
| 91732-8 | Are you able to climb a 6-foot (2 m) ladder [PROMIS] |
| 91733-6 | Are you able to row a boat for 30 minutes without stopping to rest [PROMIS] |
| 91734-4 | Are you able to lift and load one 50-pound (25 kg) bag of sand into a car [PROMIS] |
| 91735-1 | Are you able to carry a large baby (15 lbs or 7 kg) out of the house to a car or taxi [PROMIS] |
| 91736-9 | Are you able to put your hands flat on the floor with both feet flat on the ground [PROMIS] |
| 91737-7 | Are you able to walk in a straight line putting one foot in front of the other (heel to toe) for 5 yards (5 m) [PROMIS] |
| 91738-5 | Are you able to stand on one foot with your eyes closed for 30 seconds [PROMIS] |
| 91739-3 | Are you able to walk across a balance beam [PROMIS] |
| 91740-1 | Are you able to jump 2 feet (60 cm) high [PROMIS] |
| 91741-9 | Are you able to paint the walls of a room with a brush or roller for 2hours without stopping to rest [PROMIS] |
| 91742-7 | Are you able to jump over a puddle that is 3 feet (1 m) wide [PROMIS] |
| 91743-5 | Are you able to jump over an object that is 1 foot (30 cm) tall [PROMIS] |
| 91744-3 | Are you able to jump rope for 10M without stopping [PROMIS] |
| 91745-0 | Are you able to make sharp turns while running fast [PROMIS] |
| 91746-8 | Are you able to come to a complete stop while running [PROMIS] |
| 91747-6 | Are you able to walk briskly for 20 minutes without stopping to rest [PROMIS] |
| 91748-4 | Are you able to climb the stairs of a 10-story building without stopping [PROMIS] |
| 91749-2 | Are you able to complete 10 sit-ups without stopping [PROMIS] |
| 91750-0 | Are you able to remove a heavy suitcase (50 lbs or 25 kg) from an overhead bin on an airplane or bus [PROMIS] |
| 91751-8 | Are you able to hit the backboard with a basketball from the free throw line 13 ft or 4 m [PROMIS] |
| 91752-6 | Are you able to lift a heavy object (20 lbs or 10 kg) above your head [PROMIS] |
| 91753-4 | Are you able to do a pull-up [PROMIS] |
| 91754-2 | Are you able to dig a 2-foot (1/2 m) deep hole in the dirt with a shovel [PROMIS] |
| 91755-9 | Are you able to carry household items, such as heavy boxes or furniture, up a flight of stairs [PROMIS] |
| 91756-7 | Are you able to carry a suitcase up a flight of stairs [PROMIS] |
| 91757-5 | Are you able to run on even ground [PROMIS] |
| 91758-3 | Does your health now limit you in doing yard work like raking leaves, weeding, or pushing a lawn mower [PROMIS] |
| 91759-1 | Does your health now limit you in taking part in any sports (swimming, bowling, and so forth) [PROMIS] |
| 91760-9 | Does your health now limit you in dancing for half an hour [PROMIS] |
| 91910-0 | My child was too tired to read in past 7 days [PROMIS.PARENTPROXY] |
| 91911-8 | My child was too tired to eat in past 7 days [PROMIS.PARENTPROXY] |
| 91912-6 | My child needed to sleep during the day in past 7 days [PROMIS.PARENTPROXY] |
| 91913-4 | My child had trouble finishing things because he/she was too tired in past 7 days [PROMIS.PARENTPROXY] |
| 91914-2 | My child felt too tired to spend time with his/her friends in past 7 days [PROMIS.PARENTPROXY] |
| 91915-9 | Being tired made it hard for my child to keep up with schoolwork in past 7 days [PROMIS.PARENTPROXY] |
| 91916-7 | My child was too tired to go out with his/her family in past 7 days [PROMIS.PARENTPROXY] |
| 91917-5 | My child felt more tired than usual when he/she woke up in the morning in past 7 days [PROMIS.PARENTPROXY] |
| 91918-3 | My child was so tired it was hard for him/her to pay attention in past 7 days [PROMIS.PARENTPROXY] |
| 91919-1 | My child felt tired in past 7 days [PROMIS.PARENTPROXY] |
| 91920-9 | My child was too tired to do things outside in past 7 days [PROMIS.PARENTPROXY] |
| 91921-7 | Being tired kept my child from having fun in past 7 days [PROMIS.PARENTPROXY] |
| 91922-5 | My child had trouble starting things because he/she was too tired in past 7 days [PROMIS.PARENTPROXY] |
| 91923-3 | My child was too tired to do sports or exercise in past 7 days [PROMIS.PARENTPROXY] |
| 91924-1 | My child was too tired to go up and down a lot of stairs in past 7 days [PROMIS.PARENTPROXY] |
| 91925-8 | It was hard for my child to get out of bed in the morning because he/she was too tired in past 7 days [PROMIS.PARENTPROXY] |
| 91926-6 | Being tired made it hard for my child to play or go out with friends as much as he/she would like in past 7 days [PROMIS.PARENTPROXY] |
| 91927-4 | My child was too tired to focus on his/her work in past 7 days [PROMIS.PARENTPROXY] |
| 91929-0 | My child was too tired to enjoy the things he/she likes to do in past 7 days [PROMIS.PARENTPROXY] |
| 91930-8 | My child was too tired to watch television in past 7 days [PROMIS.PARENTPROXY] |
| 91931-6 | My child was too tired to take a bath or shower in past 7 days [PROMIS.PARENTPROXY] |
| 91932-4 | My child felt weak in past 7 days [PROMIS.PARENTPROXY] |
| 91933-2 | PROMIS parent proxy item bank - fatigue version 2.0 |
| 91934-0 | PROMIS parent proxy fatigue - version 2.0 T-score |
| 91935-7 | PROMIS pediatric pain behavior - version 1.0 T-score |
| 91936-5 | PROMIS pediatric item bank - pain behavior - version 1.0 |
| 91937-3 | When I was in pain I felt my body get tense in past 7 days [PROMIS] |
| 91938-1 | When I was in pain I lay down in past 7 days [PROMIS] |
| 91939-9 | WhenI was in pain I asked for someone to help me in past 7 days [PROMIS] |
| 91940-7 | WhenI was in pain I told people I couldn't do things with them in past 7 days [PROMIS] |
| 91941-5 | When I was in pain it showed on my face in past 7 days [PROMIS] |
| 91942-3 | When I was in pain I told people I couldn't do my usual chores in past 7 days [PROMIS] |
| 91943-1 | When I was in pain I took breaks from what I was doing in past 7 days [PROMIS] |
| 91944-9 | When I was in pain I sighed in past 7 days [PROMIS] |
| 91945-6 | When I was in pain I got mad and threw or hit something in past 7 days [PROMIS] |
| 91946-4 | When I was in pain I said mean words to people in past 7 days [PROMIS] |
| 91947-2 | When I was in pain I avoided using the part of my body that hurt in past 7 days [PROMIS] |
| 91948-0 | When I was in pain I argued with people in past 7 days [PROMIS] |
| 91949-8 | When I was in pain I pulled away if someone touched me where it hurt in past 7 days [PROMIS] |
| 91950-6 | When I was in pain I asked to see a doctor in past 7 days [PROMIS] |
| 91951-4 | When I was in pain I complained in past 7 days [PROMIS] |
| 91952-2 | When I was in pain I tried to rest or relax in past 7 days [PROMIS] |
| 91953-0 | When I was in pain I stayed near to someone who cares about me in past 7 days [PROMIS] |
| 91954-8 | When I was in pain I avoided lifting or carrying heavy things in past 7 days [PROMIS] |
| 91955-5 | When I was in pain I had to stop what I was doing in past 7 days [PROMIS] |
| 91956-3 | When I was in pain I went to sleep in past 7 days [PROMIS] |
| 91957-1 | When I was in pain I tried to think of something nice or fun in past 7 days [PROMIS] |
| 91958-9 | When I was in pain I was restless in past 7 days [PROMIS] |
| 91959-7 | When I was in pain I couldn't stay still in past 7 days [PROMIS] |
| 91960-5 | When I was in pain I asked people to bring me things (food, games) in past 7 days [PROMIS] |
| 91961-3 | When I was in pain I avoided standing in past 7 days [PROMIS] |
| 91962-1 | When I was in pain I didn't want anyone to touch me in past 7 days [PROMIS] |
| 91963-9 | When I was in pain I got angry at people in past 7 days [PROMIS] |
| 91964-7 | When I was in pain I moved slower in past 7 days [PROMIS] |
| 91965-4 | When I was in pain I rubbed my body where it hurt in past 7 days [PROMIS] |
| 91966-2 | When I was in pain I didn't let anyone touch me in past 7 days [PROMIS] |
| 91967-0 | When I was in pain I talked about my pain in past 7 days [PROMIS] |
| 91968-8 | When I was in pain I tightened my jaw in past 7 days [PROMIS] |
| 91969-6 | When I was in pain I asked for medicine in past 7 days [PROMIS] |
| 91970-4 | When I was in pain I stayed away from other people in past 7 days [PROMIS] |
| 91971-2 | When I was in pain I asked for help getting around in past 7 days [PROMIS] |
| 91972-0 | When I was in pain I became quiet in past 7 days [PROMIS] |
| 91973-8 | When I was in pain I limped in the past 7 days [PROMIS] |
| 91974-6 | When I was in pain I used something for support (cane, crutches, wheelchair) to move from place to place in past 7 days [PROMIS] |
| 91975-3 | When I was in pain I cried in past 7 days [PROMIS] |
| 91976-1 | When I was in pain I yelled for someone to help me in past 7 days [PROMIS] |
| 91977-9 | When I was in pain I asked people to let me be by myself in past 7 days [PROMIS] |
| 91978-7 | When I was in pain I asked for help with doing things in past 7 days [PROMIS] |
| 91979-5 | When I was in pain I tried not to move in past 7 days [PROMIS] |
| 91987-8 | PROMIS parent proxy anxiety - version 2.0 T-score |
| 91988-6 | PROMIS parent proxy item bank - anxiety - version 2.0 |
| 91989-4 | My child felt worried in past 7 days [PROMIS.PARENTPROXY] |
| 91990-2 | My child was afraid of going to school in past 7 days [PROMIS.PARENTPROXY] |
| 91991-0 | My child worried when he or she was at home in past 7 days [PROMIS.PARENTPROXY] |
| 91992-8 | My child worried when he or she went to bed at night in past 7 days [PROMIS.PARENTPROXY] |
| 91993-6 | My child was worried he or she might die in past 7 days [PROMIS.PARENTPROXY] |
| 91994-4 | My child felt scared in past 7 days [PROMIS.PARENTPROXY] |
| 91995-1 | My child felt like something awful might happen in past 7 days [PROMIS.PARENTPROXY] |
| 91996-9 | It was hard for my child to relax in past 7 days [PROMIS.PARENTPROXY] |
| 91997-7 | My child felt nervous in past 7 days [PROMIS.PARENTPROXY] |
| 91998-5 | My child worried when he or she was away from home in past 7 days [PROMIS.PARENTPROXY] |
| 91999-3 | My child woke up at night scared in past 7 days [PROMIS.PARENTPROXY] |
| 92000-9 | My child worried about what could happen to him or her in past 7 days [PROMIS.PARENTPROXY] |
| 92001-7 | My child got scared really easy in past 7 days [PROMIS.PARENTPROXY] |
| 92041-3 | Physical security assessment system [CDC Emergency Operations Centers] |
| 92042-1 | Physical security assessment system type |
| 92043-9 | Physical security assessment system name |
| 92044-7 | Physical security assessment system details |
| 92051-2 | My child had trouble staying asleep in past 7 days [PROMIS.PARENTPROXY] |
| 92052-0 | My child's neck felt tight in past 7 days [PROMIS.PARENTPROXY] |
| 92053-8 | My child felt as if he or she needed to move his or her legs a lot in past 7 days [PROMIS.PARENTPROXY] |
| 92054-6 | A sudden noise made my child jump in past 7 days [PROMIS.PARENTPROXY] |
| 92055-3 | My child's muscles felt tight in past 7 days [PROMIS.PARENTPROXY] |
| 92056-1 | My child could not stay still for long in past 7 days [PROMIS.PARENTPROXY] |
| 92057-9 | My child's mouth was dry in past 7 days [PROMIS.PARENTPROXY] |
| 92058-7 | My child's breathing was fast, even when he or she was not exercising or playing hard in past 7 days [PROMIS.PARENTPROXY] |
| 92059-5 | My child's palms were sweaty in past 7 days [PROMIS.PARENTPROXY] |
| 92060-3 | My child was sweaty, even when he or she was not exercising or playing hard in past 7 days [PROMIS.PARENTPROXY] |
| 92061-1 | My child's heart pounded, even when he or she was not exercising or playing hard in past 7 days [PROMIS.PARENTPROXY] |
| 92062-9 | My child's heart beat faster than usual, even when he or she was not exercising or playing hard in past 7 days [PROMIS.PARENTPROXY] |
| 92063-7 | My child had trouble breathing, even when he or she was not exercising or playing hard in past 7 days [PROMIS.PARENTPROXY] |
| 92064-5 | My child felt dizzy in past 7 days [PROMIS.PARENTPROXY] |
| 92065-2 | My child's breathing was fast in past 7 days [PROMIS.PARENTPROXY] |
| 92066-0 | My child's hands shook in past 7 days [PROMIS.PARENTPROXY] |
| 92067-8 | My child's legs shook in past 7 days [PROMIS.PARENTPROXY] |
| 92068-6 | My child's body shook in past 7 days [PROMIS.PARENTPROXY] |
| 92069-4 | My child had a headache in past 7 days [PROMIS.PARENTPROXY] |
| 92070-2 | My child's neck hurt in past 7 days [PROMIS.PARENTPROXY] |
| 92071-0 | My child's back hurt in past 7 days [PROMIS.PARENTPROXY] |
| 92072-8 | My child had a bad stomach ache in past 7 days [PROMIS.PARENTPROXY] |
| 92073-6 | My child had pain that really bothered him or her in past 7 days [PROMIS.PARENTPROXY] |
| 92074-4 | My child's appetite changed in past 7 days [PROMIS.PARENTPROXY] |
| 92075-1 | My child felt some food coming up into his or her throat in past 7 days [PROMIS.PARENTPROXY] |
| 92076-9 | My child threw up in past 7 days [PROMIS.PARENTPROXY] |
| 92077-7 | PROMIS parent proxy item bank - physical stress experiences - version 1.0 |
| 92078-5 | PROMIS parent proxy physical stress experiences - version 1.0 T-score |
| 92079-3 | PROMIS parent proxy meaning purpose - version 1.0 T-score |
| 92080-1 | PROMIS parent proxy item bank - meaning purpose - version 1.0 |
| 92081-9 | Thinking about your child's life, people will remember my child when he or she dies [PROMIS.PARENTPROXY] |
| 92082-7 | Thinking about your child's life, my child is satisfied with his or her purpose in life [PROMIS.PARENTPROXY] |
| 92083-5 | Thinking about your child's life, my child has a reason for living [PROMIS.PARENTPROXY] |
| 92084-3 | Thinking about your child's life, my child's life is filled with things that interest him or her [PROMIS.PARENTPROXY] |
| 92085-0 | Thinking about your child's life, my child knows what makes his or her life meaningful [PROMIS.PARENTPROXY] |
| 92086-8 | Thinking about your child's life, my child has a clear purpose in life [PROMIS.PARENTPROXY] |
| 92087-6 | Thinking about your child's life, my child thinks his or her life is filled with purpose [PROMIS.PARENTPROXY] |
| 92088-4 | Thinking about your child's life, my child thinks his or her life has purpose [PROMIS.PARENTPROXY] |
| 92089-2 | Thinking about your child's life, my child tries to find purpose in life [PROMIS.PARENTPROXY] |
| 92090-0 | Thinking about your child's life, my child thinks his or her life is filled with meaning [PROMIS.PARENTPROXY] |
| 92091-8 | Thinking about your child's life, my child thinks his or her life has meaning [PROMIS.PARENTPROXY] |
| 92092-6 | Thinking about your child's life, my child tries to find meaning in life [PROMIS.PARENTPROXY] |
| 92093-4 | Thinking about your child's life, my child wants to do what is important [PROMIS.PARENTPROXY] |
| 92094-2 | Thinking about your child's life, my child thinks his or her life is important [PROMIS.PARENTPROXY] |
| 92095-9 | Thinking about your child's life, my child's life is filled with important things [PROMIS.PARENTPROXY] |
| 92096-7 | Thinking about your child's life, my child wants to make the most out of his or her life [PROMIS.PARENTPROXY] |
| 92097-5 | Thinking about your child's life, my child can reach his or her goals in life [PROMIS.PARENTPROXY] |
| 92098-3 | Thinking about your child's life, my child knows where he or she is going in life [PROMIS.PARENTPROXY] |
| 92099-1 | Thinking about your child's life, my child expects to achieve his or her goals [PROMIS.PARENTPROXY] |
| 92100-7 | Thinking about your child's life, the things my child has done in the past will help him or her in the future [PROMIS.PARENTPROXY] |
| 92101-5 | Thinking about your child's life, my child has things he or she wants to accomplish in life [PROMIS.PARENTPROXY] |
| 92102-3 | Thinking about your child's life, my child has things he or she needs to do in life [PROMIS.PARENTPROXY] |
| 92103-1 | Thinking about your child's life, my child has things he or she wants to do in life [PROMIS.PARENTPROXY] |
| 92104-9 | Thinking about your child's life, my child makes plans for his or her future [PROMIS.PARENTPROXY] |
| 92105-6 | Thinking about your child's life, my child has goals for himself or herself [PROMIS.PARENTPROXY] |
| 92106-4 | Thinking about your child's life, my child can do almost anything if he or she has enough faith in himself or herself [PROMIS.PARENTPROXY] |
| 92107-2 | Thinking about your child's life, my child is positive about his or her future [PROMIS.PARENTPROXY] |
| 92108-0 | Thinking about your child's life, my child is hopeful about his or her future [PROMIS.PARENTPROXY] |
| 92109-8 | Thinking about your child's life, my child is hopeful about his or her plans for the future [PROMIS.PARENTPROXY] |
| 92110-6 | Thinking about your child's life, my child always has hope [PROMIS.PARENTPROXY] |
| 92111-4 | Thinking about your child's life, my child is full of hope [PROMIS.PARENTPROXY] |
| 92112-2 | Thinking about your child's life, my child has hope [PROMIS.PARENTPROXY] |
| 92113-0 | Thinking about your child's life, when bad things happen, my child expects them to get better [PROMIS.PARENTPROXY] |
| 92114-8 | Thinking about your child's life, my child expects to succeed at what he or she tries to do [PROMIS.PARENTPROXY] |
| 92115-5 | Thinking about your child's life, my child looks forward to what will happen in the future [PROMIS.PARENTPROXY] |
| 92116-3 | Thinking about your child's life, my child expects to achieve what he or she wants in life [PROMIS.PARENTPROXY] |
| 92117-1 | Thinking about your child's life, my child expects to have success in the future [PROMIS.PARENTPROXY] |
| 92118-9 | Thinking about your child's life, my child expects to have a long life [PROMIS.PARENTPROXY] |
| 92119-7 | Thinking about your child's life, my child expects to enjoy his or her future life [PROMIS.PARENTPROXY] |
| 92120-5 | Thinking about your child's life, my child expects to be successful in the future [PROMIS.PARENTPROXY] |
| 92121-3 | Thinking about your child's life, my child expects to have a family in the future [PROMIS.PARENTPROXY] |
| 92122-1 | Thinking about your child's life, my child expects to have a job in the future [PROMIS.PARENTPROXY] |
| 92123-9 | Thinking about your child's life, my child expects things to work out for the best [PROMIS.PARENTPROXY] |
| 92124-7 | Thinking about your child's life, my child expects amazing things to happen to him or her [PROMIS.PARENTPROXY] |
| 92148-6 | PROMIS item bank - dyspnea severity - version 1.0 |
| 92149-4 | PROMIS dyspnea severity - version 1.0 T-score |
| 92150-2 | How short of breath did you get washing dishes over past 7 days [PROMIS] |
| 92151-0 | How short of breath did you get walking up 5 stairs without stopping over past 7 days [PROMIS] |
| 92152-8 | How short of breath did you get walking up 30 stairs (3 flights) without stopping over past 7 days [PROMIS] |
| 92153-6 | How short of breath did you get walking up 20 stairs (2 flights) without stopping over past 7 days [PROMIS] |
| 92154-4 | How short of breath did you get walking up 10 stairs (1 flight) without stopping over past 7 days [PROMIS] |
| 92155-1 | How short of breath did you get walking 50 steps or paces on flat ground at a normal speed without stopping over past 7 days [PROMIS] |
| 92156-9 | How short of breath did you get walking 10 steps or paces on flat ground at a normal speed without stopping over past 7 days [PROMIS] |
| 92157-7 | How short of breath did you get walking .5 mile (almost 1 km) on flat ground at a normal speed without stopping over past 7 days [PROMIS] |
| 92158-5 | 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 over past 7 days [PROMIS] |
| 92159-3 | How short of breath did you get walking (faster than your usual speed) for 50 steps without stopping over past 7 days [PROMIS] |
| 92160-1 | How short of breath did you get walking (faster than your usual speed) for .5 mile (almost 1 km) without stopping over past 7 days [PROMIS] |
| 92161-9 | How short of breath did you get talking while walking over past 7 days [PROMIS] |
| 92162-7 | How short of breath did you get taking a shower over past 7 days [PROMIS] |
| 92163-5 | How short of breath did you get taking a bath without help over past 7 days [PROMIS] |
| 92164-3 | How short of breath did you get sweeping or mopping over past 7 days [PROMIS] |
| 92165-0 | How short of breath did you get standing for at least 5 minutes over past 7 days [PROMIS] |
| 92166-8 | How short of breath did you get singing or humming over past 7 days [PROMIS] |
| 92167-6 | How short of breath did you get scrubbing the floor or counter over past 7 days [PROMIS] |
| 92168-4 | How short of breath did you get putting on socks or stockings over past 7 days [PROMIS] |
| 92169-2 | How short of breath did you get preparing meals over past 7 days [PROMIS] |
| 92170-0 | How short of breath did you get moderate-intensity leisure activity (bicycling on level terrain, etc.) over past 7 days [PROMIS] |
| 92171-8 | How short of breath did you get making a bed over past 7 days [PROMIS] |
| 92172-6 | How short of breath did you get low-intensity leisure activity (gardening, etc.) over past 7 days [PROMIS] |
| 92173-4 | How short of breath did you get lifting something weighing more than 20 lbs (about 9 kg, like a medium-sized suitcase) over past 7 days [PROMIS] |
| 92174-2 | How short of breath did you get lifting something weighing less than 5 lbs (about 2 kg, like a houseplant) over past 7 days [PROMIS] |
| 92175-9 | How short of breath did you get lifting something weighing 5-10 lbs (about 2-4.5 kg, like a basket of clothes) over past 7 days [PROMIS] |
| 92176-7 | How short of breath did you get lifting something weighing 10-20 lbs (about 4.5-9 kg, like a large bag of groceries) over past 7 days [PROMIS] |
| 92177-5 | How short of breath did you get getting in or out of a car over past 7 days [PROMIS] |
| 92178-3 | How short of breath did you get dressing yourself without help over past 7 days [PROMIS] |
| 92179-1 | How short of breath did you get dining out over past 7 days [PROMIS] |
| 92180-9 | 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 over past 7 days [PROMIS] |
| 92181-7 | 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 over past 7 days [PROMIS] |
| 92182-5 | How short of breath did you get carrying something weighing 10-20 lbs (about 4.5-9 kg, like a large bag of groceries) from one room to another over past 7 days [PROMIS] |
| 92205-4 | When I'm upset with someone, a cigarette helps me cope [PROMIS] |
| 92206-2 | When I'm angry, a cigarette can calm me down [PROMIS] |
| 92207-0 | When I am worrying about something, a cigarette is helpful [PROMIS] |
| 92208-8 | Smoking helps me when I'm upset about something [PROMIS] |
| 92209-6 | Smoking helps me reduce tension [PROMIS] |
| 92210-4 | Smoking helps me deal with anxiety [PROMIS] |
| 92211-2 | Smoking calms me down [PROMIS] |
| 92212-0 | Smoking allows me to take a break from my problems for a few minutes [PROMIS] |
| 92213-8 | PROMIS smoking - coping expectancies for all smokers - version 1.0 T-score |
| 92214-6 | PROMIS item bank - smoking - coping expectancies for all smokers - version 1.0 |
| 92215-3 | I rely on smoking to deal with stress [PROMIS] |
| 92216-1 | I am tempted to smoke when I feel depressed [PROMIS] |
| 92217-9 | I am tempted to smoke when I am anxious [PROMIS] |
| 92218-7 | When I stop what I'm doing to have a cigarette it feels like 'my time' [PROMIS] |
| 92219-5 | Smoking stimulates me [PROMIS] |
| 92220-3 | Smoking makes me less depressed [PROMIS] |
| 92221-1 | Smoking makes me feel content [PROMIS] |
| 92222-9 | Smoking is the fastest way to reward myself [PROMIS] |
| 92223-7 | Smoking is relaxing [PROMIS] |
| 92224-5 | Smoking helps me concentrate [PROMIS] |
| 92225-2 | PROMIS smoking - emotional and sensory expectancies for all smokers - version 1.0 T-score |
| 92226-0 | PROMIS item bank - smoking - emotional and sensory expectancies for all smokers - version 1.0 |
| 92227-8 | I smoke to get a sense of pleasure [PROMIS] |
| 92228-6 | I smoke because smoking feels good [PROMIS] |
| 92229-4 | I smoke because it is self-satisfying [PROMIS] |
| 92230-2 | I love the feel of inhaling the smoke into my mouth [PROMIS] |
| 92231-0 | I like the way a cigarette makes me feel physically [PROMIS] |
| 92232-8 | I feel better after smoking a cigarette [PROMIS] |
| 92233-6 | I enjoy the sensations of a long, slow exhalation of smoke [PROMIS] |
| 92234-4 | Even when I feel good, smoking helps me feel better [PROMIS] |
| 92258-3 | Smoking makes my lungs hurt [PROMIS] |
| 92259-1 | Smoking makes me worry about getting heart troubles [PROMIS] |
| 92260-9 | Smoking makes me worry about getting emphysema [PROMIS] |
| 92261-7 | Smoking makes me short of breath [PROMIS] |
| 92262-5 | Smoking is taking years off my life [PROMIS] |
| 92263-3 | Smoking irritates my mouth and throat [PROMIS] |
| 92264-1 | Smoking causes me to get tired easily [PROMIS] |
| 92265-8 | Smoking causes damage to my gums and teeth [PROMIS] |
| 92266-6 | PROMIS smoking - negative health expectancies for all smokers - version 1.0 T-score |
| 92267-4 | PROMIS item bank - smoking - negative health expectancies for all smokers - version 1.0 |
| 92268-2 | It takes me longer to recover from a cold because I smoke [PROMIS] |
| 92269-0 | If I quit smoking I will feel more energetic [PROMIS] |
| 92270-8 | If I quit smoking I will breathe easier [PROMIS] |
| 92271-6 | I worry that smoking will lower my quality of life [PROMIS] |
| 92282-3 | PROMIS smoking - negative psychosocial expectancies for all smokers - version 1.0 T-score |
| 92283-1 | People think less of me if they see me smoking [PROMIS] |
| 92284-9 | People think I'm foolish for ignoring the warnings about cigarette smoking [PROMIS] |
| 92285-6 | People I care about respect me less because I smoke [PROMIS] |
| 92286-4 | My smoking makes me respect myself less [PROMIS] |
| 92287-2 | My smoking makes me less attractive to other people [PROMIS] |
| 92288-0 | My smoking makes me feel less attractive [PROMIS] |
| 92289-8 | My need for cigarettes makes me feel disappointed in myself [PROMIS] |
| 92290-6 | My cigarette smoking bothers others [PROMIS] |
| 92291-4 | If I quit smoking my friends will respect me more [PROMIS] |
| 92292-2 | If I quit smoking I will be more in control of my life [PROMIS] |
| 92293-0 | If I quit smoking I will be more attractive to others [PROMIS] |
| 92294-8 | I look ridiculous while smoking [PROMIS] |
| 92295-5 | I get upset when I think about my smoking [PROMIS] |
| 92296-3 | I feel embarrassed when I smoke [PROMIS] |
| 92297-1 | PROMIS item bank - smoking - negative psychosocial expectancies for all smokers - version 1.0 |
| 92298-9 | When I'm really craving a cigarette, it feels like I'm in the grip of some unknown force that I cannot control [PROMIS] |
| 92299-7 | When I run out of cigarettes, I find it almost unbearable [PROMIS] |
| 92300-3 | When I haven't been able to smoke for a few hours, the craving gets intolerable [PROMIS] |
| 92301-1 | When I go without a cigarette for a few hours, I experience craving [PROMIS] |
| 92302-9 | When I go too long without a cigarette I get strong urges that are hard to get rid of [PROMIS] |
| 92303-7 | When I go too long without a cigarette I feel impatient [PROMIS] |
| 92304-5 | The idea of not having any cigarettes causes me stress [PROMIS] |
| 92305-2 | PROMIS smoking - nicotine dependence for all smokers - version 1.0 T-score |
| 92306-0 | PROMIS item bank - smoking - nicotine dependence for all smokers - version v1.0 |
| 92307-8 | My urges to smoke keep getting stronger if I don't smoke [PROMIS] |
| 92308-6 | My desire to smoke seems overpowering [PROMIS] |
| 92309-4 | It is hard to ignore urges to smoke [PROMIS] |
| 92310-2 | I smoke more before going into a situation where smoking is not allowed [PROMIS] |
| 92311-0 | I smoke even when I am so ill that I am in bed most of the day [PROMIS] |
| 92312-8 | I get a real gnawing hunger for a cigarette when l haven't smoked in a while [PROMIS] |
| 92313-6 | I frequently crave cigarettes [PROMIS] |
| 92314-4 | I find myself reaching for cigarettes without thinking about it [PROMIS] |
| 92315-1 | I drop everything to go out and buy cigarettes [PROMIS] |
| 92316-9 | I crave cigarettes at certain times of day [PROMIS] |
| 92317-7 | I am tempted to smoke when I realize I haven't smoked for a while [PROMIS] |
| 92318-5 | Cravings for a cigarette make it difficult for me to quit [PROMIS] |
| 92319-3 | After not smoking for a while, I need to smoke in order to avoid feeling any discomfort [PROMIS] |
| 92320-1 | Smoking makes me feel better in social situations [PROMIS] |
| 92321-9 | Smoking is a part of my self-image [PROMIS] |
| 92322-7 | Smoking helps me feel more relaxed when I'm with other people [PROMIS] |
| 92323-5 | PROMIS smoking - social motivations for all smokers - version 1.0 T-score |
| 92324-3 | PROMIS item bank - smoking - social motivations for all smokers - version 1.0 |
| 92325-0 | If I quit smoking I will be less welcome around my friends who smoke [PROMIS] |
| 92326-8 | I feel like part of a group when I'm around other smokers [PROMIS] |
| 92327-6 | I feel a bond with other smokers [PROMIS] |
| 92328-4 | I enjoy the social aspect of smoking with other smokers [PROMIS] |
| 92329-2 | PROMIS self-efficacy for managing emotions - version 1.0 T-score |
| 92330-0 | PROMIS item bank - self-efficacy for managing emotions - version 1.0 |
| 92331-8 | Current level of confidence when I'm feeling down, I can find ways to make myself feel better [PROMIS] |
| 92332-6 | Current level of confidence I can use relaxation to deal with worries [PROMIS] |
| 92333-4 | Current level of confidence I can use a strategy (for example: humor, leaving a situation) to keep from getting upset [PROMIS] |
| 92334-2 | Current level of confidence I can stay positive when I feel like I am the only one going through this [PROMIS] |
| 92335-9 | Current level of confidence I can relax my body to reduce my anxiety [PROMIS] |
| 92336-7 | Current level of confidence I can prevent my illness from making me feel discouraged [PROMIS] |
| 92337-5 | Current level of confidence I can manage the loss of my ability to do things that are important to me (for example: parenting, work, hobbies, attend school) [PROMIS] |
| 92338-3 | Current level of confidence I can manage my frustration [PROMIS] |
| 92339-1 | Current level of confidence I can manage my anxiety about telling others I have health problems [PROMIS] |
| 92340-9 | Current level of confidence I can manage my anger when others make insensitive comments about my health problems [PROMIS] |
| 92341-7 | Current level of confidence I can manage my anger when others don't understand what I am going through [PROMIS] |
| 92342-5 | Current level of confidence I can manage anxiety about injuring myself or others (for example: falling, dropping a child, a driving accident) [PROMIS] |
| 92343-3 | Current level of confidence I can keep emotional distress from interfering with things I want to do [PROMIS] |
| 92344-1 | Current level of confidence I can keep anxiety from becoming overwhelming [PROMIS] |
| 92345-8 | Current level of confidence I can hear about symptoms and side effects without getting discouraged [PROMIS] |
| 92346-6 | Current level of confidence I can handle upsetting situations [PROMIS] |
| 92347-4 | Current level of confidence I can handle the stress of going for treatment of my medical conditions [PROMIS] |
| 92348-2 | Current level of confidence I can handle negative feelings [PROMIS] |
| 92349-0 | Current level of confidence I can focus on something else to decrease anxiety [PROMIS] |
| 92350-8 | Current level of confidence I can find ways to manage stress [PROMIS] |
| 92351-6 | Current level of confidence I can bounce back from disappointment [PROMIS] |
| 92352-4 | Current level of confidence I can avoid upsetting thoughts [PROMIS] |
| 92353-2 | Current level of confidence I can avoid feeling helpless [PROMIS] |
| 92354-0 | Current level of confidence I can avoid feeling discouraged [PROMIS] |
| 92355-7 | Current level of confidence I can avoid becoming angry [PROMIS] |
| 92356-5 | Current level of confidence I can walk around inside my house [PROMIS] |
| 92357-3 | Current level of confidence I can walk a block (about 300 feet or 100 meters) on flat ground [PROMIS] |
| 92358-1 | Current level of confidence I can use public transportation [PROMIS] |
| 92359-9 | Current level of confidence I can use a telephone to schedule an appointment [PROMIS] |
| 92360-7 | Current level of confidence I can use a computer (for example: use keyboard, see screen, login) [PROMIS] |
| 92361-5 | Current level of confidence I can travel to a new destination alone [PROMIS] |
| 92362-3 | Current level of confidence I can take my medications in the right doses and at the right times [PROMIS] |
| 92363-1 | Current level of confidence I can take care of others (for example: cook for others, help them dress, watch children) [PROMIS] |
| 92364-9 | Current level of confidence I can take care of my personal hygiene without help from anyone (for example: brush my teeth, comb my hair, shave, apply makeup) [PROMIS] |
| 92365-6 | Current level of confidence I can take a bath or shower [PROMIS] |
| 92366-4 | Current level of confidence I can stand for 5 minutes (for example: waiting in a line, waiting for a bus) [PROMIS] |
| 92367-2 | Current level of confidence I can recognize risks (for example: handling hot liquids, walking on uneven ground) and take steps to prevent accidents [PROMIS] |
| 92368-0 | Current level of confidence I can prepare my own meals (for example: plan and cook full meals by myself) [PROMIS] |
| 92369-8 | Current level of confidence I can perform my household chores [PROMIS] |
| 92370-6 | Current level of confidence I can perform my daily activities even if someone is rushing me [PROMIS] |
| 92371-4 | Current level of confidence I can manage my clothes when I need to use the toilet [PROMIS] |
| 92372-2 | Current level of confidence I can maintain my finances (for example: write checks, pay bills) [PROMIS] |
| 92373-0 | Current level of confidence I can maintain a regular exercise program [PROMIS] |
| 92374-8 | Current level of confidence I can lift and carry groceries [PROMIS] |
| 92375-5 | Current level of confidence I can keep doing my usual activities at work [PROMIS] |
| 92376-3 | Current level of confidence I can go shopping and run errands [PROMIS] |
| 92377-1 | Current level of confidence I can go outside in challenging weather for me [PROMIS] |
| 92378-9 | Current level of confidence I can get to the bathroom in time [PROMIS] |
| 92379-7 | Current level of confidence I can get in and out of bed without falling [PROMIS] |
| 92380-5 | Current level of confidence I can get in and out of a chair [PROMIS] |
| 92381-3 | Current level of confidence I can get around in an unfamiliar environment [PROMIS] |
| 92382-1 | Current level of confidence I can find new ways to manage daily activities when the old way doesn't work [PROMIS] |
| 92383-9 | Current level of confidence I can exercise at a vigorous level for 10 minutes (for example: running, jogging) [PROMIS] |
| 92384-7 | Current level of confidence I can exercise at a moderate level for 10 minutes (for example: walking briskly, biking, swimming, aerobics) [PROMIS] |
| 92385-4 | Current level of confidence I can engage in hobbies or recreational activities [PROMIS] |
| 92386-2 | Current level of confidence I can eat without help from anyone [PROMIS] |
| 92387-0 | Current level of confidence I can drive a car [PROMIS] |
| 92388-8 | Current level of confidence I can dress myself in the way I want to be dressed (including buttoning clothes and putting on shoes) [PROMIS] |
| 92389-6 | Current level of confidence I can concentrate on something difficult [PROMIS] |
| 92390-4 | Current level of confidence I can climb one flight of stairs (with or without rails) [PROMIS] |
| 92391-2 | PROMIS self-efficacy for managing daliy activities - version 1.0 T-score |
| 92392-0 | PROMIS item bank - self-efficacy for managing daily activities - version 1.0 |
| 92393-8 | PROMIS self-efficacy for managing social interactions - version 1.0 T-score |
| 92394-6 | PROMIS item bank - self-efficacy for managing social interactions - version 1.0 |
| 92395-3 | Current level of confidence People understand when I need help and when I don't need help [PROMIS] |
| 92396-1 | Current level of confidence People are concerned about my health [PROMIS] |
| 92397-9 | Current level of confidence People are accepting of my condition [PROMIS] |
| 92398-7 | Current level of confidence My doctors and nurses listen to my needs [PROMIS] |
| 92399-5 | Current level of confidence If I need help, I have someone to help with my financial affairs [PROMIS] |
| 92400-1 | Current level of confidence If I need help, I have someone to help me manage my daily activities [PROMIS] |
| 92401-9 | Current level of confidence If I need help, I can find someone to take me to the doctor's office [PROMIS] |
| 92402-7 | Current level of confidence I know when to stop talking about my condition [PROMIS] |
| 92403-5 | Current level of confidence I have someone who will go out and do things with me [PROMIS] |
| 92404-3 | Current level of confidence I have someone who helps me understand medical information [PROMIS] |
| 92405-0 | Current level of confidence I have someone to help me plan and make decisions related to my illness [PROMIS] |
| 92406-8 | Current level of confidence I can tell others about my health problems [PROMIS] |
| 92407-6 | Current level of confidence I can talk to others about my condition without being embarrassed [PROMIS] |
| 92408-4 | Current level of confidence I can talk about my health problems with someone [PROMIS] |
| 92409-2 | Current level of confidence I can stay involved in community or religious activities [PROMIS] |
| 92410-0 | Current level of confidence I can refuse help when I don't need it [PROMIS] |
| 92411-8 | Current level of confidence I can maintain my usual social activities [PROMIS] |
| 92412-6 | Current level of confidence I can keep in touch with friends and family [PROMIS] |
| 92413-4 | Current level of confidence I can get emotional support when I need it [PROMIS] |
| 92414-2 | Current level of confidence I can communicate well with my doctors and nurses [PROMIS] |
| 92415-9 | Current level of confidence I can attend social events without being embarrassed [PROMIS] |
| 92416-7 | Current level of confidence I can ask for help when I don't understand something [PROMIS] |
| 92417-5 | Current level of confidence Friends and family will come to see me when I am sick [PROMIS] |
| 92418-3 | PROMIS self-efficacy for managing medications and treatments - version 1.0 T-score |
| 92419-1 | PROMIS item bank - self-efficacy for managing medications and treatments - version 1.0 |
| 92420-9 | Current level of confidence I understand the difference between my symptoms and medication side effects [PROMIS] |
| 92421-7 | Current level of confidence I know when and how to take my medications [PROMIS] |
| 92422-5 | Current level of confidence I know what to do when my medication refill looks different than usual [PROMIS] |
| 92423-3 | Current level of confidence I know what to do if I forget to take my medication(s) [PROMIS] |
| 92424-1 | Current level of confidence I can work with my doctor to choose the treatment that seems right for me [PROMIS] |
| 92425-8 | Current level of confidence I can use technology to help me manage my medication and treatments (for example: to get information, avoid side-effects, schedule reminders) [PROMIS] |
| 92426-6 | Current level of confidence I can use my own judgment regarding treatment alternatives (including not having treatment) [PROMIS] |
| 92427-4 | Current level of confidence I can travel to my local pharmacy to fill my prescriptions [PROMIS] |
| 92428-2 | Current level of confidence I can take several medications on different schedules [PROMIS] |
| 92429-0 | Current level of confidence I can take my medicine even if it causes mild side effects [PROMIS] |
| 92430-8 | Current level of confidence I can take my medication when there is a change in my usual day (unexpected things happen) [PROMIS] |
| 92431-6 | Current level of confidence I can take my medication when I am working or away from home [PROMIS] |
| 92432-4 | Current level of confidence I can remember to take my medications when there is no one to remind me [PROMIS] |
| 92433-2 | Current level of confidence I can remember to take my medication as prescribed [PROMIS] |
| 92434-0 | Current level of confidence I can remember to refill my prescriptions before they run out [PROMIS] |
| 92435-7 | Current level of confidence I can manage my medication without help [PROMIS] |
| 92436-5 | Current level of confidence I can list my medications, including the doses and schedule [PROMIS] |
| 92437-3 | Current level of confidence I can get help when I am not sure how to take my medicine [PROMIS] |
| 92438-1 | Current level of confidence I can follow directions when my doctor changes my medications [PROMIS] |
| 92439-9 | Current level of confidence I can follow a full treatment plan (including medication, diet, physical activity) [PROMIS] |
| 92440-7 | Current level of confidence I can fit my medication schedule into my daily routine [PROMIS] |
| 92441-5 | Current level of confidence I can find information to learn more about my treatment [PROMIS] |
| 92442-3 | Current level of confidence I can figure out what treatment I need when my symptoms change [PROMIS] |
| 92443-1 | Current level of confidence I can continue my treatment when traveling [PROMIS] |
| 92444-9 | Current level of confidence I can continue my treatment when I am not feeling well [PROMIS] |
| 92445-6 | Current level of confidence I can actively participate in decisions about my treatment [PROMIS] |
| 92446-4 | Document key words |
| 92447-2 | Document synopsis |
| 92448-0 | PROMIS self-efficacy for managing symptoms - version 1.0 T-score |
| 92449-8 | PROMIS item bank - self-efficacy for managing symptoms - version 1.0 |
| 92450-6 | Current level of confidence I know what to do when my symptoms worsen [PROMIS] |
| 92451-4 | Current level of confidence I can work with my doctor to manage my symptoms [PROMIS] |
| 92452-2 | Current level of confidence I can still accomplish most of my goals in life, despite my symptoms [PROMIS] |
| 92453-0 | Current level of confidence I can rely on my judgment to manage my symptoms, even when others disagree with me [PROMIS] |
| 92454-8 | Current level of confidence I can reduce my symptoms to my satisfaction [PROMIS] |
| 92455-5 | Current level of confidence I can recognize when my symptoms change [PROMIS] |
| 92456-3 | Current level of confidence I can manage unexpected or new symptoms [PROMIS] |
| 92457-1 | Current level of confidence I can manage my symptoms when I am tired [PROMIS] |
| 92458-9 | Current level of confidence I can manage my symptoms when I am in an unfamiliar place [PROMIS] |
| 92459-7 | Current level of confidence I can manage my symptoms when I am at home [PROMIS] |
| 92460-5 | Current level of confidence I can manage my symptoms in a public place [PROMIS] |
| 92461-3 | Current level of confidence I can manage my symptoms during my daily activities [PROMIS] |
| 92462-1 | Current level of confidence I can manage my symptoms as well as other people with symptoms like mine [PROMIS] |
| 92463-9 | Current level of confidence I can make a moderate reduction in my symptoms [PROMIS] |
| 92464-7 | Current level of confidence I can maintain my sense of humor, despite my symptoms [PROMIS] |
| 92465-4 | Current level of confidence I can live a normal life, despite my symptoms [PROMIS] |
| 92466-2 | Current level of confidence I can keep my symptoms from interfering with the work I need to do [PROMIS] |
| 92467-0 | Current level of confidence I can keep my symptoms from interfering with relationships with friends and family [PROMIS] |
| 92468-8 | Current level of confidence I can keep my symptoms from interfering with my sleep [PROMIS] |
| 92469-6 | Current level of confidence I can keep my symptoms from interfering with my recreational activities [PROMIS] |
| 92470-4 | Current level of confidence I can keep my symptoms from interfering with my personal care [PROMIS] |
| 92471-2 | Current level of confidence I can find the information I need to manage my symptoms [PROMIS] |
| 92472-0 | Current level of confidence I can enjoy things, despite my symptoms [PROMIS] |
| 92473-8 | Current level of confidence I can do something to reduce my symptoms when they worsen [PROMIS] |
| 92474-6 | Current level of confidence I can do something to prevent my symptoms from worsening [PROMIS] |
| 92475-3 | Current level of confidence I can control my symptoms by using methods other than taking medication (for example: relaxation exercises, distraction) [PROMIS] |
| 92476-1 | Current level of confidence I can control my symptoms by taking my medications [PROMIS] |
| 92477-9 | Current level of confidence I can be physically active, despite my symptoms [PROMIS] |
| 92578-4 | PROMIS short form - dyspnea severity 10a - version 1.0 |
| 92579-2 | PROMIS short form - physical function 10b - version 2.0 |
| 92580-0 | PROMIS short form - physical function 10a - version 2.0 |
| 92581-8 | PROMIS pediatric short form - pain behavior 8a - version 1.0 |
| 92582-6 | PROMIS parent proxy short form - meaning and purpose 8a - version 1.0 |
| 92583-4 | PROMIS parent proxy short form - meaning and purpose 4a - version 1.0 |
| 92584-2 | PROMIS parent proxy short form - physical stress experiences 8a - version 1.0 |
| 92585-9 | PROMIS parent proxy short form - physical stress experiences 4a - version 1.0 |
| 92586-7 | PROMIS parent proxy short form - anxiety 8a - version 2.0 |
| 92587-5 | PROMIS parent proxy short form - fatigue 10a - version 2.0 |
| 92588-3 | PROMIS short form - self-efficacy for managing symptoms 8a - version 1.0 |
| 92589-1 | PROMIS short form - self-efficacy for managing symptoms 4a - version 1.0 |
| 92590-9 | PROMIS short form - self-efficacy for managing social interactions 8a - version 1.0 |
| 92591-7 | PROMIS short form - self-efficacy for managing social interactions 4a - version 1.0 |
| 92592-5 | PROMIS short form - self-efficacy for managing medications and treatments 8a - version 1.0 |
| 92593-3 | PROMIS short form - self-efficacy for managing medications and treatments 4a - version 1.0 |
| 92594-1 | PROMIS short form - self-efficacy for managing emotions 8a - version 1.0 |
| 92595-8 | PROMIS short form - self-efficacy for managing emotions 4a - version 1.0 |
| 92596-6 | PROMIS short form - self-efficacy for managing daily activities 8a - version 1.0 |
| 92597-4 | PROMIS short form - self-efficacy for managing daily activities 4a - version 1.0 |
| 92598-2 | PROMIS short form - smoking - social motivations for all smokers 4a - version 1.0 |
| 92599-0 | PROMIS short form - smoking - nicotine dependence for all smokers 8a - version 1.0 |
| 92600-6 | PROMIS short form - smoking - nicotine dependence for all smokers 4a - version 1.0 |
| 92601-4 | PROMIS short form - smoking - negative psychosocial expectancies for all smokers 6a - version 1.0 |
| 92602-2 | PROMIS short form - smoking - negative health expectancies for all smokers 6a - version 1.0 |
| 92603-0 | PROMIS short form - smoking - emotional and sensory expectancies for all smokers 6a - version 1.0 |
| 92604-8 | PROMIS short form - smoking - coping expectancies for all smokers 4a - version 1.0 |
| 92605-5 | PROMIS short form - upper extremity 7a - version 2.0 |
| 92606-3 | PROMIS short form - dyspnea severity 10a - version 1.0 raw score |
| 92607-1 | PROMIS short form - physical function 10b - version 2.0 raw score |
| 92608-9 | PROMIS short form - physical function 10a - version 2.0 raw score |
| 92609-7 | PROMIS pediatric short form - pain behavior 8a - version 1.0 raw score |
| 92610-5 | PROMIS parent proxy short form - meaning and purpose 8a - version 1.0 raw score |
| 92611-3 | PROMIS parent proxy short form - meaning and purpose 4a - version 1.0 raw score |
| 92612-1 | PROMIS parent proxy short form - physical stress experiences 8a - version 1.0 raw score |
| 92613-9 | PROMIS parent proxy short form - physical stress experiences 4a - version 1.0 raw score |
| 92614-7 | PROMIS parent proxy short form - anxiety 8a - version 2.0 raw score |
| 92615-4 | PROMIS parent proxy short form - fatigue 10a - version 2.0 raw score |
| 92616-2 | PROMIS short form - self-efficacy for managing symptoms 8a - version 1.0 raw score |
| 92617-0 | PROMIS short form - self-efficacy for managing symptoms 4a - version 1.0 raw score |
| 92618-8 | PROMIS short form - self-efficacy for managing social interactions 8a - version 1.0 raw score |
| 92619-6 | PROMIS short form - self-efficacy for managing social interactions 4a - version 1.0 raw score |
| 92620-4 | PROMIS short form - self-efficacy for managing medications and treatments 8a - version 1.0 raw score |
| 92621-2 | PROMIS short form - self-efficacy for managing medications and treatments 4a - version 1.0 raw score |
| 92622-0 | PROMIS short form - self-efficacy for managing emotions 8a - version 1.0 raw score |
| 92623-8 | PROMIS short form - self-efficacy for managing emotions 4a - version 1.0 raw score |
| 92624-6 | PROMIS short form - self-efficacy for managing daily activities 8a - version 1.0 raw score |
| 92625-3 | PROMIS short form - self-efficacy for managing daily activities 4a - version 1.0 raw score |
| 92626-1 | PROMIS short form - smoking - social motivations for all smokers 4a - version 1.0 raw score |
| 92627-9 | PROMIS short form - smoking - nicotine dependence for all smokers 8a - version 1.0 raw score |
| 92628-7 | PROMIS short form - smoking - nicotine dependence for all smokers 4a - version 1.0 raw score |
| 92629-5 | PROMIS short form - smoking - negative psychosocial expectancies for all smokers 6a - version 1.0 raw score |
| 92630-3 | PROMIS short form - smoking - negative health expectancies for all smokers 6a - version 1.0 raw score |
| 92631-1 | PROMIS short form - smoking - emotional and sensory expectancies for all smokers 6a - version 1.0 raw score |
| 92632-9 | PROMIS short form - smoking - coping expectancies for all smokers 4a - version 1.0 raw score |
| 92633-7 | PROMIS short form - upper extremity 7a - version 2.0 raw score |
| 92850-7 | Range of motion during assessment period [CMS Assessment] Upper extremity |
| 92851-5 | Range of motion during assessment period [CMS Assessment] Lower extremity |
| 92908-3 | Functional limitation in range of motion during assessment period [CMS Assessment] |
| 92939-8 | Number of residence renovations |
| 92940-6 | Residence renovation completion date |
| 92941-4 | Residence renovation start date |
| 92945-5 | Intent of carbon monoxide exposure |
| 93025-5 | Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE] |
| 93026-3 | Do you feel physically and emotionally safe where you currently live [PRAPARE] |
| 93027-1 | Are you a refugee |
| 93028-9 | Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE] |
| 93029-7 | How often do you see or talk to people that you care about and feel close to [PRAPARE] |
| 93030-5 | Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living |
| 93031-3 | Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE] |
| 93033-9 | Are you worried about losing your housing [PRAPARE] |
| 93034-7 | Discharged from the U.S. Armed Forces |
| 93035-4 | Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE] |
| 93039-6 | Optional additional questions [PRAPARE] |
| 93040-4 | Social and emotional health [PRAPARE] |
| 93041-2 | Money and resources [PRAPARE] |
| 93042-0 | Family and home [PRAPARE] |
| 93043-8 | Personal characteristics [PRAPARE] |
| 93049-5 | MDS v3.0 - RAI v1.17.2 - Correction request - SP, SD during assessment period [CMS Assessment] |
| 93050-3 | MDS v3.0 - RAI v1.17.2 - Cognitive patterns - IPA, OSA during assessment period [CMS Assessment] |
| 93051-1 | MDS v3.0 - RAI v1.17.2 - Insurance billing during assessment period [CMS Assessment] |
| 93052-9 | MDS v3.0 - RAI v1.17.2 - Alternate state Medicaid billing during assessment period [CMS Assessment] |
| 93053-7 | MDS v3.0 - RAI v1.17.2 - State Medicaid billing during assessment period [CMS Assessment] |
| 93054-5 | MDS v3.0 - RAI v1.17.2 - Assessment administration - ND, SD during assessment period [CMS Assessment] |
| 93055-2 | Outcome and assessment information set (OASIS) form - version D1 during assessment period [CMS Assessment] |
| 93056-0 | OASIS D1 - Patient history and diagnoses - follow-up during assessment period [CMS Assessment] |
| 93057-8 | OASIS D1 - ADL and IADLs - follow-up during assessment period [CMS Assessment] |
| 93058-6 | Outcome and assessment information set (OASIS) form - version D1 - Follow-up - recertification or other follow-up during assessment period [CMS Assessment] |
| 93059-4 | Are you feeling bothered, upset, or worried at this point in your pregnancy about the effect of ongoing health problems such as high blood pressure or diabetes on your pregnancy [NuPDQ] |
| 93060-2 | Are you feeling bothered, upset, or worried at this point in your pregnancy about feeling tired and having low energy during your pregnancy [NuPDQ] |
| 93061-0 | Are you feeling bothered, upset, or worried at this point in your pregnancy about paying for your medical care during pregnancy [NuPDQ] |
| 93062-8 | Are you feeling bothered, upset, or worried at this point in your pregnancy about changes in your weight and body shape during pregnancy [NuPDQ] |
| 93063-6 | Are you feeling bothered, upset, or worried at this point in your pregnancy about whether you might have an unhealthy baby [NuPDQ] |
| 93064-4 | Are you feeling bothered, upset, or worried at this point in your pregnancy about physical symptoms of pregnancy such as vomiting [NuMoM2b] |
| 93065-1 | Are you feeling bothered, upset, or worried at this point in your pregnancy about physical symptoms of pregnancy such as swollen feet [NuMoM2b] |
| 93066-9 | Are you feeling bothered, upset, or worried at this point in your pregnancy about physical symptoms of pregnancy such as backaches [NuMoM2b] |
| 93067-7 | Are you feeling bothered, upset, or worried at this point in your pregnancy about the quality of your medical care during pregnancy [NuPDQ] |
| 93068-5 | Are you feeling bothered, upset, or worried at this point in your pregnancy about working or caring for your family during your pregnancy [NuPDQ] |
| 93069-3 | Are you feeling bothered, upset, or worried at this point in your pregnancy about whether the baby might be affected by alcohol, cigarettes, or drugs that you have taken [NuPDQ] |
| 93070-1 | Are there other things that you are bothered, upset or worried about that have to do with your pregnancy, the birth, or the baby [NuPDQ] |
| 93071-9 | Other things you are feeling bothered, upset or worried about [NuPDQ] |
| 93072-7 | Are you feeling bothered, upset, or worried at this point in your pregnancy about paying for the baby's clothes, food, or medical care [NuPDQ] |
| 93073-5 | Are you feeling bothered, upset, or worried at this point in your pregnancy about taking care of a newborn baby [NuPDQ] |
| 93074-3 | Are you feeling bothered, upset, or worried at this point in your pregnancy about pain during labor and delivery [NuPDQ] |
| 93075-0 | Are you feeling bothered, upset, or worried at this point in your pregnancy about whether the baby might come too early [NuPDQ] |
| 93076-8 | Are you feeling bothered, upset, or worried at this point in your pregnancy about physical symptoms of pregnancy such as vomiting, swollen feet, or backaches [NuPDQ] |
| 93077-6 | Physical symptom of pregnancy that you are feeling bothered, upset or worried about [NuPDQ] |
| 93078-4 | Are you feeling bothered, upset, or worried at this point in your pregnancy about changes in your relationships with other people due to having a baby [NuPDQ] |
| 93079-2 | Person who you are feeling bothered, upset or worried about having a relationship change with due to having a baby [NuPDQ] |
| 93080-0 | Are you feeling bothered, upset, or worried at this point in your pregnancy about what will happen during labor and delivery [NuPDQ] |
| 93081-8 | Are you feeling bothered, upset, or worried at this point in your pregnancy about working at a job after the baby comes [NuPDQ] |
| 93082-6 | Are you feeling bothered, upset, or worried at this point in your pregnancy about getting day care, babysitters, or help to watch the baby after it comes [NuPDQ] |
| 93083-4 | Revised Prenatal Distress Questionnaire (NuPDQ) - Concurrent Self-Administered Version |
| 93084-2 | NuMoM2b Difficulties in Pregnancy form [NuMoM2b] |
| 93087-5 | Total score [NuPDQ] |
| 93088-3 | Quality of Working Life Questionnaire for Cancer Survivors [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93089-1 | During the past 4 weeks, working gives me structure in my life [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93090-9 | During the past 4 weeks, I think it is good to work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93091-7 | During the past 4 weeks, I consider that my work gives me a goal in life [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93092-5 | During the past 4 weeks, I consider my work important [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93093-3 | During the past 4 weeks, I do my work well [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93094-1 | During the past 4 weeks, I am self-confident in my work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93095-8 | During the past 4 weeks, I am suited to my work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93096-6 | During the past 4 weeks, I have control over the work I do [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93097-4 | During the past 4 weeks, I feel powerless in my work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93098-2 | During the past 4 weeks, I feel there is a positive atmosphere in my working environment [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93099-0 | During the past 4 weeks, I have the feeling I am taken seriously by people in my working environment [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93100-6 | During the past 4 weeks, I am content with my work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93101-4 | During the past 4 weeks, I have good relations with my colleagues [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93102-2 | During the past 4 weeks, I feel valuable to my colleagues [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93103-0 | During the past 4 weeks, my immediate superior understands my health situation and possible health problems [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93104-8 | During the past 4 weeks, I have good relations with my immediate superior [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93105-5 | During the past 4 weeks, I consider that employees with health problems are treated well in my organization [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93106-3 | During the past 4 weeks, I am content with the fringe benefits provided by my employer [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93107-1 | During the past 4 weeks, I am content with my current income [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93108-9 | During the past 4 weeks, because of my health situation I have problems in my work with fatigue/lack of energy [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93109-7 | During the past 4 weeks, I am limited in my work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93110-5 | During the past 4 weeks, because of my health situation I have little trust in my own body [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93111-3 | During the past 4 weeks, because of my health situation I feel uncertain about the future [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93112-1 | Total score [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93113-9 | Meaning of work [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93114-7 | Perception of your work situation [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93115-4 | Atmosphere in your working environment [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93116-2 | Understanding and recognition in your organization [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93117-0 | Problems due to your health situation [Quality of Working Life Questionnaire for Cancer Survivors] |
| 93118-8 | Difficulties in pregnancy total score [NuMoM2b] |
| 93128-7 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment] |
| 93153-5 | Drug classes of medications taken during assessment period [CMS Assessment] |
| 93154-3 | Drug classes that have an indication documented during assessment period [CMS Assessment] |
| 93155-0 | IRF-PAI v4.0, LCDS v5.00, OASIS E - High risk drug classes - use and indication during assessment period [CMS Assessment] |
| 93156-8 | How much of the time has pain made it hard for you to sleep at night during assessment period [CMS Assessment] |
| 93157-6 | How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy [SILS] |
| 93158-4 | How often have you limited your day-to-day activities because of pain during assessment period [CMS Assessment] |
| 93159-2 | How often do you feel lonely or isolated from those around you during assessment period [CMS Assessment] |
| 93160-0 | How often have you limited your participation in rehabilitation therapy sessions due to pain over during assessment period [CMS Assessment] |
| 93161-8 | IRF-PAI v4.0 - Administrative information during assessment period [CMS Assessment] |
| 93162-6 | IRF-PAI v4.0 - Cognitive patterns - admission during assessment period [CMS Assessment] |
| 93163-4 | IRF-PAI v4.0 - Cognitive patterns - discharge during assessment period [CMS Assessment] |
| 93164-2 | IRF-PAI v4.0 - Health conditions - admission during assessment period [CMS Assessment] |
| 93165-9 | IRF-PAI v4.0 - Hearing, speech, and vision - admission during assessment period [CMS Assessment] |
| 93166-7 | IRF-PAI v4.0, OASIS E - Hearing, speech, and vision - ROC, DC during assessment period [CMS Assessment] |
| 93167-5 | IRF-PAI v4.0 - Identification information during assessment period [CMS Assessment] |
| 93168-3 | IRF-PAI v4.0, LCDS v5.00 - Medications - admission during assessment period [CMS Assessment] |
| 93169-1 | IRF-PAI v4.0, LCDS v5.00 - Medications - discharge and expired during assessment period [CMS Assessment] |
| 93170-9 | IRF-PAI v4.0, LCDS v5.00, OASIS E - Mood during assessment period [CMS Assessment] |
| 93171-7 | IRF-PAI v4.0 - Quality indicators - admission during assessment period [CMS Assessment] |
| 93172-5 | IRF-PAI v4.0 - Quality indicators - discharge during assessment period [CMS Assessment] |
| 93173-3 | IRF-PAI v4.0 - Special treatments, procedures, and programs - admission during assessment period [CMS Assessment] |
| 93174-1 | IRF-PAI v4.0 - Special treatments, procedures, and programs - discharge during assessment period [CMS Assessment] |
| 93175-8 | IRF-PAI v4.0 - Swallowing/nutritional status - admission during assessment period [CMS Assessment] |
| 93176-6 | IRF-PAI v4.0, LCDS v5.00 - Swallowing/nutritional status - discharge during assessment period [CMS Assessment] |
| 93177-4 | IRF-PAI v4.0, LCDS v5.00 - Health conditions - discharge or expired during assessment period [CMS Assessment] |
| 93178-2 | Nutritional approaches during assessment period [CMS Assessment] |
| 93180-8 | IRF-PAI v4.0, LCDS v5.00 - Nutritional approaches - last 7D and discharge during assessment period [CMS Assessment] |
| 93181-6 | Provision of current reconciled medication list to patient at discharge during assessment period [CMS Assessment] |
| 93182-4 | Provision of current reconciled medication list to subsequent provider at discharge during assessment period [CMS Assessment] |
| 93183-2 | Route of current reconciled medication list transmission to patient during assessment period [CMS Assessment] |
| 93184-0 | Route of current reconciled medication list transmission to subsequent provider during assessment period [CMS Assessment] |
| 93185-7 | Special treatments, procedures, and programs at discharge [CMS Assessment] |
| 93188-1 | IRF-PAI v4.0 - Administrative information - discharge during assessment period [CMS Assessment] |
| 93202-0 | Ventilator weaning status during assessment period [CMS Assessment] |
| 93203-8 | LCDS v5.00 - Spontaneous breathing trial during assessment period [CMS Assessment] |
| 93204-6 | LCDS v5.00 - Special treatments, procedures, and programs - discharge during assessment period [CMS Assessment] |
| 93205-3 | LCDS v5.00 - Special treatments, procedures, and programs - admission during assessment period [CMS Assessment] |
| 93207-9 | LCDS v5.00 - Swallowing/nutritional status - admission during assessment period [CMS Assessment] |
| 93208-7 | LCDS v5.00 - Health conditions - admission during assessment period [CMS Assessment] |
| 93209-5 | LCDS v5.00 - Functional abilities and goals - planned discharge [CMS Assessment] |
| 93210-3 | LCDS v5.00 - Functional abilities and goals - admission during assessment period [CMS Assessment] |
| 93211-1 | LCDS v5.00 - Cognitive patterns - unplanned discharge during assessment period [CMS Assessment] |
| 93213-7 | LCDS v5.00 - Cognitive patterns - admission and planned discharge during assessment period [CMS Assessment] |
| 93214-5 | LCDS v5.00 - Hearing, speech, and vision - discharge during assessment period [CMS Assessment] |
| 93215-2 | LCDS v5.00 - Hearing, speech, and vision - admission during assessment period [CMS Assessment] |
| 93216-0 | LCDS v5.00 - Administrative information - expired during assessment period [CMS Assessment] |
| 93217-8 | LCDS v5.00 - Administrative information - planned discharge during assessment period [CMS Assessment] |
| 93218-6 | LCDS v5.00 - Administrative information - admission during assessment period [CMS Assessment] |
| 93219-4 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 5.00 during assessment period [CMS Assessment] |
| 93220-2 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.00 during assessment period [CMS Assessment] |
| 93221-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.00 during assessment period [CMS Assessment] |
| 93222-8 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.00 during assessment period [CMS Assessment] |
| 93223-6 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 5.00 during assessment period [CMS Assessment] |
| 93228-5 | LCDS v5.00 - Patient demographic information - unplanned discharge and expired during assessment period [CMS Assessment] |
| 93229-3 | LCDS v5.00 - Patient demographic information - admission during assessment period [CMS Assessment] |
| 93230-1 | LCDS v5.00 - Patient demographic information - planned discharge during assessment period [CMS Assessment] |
| 93231-9 | LCDS v5.00 - Administrative information - unplanned discharge during assessment period [CMS Assessment] |
| 93245-9 | Columbia - suicide severity rating scale - lifetime recent [C-SSRS] |
| 93246-7 | Wish to be dead 1 month |
| 93247-5 | Non-specific active suicidal thoughts 1 month |
| 93248-3 | Active suicidal ideation with any methods (not plan) without intent to act 1 month |
| 93249-1 | Active suicidal ideation with some intent to act, without specific plan 1 month |
| 93250-9 | Active suicidal ideation with specific plan and intent 1 month |
| 93251-7 | Duration of most severe suicidal ideation Lifetime [C-SSRS] |
| 93252-5 | Duration of most severe suicidal ideation 1 month [C-SSRS] |
| 93253-3 | Actual suicide attempt Lifetime |
| 93254-1 | Actual suicide attempts # Lifetime |
| 93255-8 | Actual suicide attempt 3 months |
| 93256-6 | Actual suicide attempts # 3 months |
| 93257-4 | Has subject engaged in non-suicidal self-injurious behavior Lifetime |
| 93258-2 | Has subject engaged in non-suicidal self-injurious behavior 3 months |
| 93259-0 | Interrupted suicide attempt Lifetime |
| 93260-8 | Interrupted suicide attempts # Lifetime |
| 93261-6 | Interrupted suicide attempt 3 months |
| 93262-4 | Interrupted suicide attempts # 3 months |
| 93263-2 | Aborted or self-interrupted suicide attempt Lifetime |
| 93264-0 | Aborted or self-interrupted suicide attempts # Lifetime |
| 93265-7 | Aborted or self-interrupted suicide attempt 3 months |
| 93266-5 | Aborted or self-interrupted suicide attempts # 3 months |
| 93267-3 | Preparatory acts or suicidal behavior Lifetime |
| 93268-1 | Preparatory acts or suicidal behaviors # Lifetime |
| 93269-9 | Preparatory acts or suicidal behavior 3 months |
| 93270-7 | Preparatory acts or suicidal behaviors # 3 months |
| 93271-5 | Actual lethality/medical damage most lethal suicide attempt Lifetime [C-SSRS] |
| 93272-3 | Potential lethality most lethal suicide attempt Lifetime [C-SSRS] |
| 93275-6 | Date of most lethal suicide attempt |
| 93278-0 | Suicidal ideation [C-SSRS] |
| 93279-8 | Most severe suicidal ideation description 1 month |
| 93280-6 | Most severe suicidal ideation description Lifetime |
| 93281-4 | Potential lethality initial/first suicide attempt [C-SSRS] |
| 93282-2 | Potential lethality most recent suicide attempt [C-SSRS] |
| 93283-0 | Actual lethality/medical damage initial/first suicide attempt type [C-SSRS] |
| 93284-8 | Actual lethality/medical damage most recent suicide attempt [C-SSRS] |
| 93285-5 | Reasons for most severe suicidal ideation 1 month [C-SSRS] |
| 93286-3 | Reasons for most severe suicidal ideation Lifetime [C-SSRS] |
| 93287-1 | Deterrents of most severe suicidal ideation 1 month [C-SSRS] |
| 93288-9 | Deterrents of most severe suicidal ideation Lifetime [C-SSRS] |
| 93289-7 | Controllability of most severe suicidal ideation 1 month [C-SSRS] |
| 93290-5 | Controllability of most severe suicidal ideation Lifetime [C-SSRS] |
| 93291-3 | Frequency of most severe suicidal ideation 1 month [C-SSRS] |
| 93292-1 | Frequency of most severe suicidal ideation Lifetime [C-SSRS] |
| 93293-9 | Most severe suicidal ideation 1 month |
| 93294-7 | Most severe suicidal ideation Lifetime |
| 93295-4 | Active suicidal ideation with specific plan and intent Lifetime |
| 93296-2 | Active suicidal ideation with some intent to act, without specific plan Lifetime |
| 93297-0 | Active suicidal ideation with any methods (not plan) without intent to act Lifetime |
| 93298-8 | Non-specific active suicidal thoughts Lifetime |
| 93299-6 | Wish to be dead Lifetime |
| 93301-0 | Date of initial/first suicide attempt |
| 93302-8 | Date of most recent suicide attempt |
| 93303-6 | Intensity of ideation [C-SSRS] |
| 93304-4 | Suicidal behavior [C-SSRS] |
| 93305-1 | Lethality [C-SSRS] |
| 93309-3 | Hearing.ability to hear during 3 day assessment period [CMS Assessment] |
| 93310-1 | Vision.ability to see in adequate light during 3 day assessment period [CMS Assessment] |
| 93373-9 | Columbia - suicide severity rating scale screener - recent [C-SSRS] |
| 93374-7 | Suicide risk level |
| 93414-1 | Altered level of consciousness in last 3 day [CAM.CMS] |
| 93485-1 | Columbia - suicide severity rating scale - very young child or cognitively impaired - lifetime recent [C-SSRS] |
| 93486-9 | Has subject engaged in self-injurious behavior, intent unknown 3 months |
| 93487-7 | Has subject engaged in self-injurious behavior, intent unknown Lifetime |
| 93598-1 | Intensity of ideation [C-SSRS.PCI] |
| 93599-9 | Frequency of most severe suicidal ideation 1 month [C-SSRS.PCI] |
| 93600-5 | Frequency of most severe suicidal ideation Lifetime [C-SSRS.PCI] |
| 93667-4 | WellRx Questionnaire - revised |
| 93668-2 | Did you or others you live with eat smaller meals or skip meals because you didn't have money for food in the past 2 months [WellRx] |
| 93669-0 | Are you homeless or worried that you might be in the future [WellRx] |
| 93670-8 | Do you have trouble paying for your gas or electricity bills [WellRx] |
| 93671-6 | Do you have trouble finding or paying for transportation [WellRx] |
| 93672-4 | Do you need daycare, or better daycare, for your kids [WellRx] |
| 93673-2 | Are you unemployed or without regular income [WellRx] |
| 93674-0 | Do you need help finding a better job [WellRx] |
| 93675-7 | Do you need help getting more education [WellRx] |
| 93676-5 | Are you concerned about someone in your home using drugs or alcohol [WellRx] |
| 93677-3 | Do you need help with legal issues [WellRx] |
| 93678-1 | Have you been at the emergency department more than twice in the last 6 months [WellRx] |
| 93680-7 | Hospitalized in the last 6 months |
| 93681-5 | Number of times hospitalized in last 6 months |
| 93682-3 | Do you feel unsafe in your daily life [WellRx] |
| 93683-1 | Is anyone in your home threatening or abusing you [WellRx] |
| 94041-1 | My practice makes it easy for me to get care [PCPCM] |
| 94042-9 | My practice is able to provide most of my care [PCPCM] |
| 94043-7 | In caring for me, my doctor considers all the factors that affect my health [PCPCM] |
| 94044-5 | My practice coordinates the care I get from multiple places [PCPCM] |
| 94045-2 | My doctor or practice knows me as a person [PCPCM] |
| 94046-0 | My doctor and I have been through a lot together [PCPCM] |
| 94047-8 | My doctor or practice stands up for me [PCPCM] |
| 94048-6 | The care I get takes into account knowledge of my family [PCPCM] |
| 94049-4 | The care I get in this practice is informed by knowledge of my community [PCPCM] |
| 94050-2 | Over time, my practice helps me to stay healthy [PCPCM] |
| 94051-0 | Over time, my practice helps me to meet my goals [PCPCM] |
| 94052-8 | Mean score [PCPCM] |
| 94066-8 | Person-Centered Primary Care Measure [PCPCM] |
| 94161-7 | PROMIS parent proxy item bank - mobility - version 1.0 |
| 94162-5 | PROMIS parent proxy item bank - pain interference - version 1.0 |
| 94163-3 | PROMIS parent proxy pain interference - version 1.0 T-score |
| 94164-1 | PROMIS parent proxy - global health 7 - version 1.0 raw score |
| 94165-8 | PROMIS parent proxy - global health 7 - version 1.0 |
| 94166-6 | PROMIS parent proxy short form - mobility 8 - version 1.0 |
| 94167-4 | PROMIS parent proxy short form mobility 8 - version 1.0 raw score |
| 94169-0 | PROMIS parent proxy short form - physical function - upper extremity 8 - version 1.0 |
| 94170-8 | PROMIS parent proxy physical function - upper extremity - version 1.0 raw score |
| 94171-6 | My child could pour a drink from a full pitcher in past 7D [PROMIS.PARENTPROXY] |
| 94172-4 | My child could open a jar by himself or herself in past 7D [PROMIS.PARENTPROXY] |
| 94173-2 | My child could pull open heavy doors in past 7D [PROMIS.PARENTPROXY] |
| 94174-0 | My child could use a key to unlock a door in past 7D [PROMIS.PARENTPROXY] |
| 94175-7 | My child could pull a shirt on over his or her head without help in past 7D [PROMIS.PARENTPROXY] |
| 94176-5 | My child could open the rings in school binders in past 7D [PROMIS.PARENTPROXY] |
| 94177-3 | My child could button his or her shirt or pants in past 7D [PROMIS.PARENTPROXY] |
| 94178-1 | My child could put on his or her shoes without help in past 7D [PROMIS.PARENTPROXY] |
| 94179-9 | PROMIS parent proxy short form - pain interference 8 - version 1.0 raw score |
| 94180-7 | PROMIS parent proxy short form - pain interference 8 - version 1.0 |
| 94181-5 | PROMIS parent proxy global health - version 1.0 T-score |
| 94182-3 | PROMIS parent proxy physical function - upper extremity - version 1.0 T-score |
| 94257-3 | PROMIS pediatric - global health 7 - version 1.0 |
| 94258-1 | PROMIS pediatric - global health 7 - version 1.0 raw score |
| 94263-1 | PROMIS pediatric - global health 7 - version 1.0 T-score |
| 94328-2 | Patient Health Questionnaire 8 item (PHQ-8) total score [Reported] |
| 94329-0 | Patient Health Questionnaire 8 item (PHQ-8) [Reported] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
| 94849-7 | FASI v1.0 - Self-care - usual performance during assessment period [CMS Assessment] |
| 94850-5 | FASI v1.0 - Self-care - most dependent performance [CMS Assessment] |
| 94851-3 | FASI v1.0 - Mobility - usual performance during assessment period [CMS Assessment] |
| 94852-1 | FASI v1.0 - Mobility - most dependent performance [CMS Assessment] |
| 94876-0 | Self-care priorities for the next 6 months during assessment period [CMS Assessment] |
| 94877-8 | Mobility priorities for the next 6 months during assessment period [CMS Assessment] |
| 94878-6 | Instrumental activities of daily living priorities for the next 6 months during assessment period [CMS Assessment] |
| 94879-4 | Need for and availability of a cane/crutch during assessment period [CMS Assessment] |
| 94880-2 | Need for and availability of a walker during assessment period [CMS Assessment] |
| 94881-0 | Need for and availability of a standard folding walker during assessment period [CMS Assessment] |
| 94882-8 | Need for and availability of a walker with seat during assessment period [CMS Assessment] |
| 94883-6 | Need for and availability of a walker with wheels during assessment period [CMS Assessment] |
| 94884-4 | Need for and availability of a wheelchair during assessment period [CMS Assessment] |
| 94885-1 | Need for and availability of a manual wheelchair during assessment period [CMS Assessment] |
| 94886-9 | Need for and availability of a motorized wheelchair/scooter during assessment period [CMS Assessment] |
| 94887-7 | Need for and availability of a limb prosthesis during assessment period [CMS Assessment] |
| 94888-5 | Need for and availability of a specialized seating pad during assessment period [CMS Assessment] |
| 94889-3 | Need for and availability of a mechanical lift during assessment period [CMS Assessment] |
| 94890-1 | Need for and availability of a reacher/grabber during assessment period [CMS Assessment] |
| 94891-9 | Need for and availability of a sock aid during assessment period [CMS Assessment] |
| 94892-7 | Need for and availability of an orthotic/brace during assessment period [CMS Assessment] |
| 94893-5 | Need for and availability of a bed rail during assessment period [CMS Assessment] |
| 94894-3 | Need for and availability of an electronic bed during assessment period [CMS Assessment] |
| 94895-0 | Need for and availability of grab bars during assessment period [CMS Assessment] |
| 94896-8 | Need for and availability of a transfer board during assessment period [CMS Assessment] |
| 94897-6 | Need for and availability of a shower/commode chair during assessment period [CMS Assessment] |
| 94898-4 | Need for and availability of a walk/wheel-in shower during assessment period [CMS Assessment] |
| 94899-2 | Need for and availability of glasses or contact lenses during assessment period [CMS Assessment] |
| 94900-8 | Need for and availability of a hearing aid during assessment period [CMS Assessment] |
| 94901-6 | Need for and availability of a communication device during assessment period [CMS Assessment] |
| 94902-4 | Need for and availability of stair rails during assessment period [CMS Assessment] |
| 94903-2 | Need for and availability of a lift chair during assessment period [CMS Assessment] |
| 94904-0 | Need for and availability of ramps during assessment period [CMS Assessment] |
| 94905-7 | Need for and availability of a raised toilet seat during assessment period [CMS Assessment] |
| 94906-5 | Need for and availability of a glucometer during assessment period [CMS Assessment] |
| 94907-3 | Need for and availability of Continuous Positive Airway Pressure device during assessment period [CMS Assessment] |
| 94908-1 | Need for and availability of an oxygen concentrator during assessment period [CMS Assessment] |
| 94909-9 | Assistive devices needed during assessment period [CMS Assessment] |
| 94910-7 | Need for and availability of other assistive devices during assessment period [CMS Assessment] |
| 94911-5 | Living arrangement priorities for the next 6 months during assessment period [CMS Assessment] |
| 94912-3 | Availability of caregiver assistance during assessment period [CMS Assessment] |
| 94913-1 | Level of paid caregiver assistance in the past month [CMS Assessment] |
| 94914-9 | Level of unpaid caregiver assistance in the past month [CMS Assessment] |
| 94915-6 | Paid caregiver's ability and willingness to provide self-care assistance during assessment period [CMS Assessment] |
| 94916-4 | Unpaid caregiver's ability and willingness to provide self-care assistance during assessment period [CMS Assessment] |
| 94917-2 | Paid caregiver's ability and willingness to provide mobility assistance during assessment period [CMS Assessment] |
| 94918-0 | Unpaid caregiver's ability and willingness to provide mobility assistance during assessment period [CMS Assessment] |
| 94919-8 | Paid caregiver's ability and willingness to provide instrumental activities of daily living assistance during assessment period [CMS Assessment] |
| 94920-6 | Unpaid caregiver's ability and willingness to provide instrumental activities of daily living assistance during assessment period [CMS Assessment] |
| 94921-4 | Paid caregiver's ability and willingness to provide medication administration assistance during assessment period [CMS Assessment] |
| 94922-2 | Unpaid caregiver's ability and willingness to provide medication administration assistance during assessment period [CMS Assessment] |
| 94923-0 | Paid caregiver's ability and willingness to provide medical procedure/treatment assistance during assessment period [CMS Assessment] |
| 94924-8 | Unpaid caregiver's ability and willingness to provide medical procedure/treatment assistance during assessment period [CMS Assessment] |
| 94925-5 | Paid caregiver's ability and willingness to provide management of equipment assistance during assessment period [CMS Assessment] |
| 94926-3 | Unpaid caregiver's ability and willingness to provide management of equipment assistance during assessment period [CMS Assessment] |
| 94927-1 | Paid caregiver's ability and willingness to provide supervision during assessment period [CMS Assessment] |
| 94928-9 | Unpaid caregiver's ability and willingness to provide supervision during assessment period [CMS Assessment] |
| 94929-7 | Paid caregiver's ability and willingness to provide advocacy or facilitation of person's participation during assessment period [CMS Assessment] |
| 94930-5 | Unpaid caregiver's ability and willingness to provide advocacy or facilitation of person's participation during assessment period [CMS Assessment] |
| 94931-3 | Caregiving priorities for the next 6 months during assessment period [CMS Assessment] |
| 94932-1 | Does the patient walk during assessment period [CMS Assessment] |
| 94933-9 | Eating - most dependent performance during the past month [CMS Assessment] |
| 94934-7 | Oral hygiene - most dependent performance during the past month [CMS Assessment] |
| 94935-4 | Wash upper body - most dependent performance during the past month [CMS Assessment] |
| 94936-2 | Shower/bathe self - most dependent performance during the past month [CMS Assessment] |
| 94937-0 | Upper body dressing - most dependent performance during the past month [CMS Assessment] |
| 94938-8 | Lower body dressing - most dependent performance during the past month [CMS Assessment] |
| 94939-6 | Putting on and taking off footwear - most dependent performance during the past month [CMS Assessment] |
| 94940-4 | Roll left and right - most dependent performance during the past month [CMS Assessment] |
| 94941-2 | Sit to lying - most dependent performance during the past month [CMS Assessment] |
| 94942-0 | Lying to sitting on side of bed - most dependent performance during the past month [CMS Assessment] |
| 94943-8 | Sit to stand - most dependent performance during the past month [CMS Assessment] |
| 94944-6 | Chair/bed-to-chair transfer - most dependent performance during the past month [CMS Assessment] |
| 94945-3 | Toilet transfer - most dependent performance during the past month [CMS Assessment] |
| 94946-1 | Car transfer - most dependent performance during the past month [CMS Assessment] |
| 94947-9 | Walk 10 feet - most dependent performance during the past month [CMS Assessment] |
| 94948-7 | Walk 50 feet with two turns - most dependent performance during the past month [CMS Assessment] |
| 94949-5 | Walk 150 feet - most dependent performance during the past month [CMS Assessment] |
| 94950-3 | Walking 10 feet on uneven surfaces - most dependent performance during the past month [CMS Assessment] |
| 94951-1 | Go up and down a curb/step - most dependent performance during the past month [CMS Assessment] |
| 94952-9 | Go up and down 4 steps - most dependent performance during the past month [CMS Assessment] |
| 94953-7 | Go up and down 12 steps - most dependent performance during the past month [CMS Assessment] |
| 94954-5 | Picking up object - most dependent performance during the past month [CMS Assessment] |
| 94955-2 | Walks indoors - most dependent performance during the past month [CMS Assessment] |
| 94956-0 | Carries something in both hands - most dependent performance during the past month [CMS Assessment] |
| 94957-8 | Walks for 15 minutes - most dependent performance during the past month [CMS Assessment] |
| 94958-6 | Walks across a street - most dependent performance during the past month [CMS Assessment] |
| 94959-4 | Wheel 50 feet with two turns - most dependent performance during the past month [CMS Assessment] |
| 94960-2 | Wheel 150 feet - most dependent performance during the past month [CMS Assessment] |
| 94961-0 | Wheels for 15 minutes - most dependent performance during the past month [CMS Assessment] |
| 94962-8 | Wheels across a street - most dependent performance during the past month [CMS Assessment] |
| 94963-6 | Makes a light cold meal - most dependent performance during the past month [CMS Assessment] |
| 94964-4 | Makes a light hot meal - most dependent performance during the past month [CMS Assessment] |
| 94965-1 | Light daily housework - most dependent performance during the past month [CMS Assessment] |
| 94966-9 | Heavier periodic housework - most dependent performance during the past month [CMS Assessment] |
| 94967-7 | Light shopping- most dependent performance during the past month [CMS Assessment] |
| 94968-5 | Answering telephone call - most dependent performance during the past month [CMS Assessment] |
| 94969-3 | Placing telephone call - most dependent performance during the past month [CMS Assessment] |
| 94970-1 | Medication management.oral medications - most dependent performance during the past month [CMS Assessment] |
| 94971-9 | Medication management.inhalant/mist medications - most dependent performance during the past month [CMS Assessment] |
| 94972-7 | Medication management.injectable medications - most dependent performance during the past month [CMS Assessment] |
| 94973-5 | Simple financial management - most dependent performance during the past month [CMS Assessment] |
| 94974-3 | Complex financial management - most dependent performance during the past month [CMS Assessment] |
| 94975-0 | Living arrangement during the past month [CMS Assessment] |
| 94976-8 | Makes a light cold meal - usual functional ability during assessment period [CMS Assessment] |
| 94977-6 | Makes a light hot meal - usual functional ability during assessment period [CMS Assessment] |
| 94978-4 | Light daily housework - usual functional ability during assessment period [CMS Assessment] |
| 94979-2 | Heavier periodic housework - usual functional ability during assessment period [CMS Assessment] |
| 94980-0 | Light shopping - usual functional ability during assessment period [CMS Assessment] |
| 94981-8 | Answering telephone call - usual functional ability during assessment period [CMS Assessment] |
| 94982-6 | Placing telephone call - usual functional ability during assessment period [CMS Assessment] |
| 94983-4 | Medication management.oral medications - usual functional ability during assessment period [CMS Assessment] |
| 94984-2 | Medication management.inhalant/mist medications - usual functional ability during assessment period [CMS Assessment] |
| 94985-9 | Medication management.injectable medications - usual functional ability during assessment period [CMS Assessment] |
| 94986-7 | Simple financial management - usual functional ability during assessment period [CMS Assessment] |
| 94987-5 | Complex financial management - usual functional ability during assessment period [CMS Assessment] |
| 94988-3 | Living arrangement during assessment period [CMS Assessment] |
| 94989-1 | Wheels across a street - usual functional ability during assessment period [CMS Assessment] |
| 94990-9 | Wheels for 15 minutes - usual functional ability during assessment period [CMS Assessment] |
| 94991-7 | Wheel 150 feet - usual functional ability during assessment period [CMS Assessment] |
| 94992-5 | Wheel 50 feet with two turns - usual functional ability during assessment period [CMS Assessment] |
| 94993-3 | Walks across a street - usual functional ability during assessment period [CMS Assessment] |
| 94994-1 | Walks for 15 minutes - usual functional ability during assessment period [CMS Assessment] |
| 94995-8 | Carries something in both hands - usual functional ability during assessment period [CMS Assessment] |
| 94996-6 | Walks indoors - usual functional ability during assessment period [CMS Assessment] |
| 94997-4 | Picking up object - usual functional ability during assessment period [CMS Assessment] |
| 94998-2 | Go up and down 12 steps - usual functional ability during assessment period [CMS Assessment] |
| 94999-0 | Go up and down 4 steps - usual functional ability during assessment period [CMS Assessment] |
| 95000-6 | Go up and down a curb/step - usual functional ability during assessment period [CMS Assessment] |
| 95001-4 | Walking 10 feet on uneven surfaces - usual functional ability during assessment period [CMS Assessment] |
| 95002-2 | Walk 150 feet - usual functional ability during assessment period [CMS Assessment] |
| 95003-0 | Walk 50 feet with two turns - usual functional ability during assessment period [CMS Assessment] |
| 95004-8 | Walk 10 feet - usual functional ability during assessment period [CMS Assessment] |
| 95005-5 | Car transfer - usual functional ability during assessment period [CMS Assessment] |
| 95006-3 | Toilet transfer - usual functional ability during assessment period [CMS Assessment] |
| 95007-1 | Chair/bed-to-chair transfer - usual functional ability during assessment period [CMS Assessment] |
| 95008-9 | Sit to stand - usual functional ability during assessment period [CMS Assessment] |
| 95009-7 | Lying to sitting on side of bed - usual functional ability during assessment period [CMS Assessment] |
| 95010-5 | Sit to lying - usual functional ability during assessment period [CMS Assessment] |
| 95011-3 | Roll left and right - usual functional ability during assessment period [CMS Assessment] |
| 95012-1 | Putting on/taking off footwear - usual functional ability during assessment period [CMS Assessment] |
| 95013-9 | Lower body dressing - usual functional ability during assessment period [CMS Assessment] |
| 95014-7 | Upper body dressing - usual functional ability during assessment period [CMS Assessment] |
| 95015-4 | Shower/bathe self - usual functional ability during assessment period [CMS Assessment] |
| 95016-2 | Wash upper body - usual functional ability during assessment period [CMS Assessment] |
| 95017-0 | Toileting hygiene - usual functional ability during assessment period [CMS Assessment] |
| 95018-8 | Oral hygiene - usual functional ability during assessment period [CMS Assessment] |
| 95019-6 | Eating - usual functional ability during assessment period [CMS Assessment] |
| 95020-4 | FASI v1.0 - Self-care [CMS Assessment] |
| 95021-2 | Manual wheelchair use during assessment period [CMS Assessment] |
| 95022-0 | Motorized wheelchair/scooter use during assessment period [CMS Assessment] |
| 95023-8 | FASI v1.0 - Mobility [CMS Assessment] |
| 95024-6 | FASI v1.0 - Manual wheelchair - usual performance during assessment period [CMS Assessment] |
| 95025-3 | FASI v1.0 - Manual wheelchair - most dependent performance [CMS Assessment] |
| 95026-1 | FASI v1.0 - Motorized wheelchair/scooter - most dependent performance [CMS Assessment] |
| 95027-9 | FASI v1.0 - Motorized wheelchair/scooter - usual performance during assessment period [CMS Assessment] |
| 95028-7 | FASI v1.0 - Instrumental Activities of Daily Living [CMS Assessment] |
| 95029-5 | FASI v1.0 - Instrumental Activities of Daily Living - usual performance during assessment period [CMS Assessment] |
| 95030-3 | FASI v1.0 - Instrumental Activities of Daily Living - most dependent performance [CMS Assessment] |
| 95031-1 | FASI v1.0 - Assistive Devices for Everyday Activities during assessment period [CMS Assessment] |
| 95032-9 | FASI v1.0 - Functional Abilities and Goals [CMS Assessment] |
| 95033-7 | FASI v1.0 - Preferences for Customary Routine and Activities [CMS Assessment] |
| 95034-5 | FASI v1.0 - Availability of Assistance during assessment period [CMS Assessment] |
| 95035-2 | FASI v1.0 - Availability of Paid and Unpaid Assistance during assessment period [CMS Assessment] |
| 95036-0 | FASI v1.0 - Availability of Paid Assistance during assessment period [CMS Assessment] |
| 95037-8 | FASI v1.0 - Availability of Unpaid Assistance during assessment period [CMS Assessment] |
| 95042-8 | Used or needed assistive devices in the past month [CMS Assessment] |
| 95043-6 | Toileting hygiene - most dependent performance during the past month [CMS Assessment] |
| 95131-9 | FASI v1.0 - Mobility (Wheelchair) [CMS Assessment] |
| 95246-5 | U.S. Household Food Security Survey [U.S. FSS] |
| 95247-3 | Which of these statements best describes the food eaten in your household in the last 12 months [U.S. FSS] |
| 95248-1 | In the last 12 months, we couldn't afford to eat balanced meals [U.S. FSS] |
| 95249-9 | In the last 12 months, did you ever cut the size of your meals or skip meals because there wasn't enough money for food [U.S. FSS] |
| 95250-7 | In the last 12 months, how often did you cut the size of your meals or skip meals because there wasn't enough money for food [U.S. FSS] |
| 95251-5 | In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money for food [U.S. FSS] |
| 95252-3 | In the last 12 months, were you ever hungry but didn't eat because there wasn't enough money for food [U.S. FSS] |
| 95253-1 | In the last 12 months, did you lose weight because there wasn't enough money for food [U.S. FSS] |
| 95254-9 | In the last 12 months, did you ever not eat for a whole day because there wasn't enough money for food [U.S. FSS] |
| 95255-6 | In the last 12 months, how often did you not eat for a whole day because there wasn't enough money for food [U.S. FSS] |
| 95256-4 | In the last 12 months, I relied on only a few kinds of low-cost food to feed my children because I was running out of money to buy food [U.S. FSS] |
| 95257-2 | In the last 12 months, I couldn't feed my children a balanced meal, because I couldn't afford that [U.S. FSS] |
| 95258-0 | In the last 12 months, my children were not eating enough because I just couldn't afford enough food [U.S. FSS] |
| 95259-8 | In the last 12 months, did any of the children ever skip meals because there wasn't enough money for food [U.S. FSS] |
| 95260-6 | In the last 12 months, how often did any of the children skip meals because there wasn't enough money for food [U.S. FSS] |
| 95261-4 | In the last 12 months, were the children ever hungry but you just couldn't afford more food [U.S. FSS] |
| 95262-2 | In the last 12 months, did any of the children ever not eat for a whole day because there wasn't enough money for food [U.S. FSS] |
| 95263-0 | U.S. Household Food Security Survey Score [U.S. FSS] |
| 95264-8 | Food security status [U.S. FSS] |
| 95265-5 | In the last 12 months, did you ever cut the size of any of the children's meals or skip meals because there wasn't enough money for food [U.S. FSS] |
| 95353-9 | U.S. Adult Food Security Survey [U.S. FSS] |
| 95361-2 | U.S. Household Food Security Survey - Six-Item Short Form [U.S. FSS] |
| 95378-6 | U.S. Adult Food Security Survey Score [U.S. FSS] |
| 95379-4 | U.S. Household Food Security Survey - Six-Item Short Form Score [U.S. FSS] |
| 95387-7 | Safe Environment for Every Kid Impression Caregiver [SEEK] |
| 95388-5 | Other things you'd like help with today Caregiver [SEEK] |
| 95389-3 | Have you used an illegal drug or a prescription medication for nonmedical reasons in the past 3 months Caregiver [SEEK] |
| 95390-1 | Four or more drinks in one day in the past 3 months Caregiver |
| 95391-9 | Has a partner threatened, shoved, hit or kicked you or hurt you physically in any way in the past 3 months Caregiver [SEEK] |
| 95392-7 | Have you and a partner fought a lot in the past 3 months Caregiver [SEEK] |
| 95393-5 | Little interest or pleasure in doing things in last 2 weeks Caregiver [Reported.PHQ] |
| 95394-3 | Feeling down, depressed, or hopeless in last 2 weeks Caregiver [Reported.PHQ] |
| 95395-0 | Do you often feel under extreme stress Caregiver [SEEK] |
| 95396-8 | Do you wish you had more help with your child Caregiver [SEEK] |
| 95397-6 | Do you sometimes find you need to slap or hit your child Caregiver [SEEK] |
| 95398-4 | Do you often feel your child is difficult to take care of Caregiver [SEEK] |
| 95399-2 | Within the past 12 months the food we bought just didn't last and we didn't have money to get more Caregiver [U.S. FSS] |
| 95400-8 | Within the past 12 months we worried whether our food would run out before we got money to buy more Caregiver [U.S. FSS] |
| 95402-4 | Would you like us to give you the phone number for poison control Caregiver [SEEK] |
| 95403-2 | Safe Environment for Every Kid parent questionnaire - revised [SEEK] Caregiver |
| 95404-0 | Suicidal behavior [C-SSRS.PCI] |
| 95413-1 | Living arrangement panel [CMS Assessment] |
| 95414-9 | Level of paid and unpaid caregiver assistance [CMS Assessment] |
| 95430-5 | During the past 3 months, how often have you used cannabis |
| 95431-3 | During the past 3 months, how often have you used cocaine |
| 95432-1 | During the past 3 months, how often have you used prescription stimulants |
| 95433-9 | During the past 3 months, how often have you used methamphetamine |
| 95434-7 | During the past 3 months, how often have you used inhalants |
| 95435-4 | During the past 3 months, how often have you used sedatives or sleeping pills |
| 95436-2 | During the past 3 months, how often have you used hallucinogens |
| 95437-0 | During the past 3 months, how often have you used street opioids |
| 95438-8 | During the past 3 months, how often have you used prescription opioids |
| 95439-6 | During the past 3 months, how often have you used other substances [NIDA] |
| 95440-4 | During the past 3 months, how often have you had a strong desire or urge to use cannabis [NIDA] |
| 95441-2 | During the past 3 months, how often have you had a strong desire or urge to use cocaine [NIDA] |
| 95442-0 | During the past 3 months, how often have you had a strong desire or urge to use prescription stimulants [NIDA] |
| 95443-8 | During the past 3 months, how often have you had a strong desire or urge to use methamphetamine [NIDA] |
| 95444-6 | During the past 3 months, how often have you had a strong desire or urge to use inhalants [NIDA] |
| 95445-3 | During the past 3 months, how often have you had a strong desire or urge to use sedatives or sleeping pills [NIDA] |
| 95446-1 | During the past 3 months, how often have you had a strong desire or urge to use hallucinogens [NIDA] |
| 95447-9 | During the past 3 months, how often have you had a strong desire or urge to use street opioids [NIDA] |
| 95448-7 | During the past 3 months, how often have you had a strong desire or urge to use prescription opioids [NIDA] |
| 95449-5 | During the past 3 months, how often have you had a strong desire or urge to use other substances [NIDA] |
| 95450-3 | During the past 3 months, how often has your use of cannabis led to health, social, legal or financial problems [NIDA] |
| 95451-1 | During the past 3 months, how often has your use of cocaine led to health, social, legal or financial problems [NIDA] |
| 95452-9 | During the past 3 months, how often has your use of prescription stimulants led to health, social, legal or financial problems [NIDA] |
| 95453-7 | During the past 3 months, how often has your use of methamphetamine led to health, social, legal or financial problems [NIDA] |
| 95454-5 | During the past 3 months, how often has your use of inhalants led to health, social, legal or financial problems [NIDA] |
| 95455-2 | During the past 3 months, how often has your use of sedatives or sleeping pills led to health, social, legal or financial problems [NIDA] |
| 95456-0 | During the past 3 months, how often has your use of hallucinogens led to health, social, legal or financial problems [NIDA] |
| 95457-8 | During the past 3 months, how often has your use of street opioids led to health, social, legal or financial problems [NIDA] |
| 95458-6 | During the past 3 months, how often has your use of prescription opioids led to health, social, legal or financial problems [NIDA] |
| 95459-4 | During the past 3 months, how often has your use of other substances led to health, social, legal or financial problems [NIDA] |
| 95460-2 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of cannabis [NIDA] |
| 95461-0 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of cocaine [NIDA] |
| 95462-8 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of prescribed Amphetamine type stimulants [NIDA] |
| 95463-6 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of methamphetamine [NIDA] |
| 95464-4 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of inhalants [NIDA] |
| 95465-1 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of sedatives or sleeping pills [NIDA] |
| 95466-9 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of hallucinogens [NIDA] |
| 95467-7 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of street opioids [NIDA] |
| 95468-5 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of prescription opioids [NIDA] |
| 95469-3 | During the past 3 months, how often have you failed to do what was normally expected of you because of your use of other substances [NIDA] |
| 95470-1 | Has a friend or relative or anyone else ever expressed concern about your use of cannabis [NIDA] |
| 95471-9 | Has a friend or relative or anyone else ever expressed concern about your use of cocaine [NIDA] |
| 95472-7 | Has a friend or relative or anyone else ever expressed concern about your use of prescribed Amphetamine type stimulants [NIDA] |
| 95473-5 | Has a friend or relative or anyone else ever expressed concern about your use of methamphetamine [NIDA] |
| 95474-3 | Has a friend or relative or anyone else ever expressed concern about your use of inhalants [NIDA] |
| 95475-0 | Has a friend or relative or anyone else ever expressed concern about your use of sedatives or sleeping pills [NIDA] |
| 95476-8 | Has a friend or relative or anyone else ever expressed concern about your use of hallucinogens [NIDA] |
| 95477-6 | Has a friend or relative or anyone else ever expressed concern about your use of street opioids [NIDA] |
| 95478-4 | Has a friend or relative or anyone else ever expressed concern about your use of prescription opioids [NIDA] |
| 95479-2 | Has a friend or relative or anyone else ever expressed concern about your use of other substances [NIDA] |
| 95480-0 | Other substances that have caused a friend or relative or anyone else to ever express concern about your use of other substances [NIDA] |
| 95481-8 | Substances that have caused a friend or relative or anyone else to ever express concern about your use [NIDA] |
| 95482-6 | Have you ever tried and failed to control, cut down or stop using cannabis [NIDA] |
| 95483-4 | Have you ever tried and failed to control, cut down or stop using cocaine [NIDA] |
| 95484-2 | Have you ever tried and failed to control, cut down or stop using prescribed Amphetamine type stimulants [NIDA] |
| 95485-9 | Have you ever tried and failed to control, cut down or stop using methamphetamine [NIDA] |
| 95486-7 | Have you ever tried and failed to control, cut down or stop using inhalants [NIDA] |
| 95487-5 | Have you ever tried and failed to control, cut down or stop using sedatives or sleeping pills [NIDA] |
| 95488-3 | Have you ever tried and failed to control, cut down or stop using hallucinogens [NIDA] |
| 95489-1 | Have you ever tried and failed to control, cut down or stop using street opioids [NIDA] |
| 95490-9 | Have you ever tried and failed to control, cut down or stop using prescription opioids [NIDA] |
| 95491-7 | Have you ever tried and failed to control, cut down or stop using other substances [NIDA] |
| 95493-3 | Cannabis substance involvement score [NIDA] |
| 95495-8 | Other substances used during the past 3 months [NIDA] |
| 95496-6 | Other substances that you have had a strong desire or urge to use in the past 3 months [NIDA] |
| 95497-4 | Other substances that have led to health, social, legal or financial problems in the past 3 months [NIDA] |
| 95498-2 | Other substances that have caused you to fail to do what was normally expected of you in the past 3 months [NIDA] |
| 95499-0 | Other substances that you have ever tried and failed to control, cut down or stop using [NIDA] |
| 95500-5 | Substances you have had a strong desire or urge to use during the past 3 months [NIDA] |
| 95501-3 | Substances that have led to health, social, legal or financial problems during the past 3 months [NIDA] |
| 95502-1 | Substances that have caused you to fail to do what was normally expected of you during the past 3 months [NIDA] |
| 95503-9 | Substances that you have ever tried and failed to control, cut down or stop using [NIDA] |
| 95504-7 | Cocaine substance involvement score [NIDA] |
| 95505-4 | Prescription stimulants substance involvement score [NIDA] |
| 95506-2 | Methamphetamine substance involvement score [NIDA] |
| 95507-0 | Inhalants substance involvement score [NIDA] |
| 95508-8 | Sedatives or sleeping pills substance involvement score [NIDA] |
| 95509-6 | Hallucinogens substance involvement score [NIDA] |
| 95510-4 | Street opioids substance involvement score [NIDA] |
| 95511-2 | Prescription opioids substance involvement score [NIDA] |
| 95512-0 | Other substance involvement score [NIDA] |
| 95513-8 | NIDA-Modified ASSIST version 2.0 [NIDA] |
| 95528-6 | NIDA Quick Screen [NIDA] |
| 95614-4 | Total score [HITS] |
| 95615-1 | Scream or curse at you [HITS] |
| 95616-9 | Threaten you with physical harm [HITS] |
| 95617-7 | Insult you or talk down to you [HITS] |
| 95618-5 | Physically hurt you [HITS] |
| 95619-3 | Hurts, insults, threatens, and screams [HITS] |
| 95620-1 | Neonatal pain, agitation, and sedation scale panel NPASS |
| 95621-9 | Pain/agitation panel NPASS |
| 95629-2 | Sedation panel NPASS |
| 95732-4 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2 - Self-care - admission performance during assessment period [CMS Assessment] |
| 95733-2 | IRF-PAI v3.0, LCDS v4.00 - Bladder and bowel - admission during assessment period [CMS Assessment] |
| 95734-0 | IRF-PAIv3.0, MDS v1.17.1, 1.17.2 - Self-care - discharge performance during assessment period [CMS Assessment] |
| 95735-7 | Bladder continence during assessment period [CMS Assessment] |
| 95736-5 | Bowel continence during assessment period [CMS Assessment] |
| 95737-3 | Expression of ideas and wants during assessment period [CMS Assessment] |
| 95738-1 | Does the patient use a wheelchair/scooter during assessment period [CMS Assessment] |
| 95739-9 | Indicate the type of wheelchair/scooter used during assessment period [CMS Assessment] |
| 95740-7 | Understanding verbal and non-verbal content during assessment period [CMS Assessment] |
| 95741-5 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2 - Mobility - admission performance during assessment period [CMS Assessment] |
| 95742-3 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2 - Mobility - discharge performance during assessment period [CMS Assessment] |
| 95743-1 | Memory/recall ability during assessment period [CMS Assessment] |
| 95744-9 | Hearing.ability to hear during assessment period [CMS Assessment] |
| 95745-6 | Vision.ability to see in adequate light during assessment period [CMS Assessment] |
| 95810-8 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2 - Functional abilities and goals - discharge [CMS Assessment] |
| 95811-6 | IRF-PAI v3.0, MDS v1.17.1, 1.17.2 - Functional abilities and goals - admission [CMS Assessment] |
| 95812-4 | Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said during assessment period [CAM.CMS] |
| 95813-2 | Is there evidence of an acute change in mental status from the patient's baseline during assessment period [CAM.CMS] |
| 95814-0 | Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject during assessment period [CAM.CMS] |
| 95815-7 | Altered level of consciousness during assessment period [CAM.CMS] |
| 95816-5 | Signs and symptoms of delirium (from CAM) during assessment period [CMS Assessment] |
| 95852-0 | LCDS v4.00 - Signs and Symptoms of Delirium (from CAM) during assessment period [CMS Assessment] |
| 95853-8 | LCDS v4.00 - Acute onset and fluctuating course during assessment period [CMS Assessment] |
| 95854-6 | LCDS v4.00 - Cognitive patterns during assessment period [CMS Assessment] |
| 95855-3 | Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity during assessment period [CAM.CMS] |
| 95856-1 | LCDS v4.00 - Altered level of consciousness during assessment period [CMS Assessment] |
| 95857-9 | Level of consciousness - Alert (normal) during assessment period [CAM.CMS] |
| 95858-7 | Level of consciousness - Vigilant or lethargic or stupor or coma during assessment period [CAM.CMS] |
| 95859-5 | LCDS v4.00 - Self-care - admission performance during assessment period [CMS Assessment] |
| 95860-3 | LCDS v4.00 - Self-care - discharge goal during assessment period [CMS Assessment] |
| 95861-1 | LCDS v4.00 - Self-care - discharge performance during assessment period [CMS Assessment] |
| 95862-9 | LCDS v4.00 - Mobility - discharge goal during assessment period [CMS Assessment] |
| 95863-7 | LCDS v4.00 - Bladder and bowel - planned discharge during assessment period [CMS Assessment] |
| 95864-5 | LCDS v4.00 - Active diagnoses during assessment period [CMS Assessment] |
| 95865-2 | LCDS v4.00 - Swallowing/nutritional status during assessment period [CMS Assessment] |
| 95866-0 | BRIEF health literacy screening tool [BRIEF] |
| 95871-0 | Total score [BRIEF] |
| 95872-8 | Brief cognitive assessment tool short form [BCAT] |
| 95873-6 | BCAT short form total score [BCAT] |
| 95874-4 | BCAT short form memory score [BCAT] |
| 95875-1 | Brief anxiety and depression scale [BADS] |
| 95876-9 | Total score [BADS] |
| 95877-7 | Depression score [BADS] |
| 95878-5 | Anxiety score [BADS] |
| 95892-6 | Healthcare personnel status [CDC Emergency Operations Centers] |
| 95893-4 | Hospital or facility beds utilization panel [CDC Emergency Operations Centers] |
| 95943-7 | IRF-PAI v3.0 - Hearing, speech, and vision - admission during assessment period [CMS Assessment] |
| 95944-5 | IRF-PAI v3.0 - Staff assessment for mental status during assessment period [CMS Assessment] |
| 95945-2 | IRF-PAI v3.0 - Swallowing/nutritional status - admission during assessment period [CMS Assessment] |
| 95946-0 | Usual ability to swallow during assessment period [CMS Assessment] |
| 95975-9 | Skindex-16 [Skindex-16] |
| 95976-7 | Symptom score [Skindex-16] |
| 95977-5 | Emotion score [Skindex-16] |
| 95978-3 | Function score [Skindex-16] |
| 95979-1 | Total score [Skindex-16] |
| 95980-9 | During the past 1 week, how often have you been bothered by your skin condition itching [Skindex-16] |
| 95981-7 | During the past 1 week, how often have you been bothered by your skin condition burning or stinging [Skindex-16] |
| 95982-5 | During the past 1 week, how often have you been bothered by your skin condition being irritated [Skindex-16] |
| 95983-3 | During the past 1 week, how often have you been bothered by the persistence or reoccurrence of your skin condition [Skindex-16] |
| 95984-1 | During the past 1 week, how often have you been bothered by worry about your skin condition [Skindex-16] |
| 95985-8 | During the past 1 week, how often have you been bothered by the appearance of your skin condition [Skindex-16] |
| 95986-6 | During the past 1 week, how often have you been bothered by frustration about your skin condition [Skindex-16] |
| 95987-4 | During the past 1 week, how often have you been bothered by embarrassment about your skin condition [Skindex-16] |
| 95988-2 | During the past 1 week, how often have you been bothered by being annoyed about your skin condition [Skindex-16] |
| 95989-0 | During the past 1 week, how often have you been bothered by feeling depressed about your skin condition [Skindex-16] |
| 95990-8 | During the past 1 week, how often have you been bothered by the effects of your skin condition on your interactions with others [Skindex-16] |
| 95991-6 | During the past 1 week, how often have you been bothered by the effects of your skin condition on your desire to be with people [Skindex-16] |
| 95992-4 | During the past 1 week, how often have you been bothered by your skin condition making it hard to show affection [Skindex-16] |
| 95993-2 | During the past 1 week, how often have you been bothered by the effects of your skin condition on your daily activities [Skindex-16] |
| 95994-0 | During the past 1 week, how often have you been bothered by your skin condition making it hard to work or do what you enjoy [Skindex-16] |
| 95995-7 | During the past 1 week, how often have you been bothered by your skin condition hurting [Skindex-16] |
| 95996-5 | Skindex-29 [Skindex-29] |
| 95997-3 | Symptom score [Skindex-29] |
| 95998-1 | Emotion score [Skindex-29] |
| 95999-9 | Function score [Skindex-29] |
| 96000-5 | Total score [Skindex-29] |
| 96001-3 | During the past 4 weeks, my skin hurts [Skindex-29] |
| 96002-1 | During the past 4 weeks, my skin condition affects how well I sleep [Skindex-29] |
| 96003-9 | During the past 4 weeks, I worry that my skin condition may be serious [Skindex-29] |
| 96004-7 | During the past 4 weeks, my skin condition makes it hard to work or do hobbies [Skindex-29] |
| 96005-4 | During the past 4 weeks, my skin condition affects my social life [Skindex-29] |
| 96006-2 | During the past 4 weeks, my skin condition makes me feel depressed [Skindex-29] |
| 96007-0 | During the past 4 weeks, my skin condition burns or stings [Skindex-29] |
| 96008-8 | During the past 4 weeks, I tend to stay at home because of my skin condition [Skindex-29] |
| 96009-6 | During the past 4 weeks, I worry about getting scars from my skin condition [Skindex-29] |
| 96010-4 | During the past 4 weeks, my skin itches [Skindex-29] |
| 96011-2 | During the past 4 weeks, my skin condition affects how close I can be with those I love [Skindex-29] |
| 96012-0 | During the past 4 weeks, I am ashamed of my skin condition [Skindex-29] |
| 96013-8 | During the past 4 weeks, I worry that my skin condition may get worse [Skindex-29] |
| 96014-6 | During the past 4 weeks, I tend to do things by myself because of my skin condition [Skindex-29] |
| 96015-3 | During the past 4 weeks, my skin condition makes me tired [Skindex-29] |
| 96016-1 | During the past 4 weeks, my skin condition interferes with my sex life [Skindex-29] |
| 96017-9 | During the past 4 weeks, I am annoyed by my skin condition [Skindex-29] |
| 96018-7 | During the past 4 weeks,, my skin condition bleeds [Skindex-29] |
| 96019-5 | During the past 4 weeks, I am humiliated by my skin condition [Skindex-29] |
| 96020-3 | During the past 4 weeks, my skin condition affects my desire to be with people [Skindex-29] |
| 96021-1 | During the past 4 weeks, my skin is sensitive [Skindex-29] |
| 96022-9 | During the past 4 weeks, I am frustrated by my skin condition [Skindex-29] |
| 96023-7 | During the past 4 weeks, my skin condition is a problem for the people I love [Skindex-29] |
| 96024-5 | During the past 4 weeks, I am embarrassed by my skin condition [Skindex-29] |
| 96025-2 | During the past 4 weeks, my skin condition affects my interactions with others [Skindex-29] |
| 96026-0 | During the past 4 weeks, my skin is irritated [Skindex-29] |
| 96027-8 | During the past 4 weeks, I worry about side-effects from skin medications or treatments [Skindex-29] |
| 96028-6 | During the past 4 weeks, my skin condition makes showing affection difficult [Skindex-29] |
| 96029-4 | During the past 4 weeks, water bothers my skin condition (bathing, washing hands) [Skindex-29] |
| 96030-2 | During the past 4 weeks, I am angry about my skin condition [Skindex-29] |
| 96031-0 | During the past 1 week, how often have you been bothered by symptoms of your skin problem [Skindex Mini] |
| 96032-8 | During the past 1 week, how often have you been emotionally bothered by your skin problem [Skindex Mini] |
| 96033-6 | During the past 1 week, how often have you been bothered by effects of your skin problem on your activities [Skindex Mini] |
| 96034-4 | Skindex mini [Skindex Mini] |
| 96095-5 | Indicate the patient's primary medical condition category during assessment period [CMS Assessment] |
| 96098-9 | Wash upper body - functional goal during assessment period [CMS Assessment] |
| 96099-7 | LCDS v5.00 - Mobility - admission performance during assessment period [CMS Assessment] |
| 96100-3 | LCDS v5.00 - Mobility - discharge performance during assessment period [CMS Assessment] |
| 96298-5 | IRF-PAI v3.0 - Quality indicators - admission during assessment period [CMS Assessment] |
| 96299-3 | IRF-PAI v3.0 - Cognitive patterns - admission during assessment period [CMS Assessment] |
| 96433-8 | Would like help finding daycare for child Caregiver |
| 96434-6 | Always has enough food for family Caregiver |
| 96435-3 | At risk of having utilities shut off in the next week Caregiver |
| 96436-1 | Trouble paying heating bill AndOr electricity bill Caregiver |
| 96437-9 | Needs help getting food for family for tonight Caregiver |
| 96438-7 | Would like help getting food for family Caregiver |
| 96439-5 | Emergent risk of becoming homeless Caregiver |
| 96440-3 | Would like help for being at risk of becoming homeless Caregiver |
| 96441-1 | At risk of becoming homeless Caregiver |
| 96442-9 | Needs daycare for child Caregiver |
| 96443-7 | Would like help finding employment AndOr job training Caregiver |
| 96444-5 | Has a job Caregiver |
| 96445-2 | Would like help to get a GED Caregiver |
| 96446-0 | High school degree Caregiver |
| 96447-8 | WE CARE Survey [WE CARE] Caregiver |
| 96575-6 | During the last month did you not eat for a whole day because your family didn't have enough money for food [U.S. FSS - Child] |
| 96576-4 | U.S. Child Food Security Survey [U.S. FSS - Child] |
| 96577-2 | During the last month were you hungry but didn't eat because your family didn't have enough food [U.S. FSS - Child] |
| 96578-0 | U.S. Child Food Security Survey Score [U.S. FSS - Child] |
| 96579-8 | During the last month did you have to skip a meal because your family didn't have enough money for food [U.S. FSS - Child] |
| 96580-6 | During the last month has the size of your meals been cut because your family didn't have enough money for food [U.S. FSS - Child] |
| 96581-4 | During the last month did you have to eat less because your family didn't have enough money to buy food [U.S. FSS - Child] |
| 96582-2 | During the last month how often were you not able to eat a balanced meal because your family didn't have enough money [U.S. FSS - Child] |
| 96583-0 | During the last month did your meals only include a few kinds of cheap foods because your family was running out of money to buy food [U.S. FSS - Child] |
| 96584-8 | During the last month did the food that your family bought run out, and you didn't have money to get more [U.S. FSS - Child] |
| 96585-5 | During the last month did you worry that food at home would run out before your family got money to buy more [U.S. FSS - Child] |
| 96699-4 | Total score [MyMemCheck] |
| 96700-0 | MyMemCheck assessment panel [MyMemCheck] |
| 96753-9 | Would like help with paying heating AndOr electricity bill Caregiver |
| 96771-1 | Service integration panel [R-Outcomes] |
| 96772-9 | Service integration total score [R-Outcomes] |
| 96773-7 | How well do services work together: services talk to each other |
| 96774-5 | How well do services work together: staff know what other services do |
| 96775-2 | How well do services work together: I don't have to repeat my story |
| 96776-0 | How well do services work together: different services work well together |
| 96777-8 | Accountable health communities (AHC) health-related social needs screening (HRSN) tool |
| 96778-6 | Problems with place where you live |
| 96779-4 | Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12 months |
| 96780-2 | Wants help finding or keeping work or a job |
| 96781-0 | Able to get help with daily activities when needed |
| 96782-8 | Wants help with school or training |
| 96783-6 | howRwe panel [R-Outcomes] |
| 96784-4 | howRwe score [R-Outcomes] |
| 96785-1 | How are we doing: treat you kindly |
| 96786-9 | How are we doing: listen and explain |
| 96787-7 | How are we doing: see you promptly |
| 96788-5 | How are we doing: well organized |
| 96831-3 | Coronavirus racial bias scale [CRBS] |
| 96832-1 | Due to the coronavirus I have been cyberbullied because of my race/ethnicity [CRBS] |
| 96833-9 | Since the coronavirus I have seen a lot more cyberbullying of people of my race/ethnicity [CRBS] |
| 96834-7 | Coronavirus anxiety scale |
| 96835-4 | Dizzy, lightheaded, or faint, when exposed to news about the coronavirus in past 2 weeks |
| 96836-2 | Trouble falling or staying asleep due to thinking about the coronavirus in past 2 weeks |
| 96837-0 | Paralyzed or frozen when I thought about or was exposed to information about the coronavirus in past 2 weeks |
| 96838-8 | Lost interest in eating when I thought about or was exposed to information about the coronavirus in past 2 weeks |
| 96839-6 | Nauseous or had stomach problems when I thought about or was exposed to information about the coronavirus in past 2 weeks |
| 96841-2 | Tobacco, Alcohol, Prescription medications, and other Substance use screen [TAPS] |
| 96844-6 | How often have you used any prescription medications just for the feeling, more than prescribed or that were not prescribed for you in past 12 months [TAPS] |
| 96845-3 | Tobacco, Alcohol, Prescription medications, and other Substance use assessment [TAPS] |
| 96852-9 | Have you tried and failed to control, cut down or stop drinking in past 3 months [TAPS] |
| 96853-7 | Has anyone expressed concern about your drinking in past 3 months [TAPS] |
| 96855-2 | Have you had a strong desire or urge to use marijuana at least once a week or more often in past 3 months [TAPS] |
| 96856-0 | Has anyone expressed concern about your use of marijuana in past 3 months [TAPS] |
| 96859-4 | Has anyone expressed concern about your use of cocaine, crack, or methamphetamine (crystal meth) in past 3 months [TAPS] |
| 96861-0 | Have you tried and failed to control, cut down or stop using heroin in past 3 months [TAPS] |
| 96862-8 | Has anyone expressed concern about your use of heroin in past 3 months [TAPS] |
| 96864-4 | Have you tried and failed to control, cut down or stop using an opiate pain reliever in past 3 months [TAPS] |
| 96865-1 | Has anyone expressed concern about your use of an opiate pain reliever in past 3 months [TAPS] |
| 96867-7 | Have you had a strong desire or urge to use medications for anxiety or sleep at least once a week or more often in past 3 months [TAPS] |
| 96868-5 | Has anyone expressed concern about your use of medication for anxiety or sleep in past 3 months [TAPS] |
| 96871-9 | Has anyone expressed concern about your use of a medication for ADHD (for example, Adderall or Ritalin) in past 3 months [TAPS] |
| 96873-5 | Illegal or recreational drug(s) used in past 3 months |
| 96875-0 | I believe the country has become more dangerous for people in my racial/ethnic group because of fear of the coronavirus [CRBS] |
| 96876-8 | People of my race/ethnicity are more likely to lose their job because of the coronavirus [CRBS] |
| 96877-6 | I worry about people thinking I have the coronavirus simply because of my race/ethnicity [CRBS] |
| 96878-4 | Most social and mass media reports about the coronavirus create bias against people of my racial/ethnic group [CRBS] |
| 96879-2 | People of my race/ethnicity are more likely to get the coronavirus [CRBS] |
| 96880-0 | People of my race/ethnicity will not receive coronavirus healthcare as good as the care received by other groups [CRBS] |
| 96881-8 | Negative social media posts against people of my race/ethnicity have increased because of the coronavirus [CRBS] |
| 96882-6 | In the past month, have recommendations for socially distancing caused stress for you |
| 96883-4 | Stayed home all day |
| 96884-2 | Went to workplace or volunteer site outside home |
| 96885-9 | Thinking about your current social habits, in the last 5 days: I have attended social gatherings outside my home of more than 10 people |
| 96886-7 | Thinking about your current social habits, in the last 5 days: I have attended social gatherings outside my home of less than 10 people |
| 96887-5 | Thinking about your current social habits, in the last 5 days: I have gone on shopping trips or outings that were just for fun |
| 96888-3 | Thinking about your current social habits, in the last 5 days: I have visited nursing homes or long-term care facilities (outside of work duties) |
| 96889-1 | Close contact with someone who is in a risk group for COVID-19 |
| 96890-9 | Frequency of social interaction with people outside my home |
| 96891-7 | How often in the past month are you doing the recommended pandemic hygiene |
| 96892-5 | COVID-19 participant experience survey |
| 96901-4 | MDS v3.0 - RAI v1.17.2 - Delirium during assessment period [CMS Assessment] |
| 96902-2 | MDS v3.0 - RAI v1.17.2 - Hearing, speech, and vision - NC, NP, NQ, SP during assessment period [CMS Assessment] |
| 96903-0 | MDS v3.0 - RAI v1.17.2 - Cognitive patterns - NC, NP, NQ, SP during assessment period [CMS Assessment] |
| 96904-8 | MDS v3.0 - RAI v1.17.2 - Bladder and bowel - NC during assessment period [CMS Assessment] |
| 96905-5 | MDS v3.0 - RAI v1.17.2 - Bladder and bowel - ND, SD during assessment period [CMS Assessment] |
| 96906-3 | MDS v3.0 - RAI v1.17.2 - Bladder and bowel - NP, NQ, SP during assessment period [CMS Assessment] |
| 96907-1 | MDS v3.0 - RAI v1.17.2 - Cognitive patterns - ND, SD during assessment period [CMS Assessment] |
| 96908-9 | MDS v3.0 - RAI v1.17.2 - Staff assessment for mental status during assessment period [CMS Assessment] |
| 96929-5 | Personal well-being panel [R-Outcomes] |
| 96930-3 | Personal well-being score [R-Outcomes] |
| 96931-1 | How are you feeling in general: I am satisfied with my life |
| 96932-9 | How are you feeling in general: What I do in my life is worthwhile |
| 96933-7 | How are you feeling in general: I was happy yesterday |
| 96934-5 | How are you feeling in general: I was not anxious yesterday |
| 96936-0 | Person-specific outcome panel [R-Outcomes] |
| 96937-8 | Issue you would like help with |
| 96938-6 | How much concern does the issue you would like help with cause |
| 96939-4 | Social contact panel [R-Outcomes] |
| 96940-2 | Social contact score [R-Outcomes] |
| 96941-0 | Thinking about your friends and family: I have people to talk to |
| 96942-8 | Thinking about your friends and family: I have someone I can confide in |
| 96943-6 | Thinking about your friends and family: I have people who will help me |
| 96944-4 | Thinking about your friends and family: I do things with others |
| 96945-1 | Health confidence panel [R-Outcomes] |
| 96946-9 | Health confidence score [R-Outcomes] |
| 96947-7 | How do you feel about caring for your health: I can look after my health |
| 96948-5 | How do you feel about caring for your health: I can get the right help if I need it |
| 96949-3 | How do you feel about caring for your health: I am involved in decisions about me |
| 96950-1 | How do you feel about caring for your health: I know enough about my health |
| 96951-9 | Social determinants of health panel [R-Outcomes] |
| 96952-7 | Social determinants of health score [R-Outcomes] |
| 96953-5 | Thinking about how you live: I have had a good education |
| 96954-3 | Thinking about how you live: I am valued for what I do |
| 96955-0 | Thinking about how you live: I am happy about where I live |
| 96956-8 | Thinking about how you live: I have enough money to cope |
| 96987-3 | Mass vaccination status [CDC Emergency Operations Centers] |
| 97023-6 | Accountable health communities (AHC) health-related social needs (HRSN) supplemental questions |
| 97027-7 | Speaks a language other than English at home |
| 97033-5 | Postoperative work status |
| 97074-9 | Mean score [CRBS] |
| 97075-6 | Total score [CAS] |
| 97076-4 | Common news sources |
| 97077-2 | Time spent per day getting information about COVID-19 and/or its impact |
| 97078-0 | Effect of friends, family or neighbors as source of information on mental health |
| 97079-8 | Effect of local government officials as source of information on mental health |
| 97080-6 | Effect of national government officials as source of information on mental health |
| 97081-4 | Effect of national and international health officials as source of information on mental health |
| 97082-2 | Effect of print or online news as source of information on mental health |
| 97083-0 | Effect of radio or podcast as source of information on mental health |
| 97084-8 | Effect of Facebook as source of information on mental health |
| 97085-5 | Effect of Instagram or Snapchat as source of information on mental health |
| 97086-3 | Effect of Twitter as source of information on mental health |
| 97087-1 | Effect of social media (e.g., TikTok, Reddit) as source of information on mental health |
| 97088-9 | How often friends, family or neighbors used as source of information for COVID-19 |
| 97089-7 | How often medical providers used as source of information for COVID-19 |
| 97090-5 | How often local government officials used as source of information for COVID-19 |
| 97091-3 | How often Federal Government used as source of information for COVID-19 |
| 97092-1 | How often medical or health websites used as source of information for COVID-19 |
| 97093-9 | How often print or online news used as source of information for COVID-19 |
| 97094-7 | How often TV or radio used as source of information for COVID-19 |
| 97095-4 | How often social media used as source of information for COVID-19 |
| 97096-2 | COVID-19 experiences - media use panel [COVEX] |
| 97108-5 | Employment status in the 2 weeks prior to COVID-19 outbreak |
| 97109-3 | New employment during the COVID-19 outbreak |
| 97110-1 | Work setting in the 2 weeks before the COVID-19 outbreak |
| 97111-9 | Job loss during the COVID-19 outbreak |
| 97112-7 | Worked during the COVID-19 outbreak |
| 97113-5 | Significant job changes during the COVID-19 outbreak |
| 97114-3 | Work setting during the COVID-19 outbreak |
| 97115-0 | Student in the few weeks before COVID-19 outbreak |
| 97116-8 | Student during the COVID-19 outbreak |
| 97117-6 | School has offered classes remotely during the COVID-19 outbreak |
| 97118-4 | Increase or decrease in schoolwork during the COVID-19 outbreak |
| 97119-2 | Difficulty getting work or schoolwork done because of other responsibilities at home during the COVID-19 outbreak |
| 97120-0 | Difficulty getting work or schoolwork done because of your home environment during the COIVD-19 outbreak |
| 97121-8 | Household job or income loss due to the COVID-19 outbreak |
| 97122-6 | Household member who lost job or income due to COVID-19 outbreak |
| 97123-4 | COVID-19 experiences - employment and school changes panel [COVEX] |
| 97124-2 | How helpful has texting, calling or video-calling family members or friends been as a coping strategy during the COVID-19 outbreak |
| 97125-9 | How helpful has talking to a therapist been as a coping strategy during the COVID-19 outbreak |
| 97126-7 | How helpful has exercising or walking been as a coping strategy during the COVID-19 outbreak |
| 97127-5 | How helpful has cooking or baking been as a coping strategy during the COVID-19 outbreak |
| 97128-3 | How helpful have arts and crafts projects been as a coping strategy during the COVID-19 outbreak |
| 97129-1 | How helpful has cleaning or doing household chores been as a coping strategy during the COVID-19 outbreak |
| 97130-9 | How helpful has playing games with family members been as a coping strategy during the COVID-19 outbreak |
| 97131-7 | How helpful has playing online games been as a coping strategy during the COVID-19 outbreak |
| 97132-5 | How helpful has virtual entertainment been as a coping strategy during the COVID-19 outbreak |
| 97133-3 | Helpful coping strategy used during the COVID-19 outbreak |
| 97134-1 | How helpful was your coping strategy during the COVID-19 outbreak |
| 97135-8 | Impact of COVID-19 outbreak on life |
| 97136-6 | How helpful has texting, calling or video-calling family members or friends been as a coping strategy to your child during the COVID-19 outbreak |
| 97137-4 | How helpful has virtual learning or school been as a coping strategy to your child during the COVID-19 outbreak |
| 97138-2 | How helpful has talking to a therapist been as a coping strategy to your child during the COVID-19 outbreak |
| 97139-0 | How helpful has exercising or walking been as a coping strategy to your child during the COVID-19 outbreak |
| 97140-8 | How helpful has cooking or baking been as a coping strategy to your child during the COVID-19 outbreak |
| 97141-6 | How helpful have arts and crafts projects been as a coping strategy to your child during the COVID-19 outbreak |
| 97142-4 | How helpful has playing board games, cards with family members been as a coping strategy to your child during the COVID-19 outbreak |
| 97143-2 | How helpful has playing online games been as a coping strategy to your child during the COVID-19 outbreak |
| 97144-0 | How helpful has virtual entertainment been as a coping strategy to your child during the COVID-19 outbreak |
| 97145-7 | Helpful coping strategy your child used during the COVID-19 outbreak |
| 97146-5 | How helpful was your child's coping strategy during the COVID-19 outbreak |
| 97147-3 | COVID-19 experiences - coping panel [COVEX] |
| 97327-1 | Core Outcome Measures Index for the Neck [COMI] |
| 97329-7 | Which of the following problems related to your neck condition troubles you the most |
| 97331-3 | If you had to spend the rest of your life with the symptoms you have right now how would you feel about it |
| 97734-8 | Inability to stop drinking once started |
| 97735-5 | Failed expectations due to drinking |
| 97736-3 | Drink needed in morning to begin activities after drinking session |
| 97737-1 | Guilt or remorse after drinking |
| 97738-9 | Inability to recall events from night before due to drinking |
| 97739-7 | Injury to you or someone else resulting from drinking |
| 97740-5 | Has anyone expressed concern about your drinking or suggested you cut down |
| 97874-2 | Stay Independent panel [Stay Independent] |
| 97885-8 | Stay Independent total score [Stay Independent] |
| 97886-6 | Core Outcome Measures Index for the Neck score [COMI] |
| 97887-4 | Core Outcome Measures Index for the Back [COMI] |
| 97888-2 | Which of the following problems related to your back condition troubles you the most |
| 97889-0 | Core Outcome Measures Index for the Back score [COMI] |
| 97890-8 | Sleep panel [R-Outcomes] |
| 97891-6 | Sleep score [R-Outcomes] |
| 97892-4 | Go to sleep at the same time |
| 97893-2 | Wake up at the same time |
| 97894-0 | Wake up feeling refreshed |
| 97895-7 | Sleep well |
| 97896-5 | Self-care panel [R-Outcomes] |
| 97897-3 | Self-care total score [R-Outcomes] |
| 97898-1 | Manage diet well |
| 97899-9 | Manage physical activity well |
| 97900-5 | Manage weight well |
| 97901-3 | Manage medication well |
| 97902-1 | Fatigue panel [R-Outcomes] |
| 97903-9 | Fatigue total score [R-Outcomes] |
| 97904-7 | Usually have enough energy |
| 97905-4 | Do not tire too quickly |
| 97906-2 | Usually concentrate well |
| 97907-0 | Can keep going if needed |
| 97908-8 | Oswestry Disability Index |
| 98067-2 | Patient-centered disability questionnaire |
| 98068-0 | Difficulty communicating in usual language |
| 98071-4 | Post COVID-19 functional status scale [PCFS] |
| 98072-2 | Post COVID-19 functional status grade [PCFS] |
| 98078-9 | Difficulty reading or writing |
| 98079-7 | Do you need any additional assistance or accommodations during your visit |
| 98093-8 | Rowland Universal Dementia Assessment Scale [RUDAS] |
| 98094-6 | Total score [RUDAS] |
| 98150-6 | Encephalopathy grade |
| 98151-4 | Degree of ascites |
| 98152-2 | Total score [Child-Pugh] |
| 98153-0 | Child-Pugh panel |
| 98154-8 | SARS-CoV-2-related socioeconomic questionnaire for adults |
| 98156-3 | Routine doctor's visits AndOr check-ups cancelled since the beginning of the pandemic |
| 98157-1 | Routine doctor's visits AndOr check-ups postponed since the beginning of the pandemic |
| 98158-9 | Problems accessing medication since the beginning of the pandemic |
| 98159-7 | Treatment sessions postponed by doctor or patient since the beginning of the pandemic |
| 98160-5 | Treatment sessions cancelled by doctor or patient since the beginning of the pandemic |
| 98162-1 | Financial problems since the beginning of the pandemic |
| 98163-9 | Received any financial or material aid since the beginning of the pandemic |
| 98164-7 | How often have you recently looked for information on COVID-19 |
| 98165-4 | What do you think is your current risk of infection or re-infection |
| 98166-2 | What do you think is your current risk that, in case of infection or re-infection, you will experience severe complications or even death |
| 98167-0 | How often do you wash your hands with hand-soap or hydro-alcoholic solutions |
| 98168-8 | How often do you keep a distance of at least 2 meters from others |
| 98169-6 | Stay at home to avoid social contact |
| 98170-4 | Wear face mask in public |
| 98171-2 | Has been offered COVID-19 vaccine |
| 98172-0 | Accepted or will accept COVID-19 vaccination once offered |
| 98173-8 | Reasons for not accepting COVID-19 vaccine |
| 98174-6 | Routine doctor's visits AndOr check-ups cancelled in the last 12 months |
| 98175-3 | Routine doctor's visits AndOr check-ups postponed in the last 12 months |
| 98176-1 | Problems accessing medication in last 12 months |
| 98177-9 | Treatment sessions postponed by doctor or patient in the last 12 months |
| 98178-7 | Treatment sessions cancelled by doctor or patient in the last 12 months |
| 98179-5 | Financial problems in last 12 months |
| 98180-3 | Received any financial or material aid in last 12 months |
| 98514-3 | Intensity of shortness of breath in past 7 days |
| 98515-0 | PROMIS dyspnea characteristics - version 1.0 T-score |
| 98516-8 | Frequency of shortness of breath in past 7 days |
| 98517-6 | Duration of shortness of breath in past 7 days |
| 98518-4 | Shortness of breath in general in past 7 days |
| 98520-0 | PROMIS item bank - dyspnea characteristics - version 1.0 |
| 98521-8 | I worry about becoming short of breath in past 7 days |
| 98522-6 | I become afraid when I have trouble catching my breath in past 7 days |
| 98523-4 | Exercise seems unsafe for me in past 7 days |
| 98524-2 | I am embarrassed by using my inhaled medication in public in past 7 days |
| 98525-9 | I am embarrassed by using my oxygen in public in past 7 days |
| 98526-7 | I am embarrassed by my shortness of breath in past 7 days |
| 98527-5 | Things are in the house that trigger breathing problems |
| 98528-3 | Things are outside that trigger breathing problems |
| 98529-1 | Exposed to pesticides, household cleaning products or substances with irritating odors in past 7 days |
| 98530-9 | Regularly exposed to other people's smoke |
| 98531-7 | Lives in an environment with extreme changes in temperature |
| 98532-5 | There are pets in the household |
| 98533-3 | PROMIS item bank - dyspnea airborne exposure - version 1.0 |
| 98534-1 | PROMIS dyspnea airborne exposure - version 1.0 T-score |
| 98535-8 | I get upset when I can't do something because of my shortness of breath in past 7 days |
| 98536-6 | PROMIS item bank - dyspnea emotional response - version 1.0 |
| 98537-4 | PROMIS dyspnea emotional response - version 1.0 T-score |
| 98538-2 | Feel like a failure since illness |
| 98539-0 | Felt like a failure before illness |
| 98540-8 | Feel useless since illness |
| 98541-6 | Felt useless before illness |
| 98542-4 | Feel lack of respect since illness |
| 98543-2 | Felt lack of respect before illness |
| 98544-0 | Feel worthless since illness |
| 98545-7 | Felt worthless before illness |
| 98546-5 | Feel inferior to others since illness |
| 98547-3 | Felt inferior to others before illness |
| 98548-1 | Lack confidence since illness |
| 98549-9 | Lacked confidence before illness |
| 98550-7 | Negative attitude toward self since illness |
| 98551-5 | Negative attitude toward self before illness |
| 98552-3 | Feel helpless since illness |
| 98553-1 | Felt helpless before illness |
| 98554-9 | Feel like a burden to family since illness |
| 98555-6 | Felt like a burden to family before illness |
| 98556-4 | Trouble asking others for help since illness |
| 98557-2 | Trouble asking others for help before illness |
| 98558-0 | Feel isolated from others since illness |
| 98559-8 | Felt isolated from others before illness |
| 98560-6 | Feel disconnected from others since illness |
| 98561-4 | Felt disconnected from others before illness |
| 98562-2 | Feel like a burden to others since illness |
| 98563-0 | Felt like a burden to others before illness |
| 98564-8 | Lost some close relationships since illness |
| 98565-5 | Lost some close relationships before illness |
| 98566-3 | Feel avoided since illness |
| 98567-1 | Felt avoided before illness |
| 98568-9 | Feel guilty for being unavailable to family and friends since illness |
| 98569-7 | Felt guilty for being unavailable to family and friends before illness |
| 98570-5 | Hard to get close to people since illness |
| 98571-3 | Hard to get close to people before illness |
| 98572-1 | Trouble relating to others since illness |
| 98573-9 | Trouble relating to others before illness |
| 98574-7 | Feel the need to hide true feelings since illness |
| 98575-4 | Felt the need to hide true feelings before illness |
| 98576-2 | Worry about the future since illness |
| 98577-0 | Worried about the future before illness |
| 98578-8 | Bothered by little things since illness |
| 98579-6 | Bothered by little things before illness |
| 98580-4 | Have difficulty accepting that things aren't always in my control since illness |
| 98581-2 | Had difficulty accepting that things weren't always in my control before illness |
| 98582-0 | Upset by small changes in health since illness |
| 98583-8 | Upset by small changes in health before illness |
| 98584-6 | Worry about health interfering with life since illness |
| 98585-3 | Worried about health interfering with life before illness |
| 98586-1 | Fear what will happen in the future since illness |
| 98587-9 | Feared what would happen in the future before illness |
| 98588-7 | Worry about health interfering with sleep since illness |
| 98589-5 | Worried about health interfering with sleep before illness |
| 98590-3 | Get nervous before going to the doctor since illness |
| 98591-1 | Got nervous before going to the doctor before illness |
| 98592-9 | Feel I have been given more than I can take since illness |
| 98593-7 | Felt I had been given more than I could take before illness |
| 98594-5 | Trouble feeling peace of mind since illness |
| 98595-2 | Trouble feeling peace of mind before illness |
| 98596-0 | Life lacks meaning since illness |
| 98597-8 | Life lacked meaning before illness |
| 98598-6 | Life lacks purpose since illness |
| 98599-4 | Life lacked purpose before illness |
| 98600-0 | Question the purpose of life since illness |
| 98601-8 | Questioned the purpose of life before illness |
| 98602-6 | PROMIS item bank - psychosocial illness impact - negative - version 1.0 |
| 98603-4 | PROMIS psychosocial illness impact - negative - version 1.0 T-score |
| 98871-7 | COVID-19 comorbidity and healthcare questionnaire |
| 98872-5 | SARS-CoV-2-related socioeconomic questionnaire for school-age children |
| 98873-3 | Were classes suspended |
| 98874-1 | How long were classes suspended |
| 98875-8 | Able to participate in remote learning |
| 98876-6 | Reason for not participating in remote learning |
| 98877-4 | Amount of school lost |
| 98878-2 | Received or applied for other assistance since the beginning of the pandemic |
| 98879-0 | Received or applied for assistance from a food pantry since the beginning of the pandemic |
| 98880-8 | Received or applied for assistance from community organization since the beginning of the pandemic |
| 98881-6 | Received or applied for assistance from a religious organization since the beginning of the pandemic |
| 98882-4 | Received or applied for assistance from a union since the beginning of the pandemic |
| 98883-2 | Received or applied for other government aid since the beginning of the pandemic |
| 98884-0 | Received or applied for paycheck protection since the beginning of the pandemic |
| 98885-7 | Received or applied for government health insurance since the beginning of the pandemic |
| 98886-5 | Received or applied for supplemental social security since the beginning of the pandemic |
| 98887-3 | Received or applied for social security since the beginning of the pandemic |
| 98888-1 | Received or applied for nutrition assistance since the beginning of the pandemic |
| 98889-9 | COVID-19 related household finances |
| 98890-7 | Received or applied for unemployment insurance since the beginning of the pandemic |
| 98891-5 | Methods using or plan to use to cover expenses |
| 98892-3 | Emergency expense payment method |
| 98893-1 | Difficulty level of paying expenses in past month |
| 98894-9 | Level of worry that asset value has been or will be negatively impacted by COVID-19 |
| 98895-6 | Level of worry that household income has been or will be negatively impacted by COVID-19 |
| 98896-4 | Household income changed significantly since the beginning of the pandemic |
| 98901-2 | Received or applied for temporary assistance since the beginning of the pandemic |
| 98915-2 | Knee injury and osteoarthritis outcome score - physical function shortform panel [KOOS-PS] |
| 98916-0 | Total score [KOOS-PS] |
| 98917-8 | WHO Quality of life-BREF [WHOQOL_BREF] |
| 98918-6 | Quality of life in last 2 weeks |
| 98919-4 | Satisfaction with health in last 2 weeks |
| 98920-2 | Extent that physical pain prevents activity in last 2 weeks |
| 98921-0 | Dependency on medical treatment to function in daily life in last 2 weeks |
| 98922-8 | Enjoyment of life in last 2 weeks |
| 98923-6 | Extent to which life is meaningful in last 2 weeks |
| 98924-4 | Ability to concentrate in last 2 weeks |
| 98925-1 | How safe do you feel in your daily life in last 2 weeks |
| 98926-9 | Healthiness of physical environment in last 2 weeks |
| 98927-7 | Have enough energy for everyday life in last 2 weeks |
| 98928-5 | Able to accept body appearance in last 2 weeks |
| 98929-3 | Have enough money to meet needs in last 2 weeks |
| 98930-1 | Availability of information needed in daily life in last 2 weeks |
| 98931-9 | Extent of opportunity for leisure activities in last 2 weeks |
| 98932-7 | Ability to get around in last 2 weeks |
| 98933-5 | Satisfaction with sleep in last 2 weeks |
| 98934-3 | Satisfaction with ability to perform daily living activities in last 2 weeks |
| 98935-0 | Satisfaction with capacity for work in last 2 weeks |
| 98936-8 | Satisfaction with self in last 2 weeks |
| 98937-6 | Satisfaction with personal relationships in last 2 weeks |
| 98938-4 | Satisfaction with sex life in last 2 weeks |
| 98939-2 | Satisfaction with support from friends in last 2 weeks |
| 98940-0 | Satisfaction with condition of living place in last 2 weeks |
| 98941-8 | Satisfaction with access to health services in last 2 weeks |
| 98942-6 | Satisfaction with access to transportation in last 2 weeks |
| 98943-4 | Frequency of negative feelings in last 2 weeks |
| 98944-2 | Total score [WHOQOL_BREF] |
| 98945-9 | Hip disability and osteoarthritis outcome score - physical function shortform panel [HOOS-PS] |
| 98946-7 | Total score [HOOS-PS] |
| 98947-5 | SARS-CoV-2-related socioeconomic questionnaire for school-age children intake questions |
| 98948-3 | SARS-CoV-2-related socioeconomic questionnaire for school-age children 12 month follow-up |
| 98949-1 | Were classes suspended in last 12 months |
| 98950-9 | How long were classes suspended in last 12 months |
| 98951-7 | Amount of school lost in last 12 months |
| 98952-5 | Reason for not participating in remote learning in last 12 months |
| 98953-3 | Able to participate in remote learning in last 12 months |
| 98975-6 | Children's Health Watch Housing Stability Vital Signs |
| 98976-4 | Behind on rent or mortgage in past 12 months |
| 98977-2 | Number of residential moves in past 12 months |
| 98978-0 | Homeless in past 12 months |
| 99046-5 | Total score [EPDS] |
| 99106-7 | How often do you attend meetings of the clubs or organizations you belong to |
| 99130-7 | Outcome and assessment information set (OASIS) form - version E during assessment period [CMS Assessment] |
| 99131-5 | Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment] |
| 99132-3 | OASIS E - Administrative information - SOC during assessment period [CMS Assessment] |
| 99134-9 | You or your families' health is affected by environmental conditions at home |
| 99135-6 | Environmental conditions in the home that affect you or your families' health |
| 99138-0 | OASIS E - Hearing, speech, and vision - SOC during assessment period [CMS Assessment] |
| 99140-6 | OASIS E - Cognitive Patterns - SOC, ROC, DC during assessment period [CMS Assessment] |
| 99142-2 | OASIS E - Health Conditions - SOC, ROC during assessment period [CMS Assessment] |
| 99143-0 | OASIS E - Special Treatment, Procedures, and Programs - SOC during assessment period [CMS Assessment] |
| 99144-8 | OASIS E - Behavior - SOC, ROC, DC during assessment period [CMS Assessment] |
| 99146-3 | OASIS E - Active Diagnoses - SOC during assessment period [CMS Assessment] |
| 99147-1 | OASIS E - Preferences for Customary Routine Activities - SOC, ROC during assessment period [CMS Assessment] |
| 99148-9 | OASIS E - Functional Status - SOC, ROC, DC during assessment period [CMS Assessment] |
| 99149-7 | OASIS E - Self-care - follow-up performance during assessment period [CMS Assessment] |
| 99150-5 | OASIS E - Mobility - follow-up performance during assessment period [CMS Assessment] |
| 99151-3 | OASIS E - Medications - SOC, ROC during assessment period [CMS Assessment] |
| 99152-1 | OASIS E - Swallowing And Or Nutritional Status - SOC during assessment period [CMS Assessment] |
| 99153-9 | Outcome and assessment information set (OASIS) form - version E - Follow Up during assessment period [CMS Assessment] |
| 99154-7 | OASIS E - Functional abilities and goals - FU during assessment period [CMS Assessment] |
| 99155-4 | OASIS E - Functional Status - follow up during assessment period [CMS Assessment] |
| 99156-2 | OASIS E - Health Conditions - FU during assessment period [CMS Assessment] |
| 99157-0 | OASIS E - Skin Conditions - FU during assessment period [CMS Assessment] |
| 99158-8 | Outcome and assessment information set (OASIS) form - version E - Death at Home during assessment period [CMS Assessment] |
| 99159-6 | OASIS E - Administrative information - DAH during assessment period [CMS Assessment] |
| 99160-4 | Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment] |
| 99161-2 | OASIS E - Administrative information - ROC during assessment period [CMS Assessment] |
| 99169-5 | OASIS E - Active Diagnoses - ROC during assessment period [CMS Assessment] |
| 99170-3 | OASIS E - Health Conditions - DC during assessment period [CMS Assessment] |
| 99171-1 | OASIS E - Swallowing And Or Nutritional Status - ROC during assessment period [CMS Assessment] |
| 99173-7 | OASIS E - Special Treatment, Procedures, and Programs - ROC during assessment period [CMS Assessment] |
| 99174-5 | Outcome and assessment information set (OASIS) form - version E - Transfer to an Inpatient Facility during assessment period [CMS Assessment] |
| 99175-2 | OASIS E - Administrative information - TRN during assessment period [CMS Assessment] |
| 99176-0 | OASIS E - Special Treatment, Procedures, and Programs - transfer to an inpatient facility during assessment period [CMS Assessment] |
| 99177-8 | OASIS E - Participation in Assessment and Goal Setting - TRN, DC during assessment period [CMS Assessment] |
| 99178-6 | Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment] |
| 99179-4 | OASIS E - Administrative information - DC during assessment period [CMS Assessment] |
| 99188-5 | OASIS E - Swallowing And Or Nutritional Status - DC during assessment period [CMS Assessment] |
| 99189-3 | OASIS E - Skin Conditions - DC during assessment period [CMS Assessment] |
| 99190-1 | OASIS E - Special Treatment, Procedures, and Programs - discharge from agency during assessment period [CMS Assessment] |
| 99191-9 | OASIS E - Medications - DC during assessment period [CMS Assessment] |
| 99192-7 | Patient-reported outcomes with LASIK - pre-operative panel [Patient reported outcomes with LASIK] |
| 99194-3 | Could accept less than perfect vision if able to see well enough to drive without corrective lenses |
| 99195-0 | Expected corrective lens use frequency after healing from LASIK.distance |
| 99196-8 | Expected corrective lens use frequency after healing from LASIK.near |
| 99197-6 | Expect clear vision after healing from LASIK |
| 99198-4 | Expect perfect vision after healing from LASIK |
| 99199-2 | Could accept less than perfect vision without corrective lenses after healing from LASIK |
| 99209-9 | Level of difficulty getting used to the dark when moving from a lighted area into a dark place |
| 99210-7 | Level of difficulty seeing because of changes in vision clarity during the course of the day |
| 99211-5 | Frequency of being bothered by changes in the clarity of vision over the course of the day |
| 99212-3 | Frequency of seeing starbursts or halos that are bothersome or make it difficult to see when around bright lights at night |
| 99224-8 | Hours missed from work because of any non vision related reasons in past 7 days |
| 99242-0 | Level of difficulty doing usual activities because of glare when not wearing corrective lenses in past 7 days |
| 99243-8 | Impact of best corrective lenses on glare |
| 99245-3 | Frequency of seeing halos when wearing best corrective lenses in past 7 days |
| 99246-1 | Frequency of seeing halos when not wearing corrective lenses in past 7 days |
| 99247-9 | How bothersome have halos been when wearing best corrective lenses in past 7 days |
| 99248-7 | How bothersome have halos been when not wearing corrective lenses in past 7 days |
| 99249-5 | Level of difficulty doing usual activities because of halos when wearing best corrective lenses in past 7 days |
| 99250-3 | Level of difficulty doing usual activities because of halos when not wearing corrective lenses in past 7 days |
| 99251-1 | Impact of best corrective lenses on halos |
| 99253-7 | Frequency of seeing starbursts when wearing best corrective lenses in past 7 days |
| 99254-5 | Frequency of seeing starbursts when not wearing corrective lenses in past 7 days |
| 99255-2 | How bothersome have starbursts been when wearing best corrective lenses in past 7 days |
| 99256-0 | How bothersome have starbursts been when not wearing corrective lenses in past 7 days |
| 99257-8 | Level of difficulty doing usual activities because of starbursts when wearing best corrective lenses in past 7 days |
| 99258-6 | Level of difficulty doing usual activities because of starbursts when not wearing corrective lenses in past 7 days |
| 99259-4 | Impact of best corrective lenses on starbursts |
| 99260-2 | Information source for medical procedure |
| 99261-0 | Told not to have LASIK by an eye care professional |
| 99283-4 | Tegner Activity Scale panel [Tegner] |
| 99284-2 | Activity level before injury |
| 99285-9 | Current activity level |
| 99286-7 | Provision of current reconciled medication list to subsequent provider at transfer during assessment period [CMS Assessment] |
| 99287-5 | Checklist of nonverbal pain indicators panel [CNPI] |
| 99288-3 | Checklist of nonverbal pain indicators with movement panel [CNPI] |
| 99289-1 | Nonverbal vocal complaints during movement |
| 99290-9 | Facial grimaces or winces during movement |
| 99291-7 | Bracing during movement |
| 99292-5 | Rubbing during movement |
| 99293-3 | Restlessness during movement |
| 99294-1 | Verbal complaints during movement |
| 99295-8 | With movement score [CNPI] |
| 99296-6 | Checklist of nonverbal pain indicators at rest panel [CNPI] |
| 99297-4 | Nonverbal vocal complaints while at rest |
| 99298-2 | Facial grimaces or winces while at rest |
| 99299-0 | Bracing while at rest |
| 99300-6 | Restlessness while at rest |
| 99301-4 | Rubbing while at rest |
| 99302-2 | Verbal complaints while at rest |
| 99303-0 | At rest score [CNPI] |
| 99304-8 | Total score [CNPI] |
| 99305-5 | Checklist of nonverbal pain indicators assessment [CNPI] |
| 99315-4 | OASIS E - Intervention synopsis - DC, TRN during assessment period [CMS Assessment] |
| 99342-8 | Days since symptom started |
| 99343-6 | Days since symptom finished |
| 99344-4 | Sought medical attention for symptoms |
| 99345-1 | Type of medical attention accessed |
| 99348-5 | Close contact with COVID-19 in last 2W |
| 99349-3 | Has or had COVID-19 |
| 99350-1 | Date of first infection onset |
| 99351-9 | Informed of being at severe risk from COVID-19 due to an underlying health condition |
| 99352-7 | Has health problems that require activity limits |
| 99357-6 | COVID-19 health questions panel |
| 99417-8 | Shared decision making panel [R-Outcomes] |
| 99418-6 | Shared decision making total score [R-Outcomes] |
| 99419-4 | Know possible benefits of treatment plan |
| 99420-2 | Know possible downside of treatment plan |
| 99421-0 | Know available choices for treatment plan |
| 99422-8 | Feel fully involved in treatment plan |
| 99423-6 | Time to complete survey |
| 99549-8 | Health Leads screening panel |
| 99550-6 | Worried about housing stability in next 2 months |
| 99551-4 | Problems getting child care make work or study difficult |
| 99552-2 | Could not see doctor due to cost in past 12Mo |
| 99553-0 | Went without health care due to lack of transportation in last 12 months |
| 99554-8 | Personal needs are urgent |
| 99555-5 | Want assistance with personal needs |
| 99556-3 | Behavior change panel [R-Outcomes] |
| 99557-1 | Behavior change total score [R-Outcomes] |
| 99558-9 | Skills and tools to change behavior |
| 99559-7 | Nothing prevents behavior change |
| 99560-5 | Choose to change behavior |
| 99561-3 | Change behavior without thinking |
| 99562-1 | Adherence panel [R-Outcomes] |
| 99563-9 | Adherence total score [R-Outcomes] |
| 99564-7 | Remember to follow treatment instructions |
| 99565-4 | Follow treatment instructions if feel bad |
| 99566-2 | Follow treatment instructions if feel better |
| 99567-0 | Acceptance of loss panel [R-Outcomes] |
| 99568-8 | Acceptance of loss total score [R-Outcomes] |
| 99569-6 | Know capabilities following loss |
| 99570-4 | Recognize life changes following loss |
| 99571-2 | Activities done differently following loss |
| 99572-0 | Moved on following loss |
| 99573-8 | Often feel lack of companionship |
| 99574-6 | Roland Morris Disability Questionnaire panel [RMDQ] |
| 99575-3 | Total score [RMDQ] |
| 99576-1 | Impact of back pain today |
| 99577-9 | Columbia Behavior Scale for Dementia panel [CBS-8] |
| 99578-7 | Total score [CBS-8] |
| 99579-5 | Psychosis factor score [CBS-8] |
| 99580-3 | Aggression factor score [CBS-8] |
| 99581-1 | Motor disinhibition factor score [CBS-8] |
| 99583-7 | Lysholm Knee Scoring Scale [LKSS] |
| 99592-8 | Total score [LKSS] |
| 99593-6 | American Academy of Family Physicians Social Needs Screening Tool |
| 99594-4 | Delayed medical care due to distance or lack of transportation |
| 99595-1 | American Academy of Family Physicians Social Needs Screening Tool - short form |
| 99627-2 | How often does this describe you, I don't have enough money to pay my bills |
| 99634-8 | Federal, state, or local governments required limiting non-essential travel |
| 99635-5 | Main symptoms experienced by people infected with condition of interest |
| 99636-3 | Activity related to possible exposure to condition of interest |
| 99637-1 | Measures taken to keep safe from condition of interest |
| 99638-9 | Federal, state, or local governments encouraged limiting non-essential travel |
| 99639-7 | Effectiveness of wearing a face mask to keep safe from condition of interest |
| 99640-5 | Effectiveness of praying to keep safe from condition of interest |
| 99641-3 | Effectiveness of washing your hands with soap or using hand sanitizer frequently to keep safe from condition of interest |
| 99642-1 | Effectiveness of seeing a doctor if you feel sick to keep safe from condition of interest |
| 99643-9 | Effectiveness of seeing a doctor if you feel healthy but worry that you were exposed to keep safe from condition of interest |
| 99644-7 | Effectiveness of avoiding public spaces, gatherings, and crowds to keep safe from condition of interest |
| 99645-4 | Effectiveness of avoiding contact with people who could be high-risk to keep safe from condition of interest |
| 99646-2 | Effectiveness of avoiding hospitals and clinics to keep safe from condition of interest |
| 99647-0 | Effectiveness of avoiding restaurants to keep safe from condition of interest |
| 99648-8 | Effectiveness of avoiding airplanes to keep safe from condition of interest |
| 99649-6 | Safety of grocery shopping for avoiding exposure to condition of interest |
| 99650-4 | Safety of attending gatherings of more than 100 people for avoiding exposure to condition of interest |
| 99651-2 | Safety of going to the hospital for avoiding exposure to condition of interest |
| 99652-0 | Safety of dining in at restaurants for avoiding exposure to condition of interest |
| 99653-8 | Safety of eating take-out meals from restaurants for avoiding exposure to condition of interest |
| 99654-6 | Safety of visiting with relatives or friends in their home for avoiding exposure to condition of interest |
| 99655-3 | Safety of handling packages that have been delivered for avoiding exposure to condition of interest |
| 99656-1 | Safety of playing on playground equipment for avoiding exposure to condition of interest |
| 99657-9 | Safety of touching door knobs, countertops, and other surfaces in your home for avoiding exposure to condition of interest |
| 99658-7 | Safety of interacting closely with other members of your household for avoiding exposure to condition of interest |
| 99659-5 | Safety of going outside to walk, hike, or exercise for avoiding exposure to condition of interest |
| 99660-3 | Number of family members or close friends |
| 99661-1 | Number of family members or close friends that have been infected with condition of interest |
| 99662-9 | Percent chance of contracting condition of interest in next 3 months |
| 99663-7 | Percent chance of death from condition of interest if infected |
| 99664-5 | Agreement with statement: childhood vaccines have many known harmful side effects |
| 99665-2 | Agreement with statement: childhood vaccines provide important benefits to society |
| 99666-0 | Agreement with statement: childhood vaccines may lead to illness and death |
| 99667-8 | Agreement with statement: childhood vaccines are useful and effective |
| 99668-6 | Likelihood of getting vaccinated for condition of interest when available |
| 99669-4 | Agreement with statement: most people believe that people with condition of interest are dangerous |
| 99670-2 | Agreement with statement: most people believe that people who used to have condition of interest are dangerous |
| 99671-0 | Agreement with statement: most people believe that having condition of interest is a sign of personal weakness or failure |
| 99672-8 | Agreement with statement: if I caught condition of interest, I would consider it a sign of my personal weakness or failure |
| 99673-6 | COVID-19 Knowledge, Attitudes, and Avoidant Behaviors panel |
| 99745-2 | Patient reported outcomes with LASIK - post-operative panel [Patient reported outcomes with LASIK] |
| 99746-0 | New problem or limitation after LASIK |
| 99747-8 | Problem or limitation because of LASIK |
| 99748-6 | Problem or limitation after LASIK affected quality of life |
| 99749-4 | Surgery provider explained what to expect during LASIK recovery period |
| 99750-2 | Satisfaction level with LASIK result |
| 99751-0 | Satisfaction level with length of time for vision improvement after LASIK |
| 99752-8 | Satisfaction level with length of time it took for improvement in post-operative discomfort after LASIK |
| 99753-6 | Level of understanding risk and benefit of LASIK before treatment |
| 99754-4 | When not wearing corrective lenses, distance vision is as good as anticipated after LASIK |
| 99755-1 | Wear corrective lenses to see in the distance |
| 99756-9 | Goal for LASIK achieved |
| 99757-7 | Happiness level of having LASIK |
| 99759-3 | Would recommend LASIK to friend or family member |
| 99760-1 | Reason not to have or recommend LASIK |
| 99788-2 | Functional Communication Measure - Cognition ages 6 or older panel [ASHA NOMS] |
| 99789-0 | Frequency of demonstrating cognitive-communication skills for completing rote AndOr simple routine living tasks |
| 99790-8 | Frequency of demonstrating cognitive-communication skills for completing age-appropriate common daily living tasks |
| 99791-6 | Frequency of demonstrating cognitive-communication skills for completing age-appropriate complex living tasks |
| 99792-4 | Frequency of demonstrating cognitive-communication skills to independently function safely without supervision AndOr assistance |
| 99793-2 | Functional Communication Measure - Cognition ages 6 or older score [ASHA NOMS] |
| 99794-0 | Number of household members enrolled in preschool or day care |
| 99795-7 | Number of household members enrolled in elementary school |
| 99796-5 | Number of household members enrolled in middle school or junior high |
| 99797-3 | Number of household members enrolled in high school |
| 99798-1 | Number of household members enrolled in college or trade school, including four-year colleges, community colleges, technical institutes, and vocational schools |
| 99799-9 | Enrolled in college or trade school, including four-year colleges, community colleges |
| 99800-5 | Do children in this household have access to the internet during the day to support learning |
| 99801-3 | Type of internet available to children in household to support learning |
| 99802-1 | Devices used in household to access the internet for learning |
| 99803-9 | Number of laptops or desktops used in household for learning |
| 99804-7 | Number of tablets used in household for learning |
| 99805-4 | Number of smartphones used in household use for learning |
| 99806-2 | Number of household members enrolled in preschool or day care that had school suspended or canceled because of the condition of interest |
| 99807-0 | Number of household members enrolled in elementary school that had school suspended or canceled because of the condition of interest |
| 99808-8 | Household members in elementary school do educational activities at home |
| 99809-6 | Provider of educational activities |
| 99810-4 | Number of household members enrolled in middle school or junior high that had school suspended or canceled because of the condition of interest |
| 99811-2 | Household members in middle school or junior high do educational activities at home |
| 99812-0 | Number of household members enrolled in high school that have had school suspended or canceled because of the condition of interest |
| 99813-8 | Household members in high school do educational activities at home |
| 99814-6 | Number of household members in grade 12 |
| 99815-3 | Name of the household member in grade 12 Household member |
| 99816-1 | Plans for after high school Household member |
| 99817-9 | Post high school plans changed due to condition of interest or school closures Household member |
| 99818-7 | Previous plans for after high school Household member |
| 99819-5 | Primary child care provider while school is suspended or canceled |
| 99820-3 | Level of difficulty finding affordable child care while school is suspended or canceled |
| 99821-1 | Agreement with statement: School closures made it difficult for me to work or do other household tasks |
| 99822-9 | Agreement with statement: I am satisfied with the communication to support learning from my child's school |
| 99823-7 | Agreement with statement: My child will be prepared for school in the next school year |
| 99824-5 | Earliest date school will resume in person |
| 99825-2 | Educational impact due to COVID-19 panel |
| 99828-6 | Functional Communication Measure - Multi-Modal Functional Communication panel [ASHA NOMS] |
| 99829-4 | Frequency of conveying meaningful simple messages in routine low demand situations |
| 99830-2 | Frequency of participating in meaningful short structured conversations in low demand situations |
| 99831-0 | Frequency of conveying meaningful complex messages in low demand situations |
| 99832-8 | Frequency of conveying meaningful simple messages in routine high demand situations |
| 99833-6 | Frequency of participating in meaningful short structured conversations in high demand situations |
| 99834-4 | Frequency of conveying meaningful complex messages in high demand situations |
| 99835-1 | Functional Communication Measure - Multi-Modal Functional Communication score [ASHA NOMS] |
| 99836-9 | Functional Communication Measure - Spoken Language Comprehension ages 6 or older panel [ASHA NOMS] |
| 99837-7 | Frequency of understanding simple messages in routine low demand situations |
| 99838-5 | Frequency of understanding complex messages in low demand situations |
| 99839-3 | Frequency of understanding simple messages in routine high demand situations |
| 99840-1 | Frequency of understanding complex messages in high demand situations |
| 99841-9 | Frequency of functioning without assistance due to comprehension deficit |
| 99842-7 | Frequency of participating in spoken language comprehension communication without assistance |
| 99843-5 | Functional Communication Measure - Spoken Language Comprehension ages 6 or older score [ASHA NOMS] |
| 99844-3 | Functional Communication Measure - Spoken Language Expression ages 6 or older panel [ASHA NOMS] |
| 99845-0 | Frequency of noticeable spoken language expression difficulties |
| 99846-8 | Frequency of simple meaningful word or phrase expression |
| 99847-6 | Frequency of producing verbal messages with appropriate form in low demand situations |
| 99848-4 | Frequency of producing verbal messages with appropriate content in low demand situations |
| 99849-2 | Frequency of producing verbal messages with appropriate form in high demand situations |
| 99850-0 | Frequency of producing verbal messages with appropriate content in high demand situations |
| 99851-8 | Functional Communication Measure - Spoken Language Expression ages 6 or older score [ASHA NOMS] |
| 99852-6 | Functional Communication Measure - Swallowing panel [ASHA NOMS] |
| 99853-4 | Recommended modified solids diet |
| 99854-2 | Recommended modified liquids diet |
| 99855-9 | Percentage of daily diet delivered through non-oral means |
| 99856-7 | Frequency of difficulties with oral containment or secretion management |
| 99857-5 | Frequency of required supervision or assistance for swallowing safety |
| 99858-3 | Functional Communication Measure - Swallowing score [ASHA NOMS] |
| 99934-2 | Mainz pain staging system panel [Mainz Pain Staging System] |
| 99946-6 | Total score [Mainz Pain Staging System] |
| 99974-8 | No risk of injury due to a thermal source |
| 99975-5 | No injury related to a chemical source |
| 99976-3 | No injury related to a radiation source |
| 99977-1 | No injury related to transfer AndOr transport during care |
| 99978-9 | No harm related to medications administered |
| 99979-7 | No injury related to unintended retained surgical item |
| 99980-5 | Wound is healing or improved from baseline levels |
| 99981-3 | Culture and demographics incorporated into plan of care |
| 99982-1 | Care provided is consistent with established plan of care |
| 99983-9 | Patient's right to privacy is maintained |
| 99984-7 | Patient receives competent and ethical care within legal standards of practice |
| 99985-4 | Patient receives consistent and comparable care regardless of the setting |
| 99986-2 | Tissue perfusion is maintained at or improved from baseline levels |
| 99987-0 | Gastrointestinal status is maintained at or improved from baseline levels |
| 99988-8 | Genitourinary status is maintained at or improved from baseline levels |
| 99989-6 | Musculoskeletal status is maintained at or improved from baseline levels |
| 99990-4 | Endocrine status is maintained at or improved from baseline levels |
| 99991-2 | No signs and symptoms of infection |
| 99992-0 | Thermoregulation maintained core body temperature at desired range |
| 99993-8 | No injury related to an incorrect procedure performed |
| 99994-6 | Fluid, electrolyte, and acid-base balances are maintained at or improved from baseline levels |
| 99995-3 | Respiratory status is maintained at or improved from baseline levels |
| 99996-1 | Cardiovascular status is maintained at or improved from baseline levels |
| 99997-9 | Demonstrates AndOr reports adequate pain control |
| 99998-7 | Neurological status is maintained at or improved from baseline levels |