-3676
Property | Specification |
Data System | OSA |
Data Specs | V3.01.0 |
Edit Type | Format |
Severity | Fatal |
Edit Text |
Values of Code and Checklist Items: Only the coded values listed in the "Item Values" table of the Detailed Data Specifications Report may be submitted for this item. |
Version Notes | [V3.01.0]-Added mappings to new items A1005A-Y, A1010A-Z, and A1110B. |
Item List | |
Item ID | Description |
ASMT_SYS_CD | Assessment system code |
ITM_SBST_CD | Item subset code |
PRODN_TEST_CD | Production/test indicator |
STATE_CD | Facility"s state postal code |
STATE_PDPM_OBRA_CD | State calculation of PDPM for OBRA |
A0050 | Type of transaction (formerly X0100) |
A0200 | Type of provider |
A0300A | State Payment Assessment Purpose |
A0300B | State Payment Assessment Type |
A0410 | Submission requirement |
A0800 | Gender |
A1005A | Ethnicity: No, not Hispanic, Latino/a, Spanish |
A1005B | Ethnicity: Yes, Mex, Mex Amer, Chicano/a |
A1005C | Ethnicity: Yes, Puerto Rican |
A1005D | Ethnicity: Yes, Cuban |
A1005E | Ethnicity: Yes, another Hispanic/Latino/Spanish |
A1005X | Ethnicity: Patient unable to respond |
A1005Y | Ethnicity: Patient declines to respond |
A1010A | Race: White |
A1010B | Race: Black or African American |
A1010C | Race: American Indian or Alaska Native |
A1010D | Race: Asian Indian |
A1010E | Race: Chinese |
A1010F | Race: Filipino |
A1010G | Race: Japanese |
A1010H | Race: Korean |
A1010I | Race: Vietnamese |
A1010J | Race: Other Asian |
A1010K | Race: Native Hawaiian |
A1010L | Race: Guamanian or Chamorro |
A1010M | Race: Samoan |
A1010N | Race: Other Pacific Islander |
A1010X | Race: Patient unable to respond |
A1010Y | Race: Patient declines to respond |
A1010Z | Race: None of the above |
A1110B | Does the patient need or want an interpreter |
A1200 | Marital status |
B0100 | Comatose |
B0700 | Makes self understood |
C0100 | BIMS: should resident interview be conducted |
C0200 | BIMS res interview: repetition of three words |
C0300A | BIMS res interview: able to report correct year |
C0300B | BIMS res interview: able to report correct month |
C0300C | BIMS res interview: can report correct day of week |
C0400A | BIMS res interview: able to recall "sock" |
C0400B | BIMS res interview: able to recall "blue" |
C0400C | BIMS res interview: able to recall "bed" |
C0600 | Staff asmt mental status: conduct asmt |
C0700 | Staff asmt mental status: short-term memory OK |
C1000 | Cognitive skills for daily decision making |
D0100 | PHQ: should resident mood interview be conducted |
D0200A1 | PHQ res: little interest or pleasure - presence |
D0200A2 | PHQ res: little interest or pleasure - frequency |
D0200B1 | PHQ res: feeling down, depressed - presence |
D0200B2 | PHQ res: feeling down, depressed - frequency |
D0200C1 | PHQ res: trouble with sleep - presence |
D0200C2 | PHQ res: trouble with sleep - frequency |
D0200D1 | PHQ res: feeling tired/little energy - presence |
D0200D2 | PHQ res: feeling tired/little energy - frequency |
D0200E1 | PHQ res: poor appetite or overeating - presence |
D0200E2 | PHQ res: poor appetite or overeating - frequency |
D0200F1 | PHQ res: feeling bad about self - presence |
D0200F2 | PHQ res: feeling bad about self - frequency |
D0200G1 | PHQ res: trouble concentrating - presence |
D0200G2 | PHQ res: trouble concentrating - frequency |
D0200H1 | PHQ res: slow, fidgety, restless - presence |
D0200H2 | PHQ res: slow, fidgety, restless - frequency |
D0200I1 | PHQ res: thoughts better off dead - presence |
D0200I2 | PHQ res: thoughts better off dead - frequency |
D0500A1 | PHQ staff: little interest or pleasure - presence |
D0500A2 | PHQ staff: little interest or pleasure - frequency |
D0500B1 | PHQ staff: feeling down, depressed - presence |
D0500B2 | PHQ staff: feeling down, depressed - frequency |
D0500C1 | PHQ staff: trouble with sleep - presence |
D0500C2 | PHQ staff: trouble with sleep - frequency |
D0500D1 | PHQ staff: feeling tired/little energy - presence |
D0500D2 | PHQ staff: feeling tired/little energy - frequency |
D0500E1 | PHQ staff: poor appetite or overeating - presence |
D0500E2 | PHQ staff: poor appetite or overeating - frequency |
D0500F1 | PHQ staff: feeling bad about self - presence |
D0500F2 | PHQ staff: feeling bad about self - frequency |
D0500G1 | PHQ staff: trouble concentrating - presence |
D0500G2 | PHQ staff: trouble concentrating - frequency |
D0500H1 | PHQ staff: slow, fidgety, restless - presence |
D0500H2 | PHQ staff: slow, fidgety, restless - frequency |
D0500I1 | PHQ staff: thoughts better off dead - presence |
D0500I2 | PHQ staff: thoughts better off dead - frequency |
D0500J1 | PHQ staff: short-tempered - presence |
D0500J2 | PHQ staff: short-tempered - frequency |
E0100A | Psychosis: hallucinations |
E0100B | Psychosis: delusions |
E0100Z | Psychosis: none of the above |
E0200A | Physical behav symptoms directed toward others |
E0200B | Verbal behav symptoms directed toward others |
E0200C | Other behav symptoms not directed toward others |
E0800 | Rejection of care: presence and frequency |
E0900 | Wandering: presence and frequency |
G0110A1 | Bed mobility: self-performance |
G0110A2 | Bed mobility: support provided |
G0110B1 | Transfer: self-performance |
G0110B2 | Transfer: support provided |
G0110H1 | Eating: self-performance |
G0110H2 | Eating: support provided |
G0110I1 | Toilet use: self-performance |
G0110I2 | Toilet use: support provided |
H0200C | Urinary toileting program: current program/trial |
H0500 | Bowel toileting program being used |
I2000 | Pneumonia |
I2100 | Septicemia |
I2900 | Diabetes mellitus (DM) |
I4300 | Aphasia |
I4400 | Cerebral palsy |
I4900 | Hemiplegia or hemiparesis |
I5100 | Quadriplegia |
I5200 | Multiple sclerosis |
I5300 | Parkinson"s disease |
I6200 | Asthma (COPD) or chronic lung disease |
I6300 | Respiratory failure |
I7900 | None of above active diseases within last 7 days |
J1100C | Short breath/trouble breathing: lying flat |
J1100Z | Short breath/trouble breathing: none of above |
J1550A | Problem conditions: fever |
J1550B | Problem conditions: vomiting |
J1550C | Problem conditions: dehydrated |
J1550D | Problem conditions: internal bleeding |
J1550Z | Problem conditions: none of the above |
K0300 | Weight loss |
K0510A1 | Nutrition approach: Not Res: parenteral/IV feeding |
K0510A2 | Nutrition approach: Res: parenteral /IV feeding |
K0510B1 | Nutrition approach: Not Res: feeding tube |
K0510B2 | Nutrition approach: Res: feeding tube |
K0510Z1 | Nutrition approach: Not Res: none of the above |
K0510Z2 | Nutrition approach: Res: none of the above |
K0710A3 | Prop calories parenteral/tube feed: 7 days |
K0710B3 | Avg fluid intake per day IV/tube: 7 days |
M0210 | Resident has 1+ unhealed PU/injuries |
M1040A | Other skin probs: infection of the foot |
M1040B | Other skin probs: diabetic foot ulcer(s) |
M1040C | Other skin probs: other open lesion(s) on the foot |
M1040D | Other skin probs: lesions not ulcers, rashes, cuts |
M1040E | Other skin probs: surgical wound(s) |
M1040F | Other skin probs: burns (second or third degree) |
M1040Z | Other skin probs: none of the above |
M1200A | Skin/ulcer/injry treat: prssr rduce dvc for chair |
M1200B | Skin/ulcer/injry treat: prssr reducing dvc for bed |
M1200C | Skin/ulcer/injry treat: turning/repositioning |
M1200D | Skin/ulcer/injry treat: nutrition/hydration |
M1200E | Skin/ulcer/injry treat: prssr ulcer/injry care |
M1200F | Skin/ulcer/injry treat: surgical wound care |
M1200G | Skin/ulcer/injry treat: application of dressings |
M1200H | Skin/ulcer/injry treat: apply ointments/meds |
M1200I | Skin/ulcer/injry treat: apply dressings to feet |
M1200Z | Skin/ulcer/injry treat: none of the above |
O0100A1 | Treatment: chemotherapy - while not resident |
O0100A2 | Treatment: chemotherapy - while resident |
O0100B1 | Treatment: radiation - while not resident |
O0100B2 | Treatment: radiation - while resident |
O0100C1 | Treatment: oxygen therapy - while not resident |
O0100C2 | Treatment: oxygen therapy - while resident |
O0100D1 | Treatment: suctioning - while not resident |
O0100D2 | Treatment: suctioning - while resident |
O0100E1 | Treatment: tracheostomy care - while not resident |
O0100E2 | Treatment: tracheostomy care - while resident |
O0100F1 | Treat: Invsv Mech Vent - while not resident |
O0100F2 | Treat: Invsv Mech Vent - while resident |
O0100H1 | Treatment: IV medications - while not resident |
O0100H2 | Treatment: IV medications - while resident |
O0100I1 | Treatment: transfusions - while not resident |
O0100I2 | Treatment: transfusions - while resident |
O0100J1 | Treatment: dialysis - while not resident |
O0100J2 | Treatment: dialysis - while resident |
O0100M2 | Treatment: isolate/quarantine - while resident |
O0100Z1 | Treatment: none of above - while not resident |
O0100Z2 | Treatment: none of above - while resident |
O0450A | Has therapy resumed |
X0150 | Correction: type of provider |
X0300 | Correction: resident gender |
X0570A | Correction: Optional State Assessment Purpose |
X0570B | Correction: Optional State Assessment Type |
X0900A | Correction: modif reasons - transcription error |
X0900B | Correction: modif reasons - data entry error |
X0900C | Correction: modif reasons - software error |
X0900D | Correction: modif reasons - item coding error |
X0900Z | Correction: modif reasons - other error |
X1050A | Correction: inact reasons - event did not occur |
X1050Z | Correction: inact reasons - other reason |
Z0200C | State case mix: Short Stay Assessment |
NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 06/06/2023 01:46:59 PM