OSA Item Summary
Item |
Group |
Type |
Length |
Fixed Start-End |
Description |
ASMT_SYS_CD | Control | Code | 10 | 1-10 | Assessment system code |
ITM_SBST_CD | Control | Code | 3 | 11-13 | Item subset code |
ITM_SET_VRSN_CD | Control | Code | 10 | 14-23 | Item set version code |
SPEC_VRSN_CD | Control | Code | 10 | 24-33 | Specifications version code |
PRODN_TEST_CD | Control | Code | 1 | 34-34 | Production/test indicator |
STATE_CD | Control | Code | 2 | 35-36 | Facility"s state postal code |
FAC_ID | Control | Text | 16 | 37-52 | Assigned facility/provider submission ID |
SFTWR_VNDR_ID | Control | Text | 9 | 53-61 | Software vendor federal employer tax ID |
SFTWR_VNDR_NAME | Control | Text | 30 | 62-91 | Software vendor company name |
SFTWR_VNDR_EMAIL_ADR | Control | Text | 50 | 92-141 | Software vendor email address |
SFTWR_PROD_NAME | Control | Text | 50 | 142-191 | Software product name |
SFTWR_PROD_VRSN_CD | Control | Text | 20 | 192-211 | Software product version code |
FAC_DOC_ID | Control | Text | 20 | 212-231 | Facility document ID |
STATE_PDPM_OBRA_CD | Control | Code | 1 | 1827-1827 | State calculation of PDPM for OBRA |
A0050 | Asmt | Code | 1 | 1216-1216 | Type of transaction (formerly X0100) |
A0100A | Asmt | Text | 10 | 232-241 | Facility National Provider Identifier (NPI) |
A0100B | Asmt | Text | 12 | 242-253 | Facility CMS Certification Number (CCN) |
A0100C | Asmt | Text | 15 | 254-268 | State provider number |
A0200 | Asmt | Code | 1 | 269-269 | Type of provider |
A0300A | Asmt | Code | 1 | 1701-1701 | State Payment Assessment Purpose |
A0300B | Asmt | Code | 1 | 1702-1702 | State Payment Assessment Type |
A0410 | Asmt | Code | 1 | 279-279 | Submission requirement |
A0500A | Asmt | Text | 12 | 280-291 | Resident first name |
A0500B | Asmt | Text | 1 | 292-292 | Resident middle initial |
A0500C | Asmt | Text | 18 | 293-310 | Resident last name |
A0500D | Asmt | Text | 3 | 311-313 | Resident name suffix |
A0600A | Asmt | Text | 9 | 314-322 | Social Security Number |
A0600B | Asmt | Text | 12 | 323-334 | Medicare number |
A0700 | Asmt | Text | 14 | 335-348 | Medicaid number |
A0800 | Asmt | Code | 1 | 350-350 | Gender |
A0900 | Asmt | Date | 8 | 351-358 | Birthdate |
A1005A | Asmt | Checklist | 1 | 1828-1828 | Ethnicity: No, not Hispanic, Latino/a, Spanish |
A1005B | Asmt | Checklist | 1 | 1829-1829 | Ethnicity: Yes, Mex, Mex Amer, Chicano/a |
A1005C | Asmt | Checklist | 1 | 1830-1830 | Ethnicity: Yes, Puerto Rican |
A1005D | Asmt | Checklist | 1 | 1831-1831 | Ethnicity: Yes, Cuban |
A1005E | Asmt | Checklist | 1 | 1832-1832 | Ethnicity: Yes, another Hispanic/Latino/Spanish |
A1005X | Asmt | Checklist | 1 | 1833-1833 | Ethnicity: Patient unable to respond |
A1005Y | Asmt | Checklist | 1 | 1834-1834 | Ethnicity: Patient declines to respond |
A1010A | Asmt | Checklist | 1 | 1835-1835 | Race: White |
A1010B | Asmt | Checklist | 1 | 1836-1836 | Race: Black or African American |
A1010C | Asmt | Checklist | 1 | 1837-1837 | Race: American Indian or Alaska Native |
A1010D | Asmt | Checklist | 1 | 1838-1838 | Race: Asian Indian |
A1010E | Asmt | Checklist | 1 | 1839-1839 | Race: Chinese |
A1010F | Asmt | Checklist | 1 | 1840-1840 | Race: Filipino |
A1010G | Asmt | Checklist | 1 | 1841-1841 | Race: Japanese |
A1010H | Asmt | Checklist | 1 | 1842-1842 | Race: Korean |
A1010I | Asmt | Checklist | 1 | 1843-1843 | Race: Vietnamese |
A1010J | Asmt | Checklist | 1 | 1844-1844 | Race: Other Asian |
A1010K | Asmt | Checklist | 1 | 1845-1845 | Race: Native Hawaiian |
A1010L | Asmt | Checklist | 1 | 1846-1846 | Race: Guamanian or Chamorro |
A1010M | Asmt | Checklist | 1 | 1847-1847 | Race: Samoan |
A1010N | Asmt | Checklist | 1 | 1848-1848 | Race: Other Pacific Islander |
A1010X | Asmt | Checklist | 1 | 1849-1849 | Race: Patient unable to respond |
A1010Y | Asmt | Checklist | 1 | 1850-1850 | Race: Patient declines to respond |
A1010Z | Asmt | Checklist | 1 | 1851-1851 | Race: None of the above |
A1110A | Asmt | Text | 15 | 1852-1866 | Preferred language |
A1110B | Asmt | Code | 1 | 1867-1867 | Does the patient need or want an interpreter |
A1200 | Asmt | Code | 1 | 381-381 | Marital status |
A1300A | Asmt | Text | 12 | 382-393 | Medical record number |
A1300B | Asmt | Text | 10 | 394-403 | Room number |
A1300C | Asmt | Text | 23 | 404-426 | Name by which resident prefers to be addressed |
A1300D | Asmt | Text | 23 | 427-449 | Lifetime occupation(s) |
A1600 | Asmt | Date | 8 | 457-464 | Entry date (date of admission/reentry in facility) |
A1900 | Asmt | Date | 8 | 1485-1492 | Admission date |
A2300 | Asmt | Date | 8 | 486-493 | Assessment reference date |
A2400B | Asmt | Date | 8 | 495-502 | Start date of most recent Medicare stay |
A2400C | Asmt | Date | 8 | 503-510 | End date of most recent Medicare stay |
B0100 | Asmt | Code | 1 | 511-511 | Comatose |
B0700 | Asmt | Code | 1 | 515-515 | Makes self understood |
C0100 | Asmt | Code | 1 | 519-519 | BIMS: should resident interview be conducted |
C0200 | Asmt | Code | 1 | 520-520 | BIMS res interview: repetition of three words |
C0300A | Asmt | Code | 1 | 521-521 | BIMS res interview: able to report correct year |
C0300B | Asmt | Code | 1 | 522-522 | BIMS res interview: able to report correct month |
C0300C | Asmt | Code | 1 | 523-523 | BIMS res interview: can report correct day of week |
C0400A | Asmt | Code | 1 | 524-524 | BIMS res interview: able to recall "sock" |
C0400B | Asmt | Code | 1 | 525-525 | BIMS res interview: able to recall "blue" |
C0400C | Asmt | Code | 1 | 526-526 | BIMS res interview: able to recall "bed" |
C0500 | Asmt | Number | 2 | 527-528 | BIMS res interview: summary score |
C0600 | Asmt | Code | 1 | 529-529 | Staff asmt mental status: conduct asmt |
C0700 | Asmt | Code | 1 | 530-530 | Staff asmt mental status: short-term memory OK |
C1000 | Asmt | Code | 1 | 537-537 | Cognitive skills for daily decision making |
D0100 | Asmt | Code | 1 | 543-543 | PHQ: should resident mood interview be conducted |
D0200A1 | Asmt | Code | 1 | 544-544 | PHQ res: little interest or pleasure - presence |
D0200A2 | Asmt | Code | 1 | 545-545 | PHQ res: little interest or pleasure - frequency |
D0200B1 | Asmt | Code | 1 | 546-546 | PHQ res: feeling down, depressed - presence |
D0200B2 | Asmt | Code | 1 | 547-547 | PHQ res: feeling down, depressed - frequency |
D0200C1 | Asmt | Code | 1 | 548-548 | PHQ res: trouble with sleep - presence |
D0200C2 | Asmt | Code | 1 | 549-549 | PHQ res: trouble with sleep - frequency |
D0200D1 | Asmt | Code | 1 | 550-550 | PHQ res: feeling tired/little energy - presence |
D0200D2 | Asmt | Code | 1 | 551-551 | PHQ res: feeling tired/little energy - frequency |
D0200E1 | Asmt | Code | 1 | 552-552 | PHQ res: poor appetite or overeating - presence |
D0200E2 | Asmt | Code | 1 | 553-553 | PHQ res: poor appetite or overeating - frequency |
D0200F1 | Asmt | Code | 1 | 554-554 | PHQ res: feeling bad about self - presence |
D0200F2 | Asmt | Code | 1 | 555-555 | PHQ res: feeling bad about self - frequency |
D0200G1 | Asmt | Code | 1 | 556-556 | PHQ res: trouble concentrating - presence |
D0200G2 | Asmt | Code | 1 | 557-557 | PHQ res: trouble concentrating - frequency |
D0200H1 | Asmt | Code | 1 | 558-558 | PHQ res: slow, fidgety, restless - presence |
D0200H2 | Asmt | Code | 1 | 559-559 | PHQ res: slow, fidgety, restless - frequency |
D0200I1 | Asmt | Code | 1 | 560-560 | PHQ res: thoughts better off dead - presence |
D0200I2 | Asmt | Code | 1 | 561-561 | PHQ res: thoughts better off dead - frequency |
D0300 | Asmt | Number | 2 | 562-563 | PHQ res: total mood severity score |
D0500A1 | Asmt | Code | 1 | 565-565 | PHQ staff: little interest or pleasure - presence |
D0500A2 | Asmt | Code | 1 | 566-566 | PHQ staff: little interest or pleasure - frequency |
D0500B1 | Asmt | Code | 1 | 567-567 | PHQ staff: feeling down, depressed - presence |
D0500B2 | Asmt | Code | 1 | 568-568 | PHQ staff: feeling down, depressed - frequency |
D0500C1 | Asmt | Code | 1 | 569-569 | PHQ staff: trouble with sleep - presence |
D0500C2 | Asmt | Code | 1 | 570-570 | PHQ staff: trouble with sleep - frequency |
D0500D1 | Asmt | Code | 1 | 571-571 | PHQ staff: feeling tired/little energy - presence |
D0500D2 | Asmt | Code | 1 | 572-572 | PHQ staff: feeling tired/little energy - frequency |
D0500E1 | Asmt | Code | 1 | 573-573 | PHQ staff: poor appetite or overeating - presence |
D0500E2 | Asmt | Code | 1 | 574-574 | PHQ staff: poor appetite or overeating - frequency |
D0500F1 | Asmt | Code | 1 | 575-575 | PHQ staff: feeling bad about self - presence |
D0500F2 | Asmt | Code | 1 | 576-576 | PHQ staff: feeling bad about self - frequency |
D0500G1 | Asmt | Code | 1 | 577-577 | PHQ staff: trouble concentrating - presence |
D0500G2 | Asmt | Code | 1 | 578-578 | PHQ staff: trouble concentrating - frequency |
D0500H1 | Asmt | Code | 1 | 579-579 | PHQ staff: slow, fidgety, restless - presence |
D0500H2 | Asmt | Code | 1 | 580-580 | PHQ staff: slow, fidgety, restless - frequency |
D0500I1 | Asmt | Code | 1 | 581-581 | PHQ staff: thoughts better off dead - presence |
D0500I2 | Asmt | Code | 1 | 582-582 | PHQ staff: thoughts better off dead - frequency |
D0500J1 | Asmt | Code | 1 | 583-583 | PHQ staff: short-tempered - presence |
D0500J2 | Asmt | Code | 1 | 584-584 | PHQ staff: short-tempered - frequency |
D0600 | Asmt | Number | 2 | 585-586 | PHQ staff: total mood score |
E0100A | Asmt | Checklist | 1 | 588-588 | Psychosis: hallucinations |
E0100B | Asmt | Checklist | 1 | 589-589 | Psychosis: delusions |
E0100Z | Asmt | Checklist | 1 | 590-590 | Psychosis: none of the above |
E0200A | Asmt | Code | 1 | 591-591 | Physical behav symptoms directed toward others |
E0200B | Asmt | Code | 1 | 592-592 | Verbal behav symptoms directed toward others |
E0200C | Asmt | Code | 1 | 593-593 | Other behav symptoms not directed toward others |
E0800 | Asmt | Code | 1 | 601-601 | Rejection of care: presence and frequency |
E0900 | Asmt | Code | 1 | 602-602 | Wandering: presence and frequency |
G0110A1 | Asmt | Code | 1 | 646-646 | Bed mobility: self-performance |
G0110A2 | Asmt | Code | 1 | 647-647 | Bed mobility: support provided |
G0110B1 | Asmt | Code | 1 | 648-648 | Transfer: self-performance |
G0110B2 | Asmt | Code | 1 | 649-649 | Transfer: support provided |
G0110H1 | Asmt | Code | 1 | 660-660 | Eating: self-performance |
G0110H2 | Asmt | Code | 1 | 661-661 | Eating: support provided |
G0110I1 | Asmt | Code | 1 | 662-662 | Toilet use: self-performance |
G0110I2 | Asmt | Code | 1 | 663-663 | Toilet use: support provided |
H0200C | Asmt | Code | 1 | 689-689 | Urinary toileting program: current program/trial |
H0500 | Asmt | Code | 1 | 692-692 | Bowel toileting program being used |
I2000 | Asmt | Checklist | 1 | 711-711 | Pneumonia |
I2100 | Asmt | Checklist | 1 | 712-712 | Septicemia |
I2900 | Asmt | Checklist | 1 | 717-717 | Diabetes mellitus (DM) |
I4300 | Asmt | Checklist | 1 | 727-727 | Aphasia |
I4400 | Asmt | Checklist | 1 | 728-728 | Cerebral palsy |
I4900 | Asmt | Checklist | 1 | 731-731 | Hemiplegia or hemiparesis |
I5100 | Asmt | Checklist | 1 | 733-733 | Quadriplegia |
I5200 | Asmt | Checklist | 1 | 734-734 | Multiple sclerosis |
I5300 | Asmt | Checklist | 1 | 736-736 | Parkinson"s disease |
I6200 | Asmt | Checklist | 1 | 747-747 | Asthma (COPD) or chronic lung disease |
I6300 | Asmt | Checklist | 1 | 748-748 | Respiratory failure |
I7900 | Asmt | Checklist | 1 | 750-750 | None of above active diseases within last 7 days |
J1100C | Asmt | Checklist | 1 | 851-851 | Short breath/trouble breathing: lying flat |
J1100Z | Asmt | Checklist | 1 | 852-852 | Short breath/trouble breathing: none of above |
J1550A | Asmt | Checklist | 1 | 855-855 | Problem conditions: fever |
J1550B | Asmt | Checklist | 1 | 856-856 | Problem conditions: vomiting |
J1550C | Asmt | Checklist | 1 | 857-857 | Problem conditions: dehydrated |
J1550D | Asmt | Checklist | 1 | 858-858 | Problem conditions: internal bleeding |
J1550Z | Asmt | Checklist | 1 | 859-859 | Problem conditions: none of the above |
K0300 | Asmt | Code | 1 | 877-877 | Weight loss |
K0510A1 | Asmt | Checklist | 1 | 1444-1444 | Nutrition approach: Not Res: parenteral/IV feeding |
K0510A2 | Asmt | Checklist | 1 | 1445-1445 | Nutrition approach: Res: parenteral /IV feeding |
K0510B1 | Asmt | Checklist | 1 | 1446-1446 | Nutrition approach: Not Res: feeding tube |
K0510B2 | Asmt | Checklist | 1 | 1447-1447 | Nutrition approach: Res: feeding tube |
K0510Z1 | Asmt | Checklist | 1 | 1452-1452 | Nutrition approach: Not Res: none of the above |
K0510Z2 | Asmt | Checklist | 1 | 1453-1453 | Nutrition approach: Res: none of the above |
K0710A3 | Asmt | Code | 1 | 1468-1468 | Prop calories parenteral/tube feed: 7 days |
K0710B3 | Asmt | Code | 1 | 1471-1471 | Avg fluid intake per day IV/tube: 7 days |
M0210 | Asmt | Code | 1 | 898-898 | Resident has 1+ unhealed PU/injuries |
M0300A | Asmt | Number | 1 | 899-899 | Stage 1 pressure injuries: number present |
M0300B1 | Asmt | Number | 1 | 900-900 | Stage 2 pressure ulcers: number present |
M0300C1 | Asmt | Number | 1 | 910-910 | Stage 3 pressure ulcers: number present |
M0300D1 | Asmt | Number | 1 | 912-912 | Stage 4 pressure ulcers: number present |
M0300F1 | Asmt | Number | 1 | 916-916 | Unstaged slough/eschar: number present |
M1030 | Asmt | Number | 1 | 940-940 | Number of venous and arterial ulcers |
M1040A | Asmt | Checklist | 1 | 941-941 | Other skin probs: infection of the foot |
M1040B | Asmt | Checklist | 1 | 942-942 | Other skin probs: diabetic foot ulcer(s) |
M1040C | Asmt | Checklist | 1 | 943-943 | Other skin probs: other open lesion(s) on the foot |
M1040D | Asmt | Checklist | 1 | 944-944 | Other skin probs: lesions not ulcers, rashes, cuts |
M1040E | Asmt | Checklist | 1 | 945-945 | Other skin probs: surgical wound(s) |
M1040F | Asmt | Checklist | 1 | 946-946 | Other skin probs: burns (second or third degree) |
M1040Z | Asmt | Checklist | 1 | 947-947 | Other skin probs: none of the above |
M1200A | Asmt | Checklist | 1 | 948-948 | Skin/ulcer/injry treat: prssr rduce dvc for chair |
M1200B | Asmt | Checklist | 1 | 949-949 | Skin/ulcer/injry treat: prssr reducing dvc for bed |
M1200C | Asmt | Checklist | 1 | 950-950 | Skin/ulcer/injry treat: turning/repositioning |
M1200D | Asmt | Checklist | 1 | 951-951 | Skin/ulcer/injry treat: nutrition/hydration |
M1200E | Asmt | Checklist | 1 | 952-952 | Skin/ulcer/injry treat: prssr ulcer/injry care |
M1200F | Asmt | Checklist | 1 | 953-953 | Skin/ulcer/injry treat: surgical wound care |
M1200G | Asmt | Checklist | 1 | 954-954 | Skin/ulcer/injry treat: application of dressings |
M1200H | Asmt | Checklist | 1 | 955-955 | Skin/ulcer/injry treat: apply ointments/meds |
M1200I | Asmt | Checklist | 1 | 956-956 | Skin/ulcer/injry treat: apply dressings to feet |
M1200Z | Asmt | Checklist | 1 | 957-957 | Skin/ulcer/injry treat: none of the above |
N0300 | Asmt | Number | 1 | 958-958 | Number of days injectable medications received |
N0350A | Asmt | Number | 1 | 959-959 | Insulin: insulin injections |
N0350B | Asmt | Number | 1 | 960-960 | Insulin: orders for insulin |
O0100A1 | Asmt | Checklist | 1 | 969-969 | Treatment: chemotherapy - while not resident |
O0100A2 | Asmt | Checklist | 1 | 970-970 | Treatment: chemotherapy - while resident |
O0100B1 | Asmt | Checklist | 1 | 971-971 | Treatment: radiation - while not resident |
O0100B2 | Asmt | Checklist | 1 | 972-972 | Treatment: radiation - while resident |
O0100C1 | Asmt | Checklist | 1 | 973-973 | Treatment: oxygen therapy - while not resident |
O0100C2 | Asmt | Checklist | 1 | 974-974 | Treatment: oxygen therapy - while resident |
O0100D1 | Asmt | Checklist | 1 | 975-975 | Treatment: suctioning - while not resident |
O0100D2 | Asmt | Checklist | 1 | 976-976 | Treatment: suctioning - while resident |
O0100E1 | Asmt | Checklist | 1 | 977-977 | Treatment: tracheostomy care - while not resident |
O0100E2 | Asmt | Checklist | 1 | 978-978 | Treatment: tracheostomy care - while resident |
O0100F1 | Asmt | Checklist | 1 | 979-979 | Treat: Invsv Mech Vent - while not resident |
O0100F2 | Asmt | Checklist | 1 | 980-980 | Treat: Invsv Mech Vent - while resident |
O0100H1 | Asmt | Checklist | 1 | 983-983 | Treatment: IV medications - while not resident |
O0100H2 | Asmt | Checklist | 1 | 984-984 | Treatment: IV medications - while resident |
O0100I1 | Asmt | Checklist | 1 | 985-985 | Treatment: transfusions - while not resident |
O0100I2 | Asmt | Checklist | 1 | 986-986 | Treatment: transfusions - while resident |
O0100J1 | Asmt | Checklist | 1 | 987-987 | Treatment: dialysis - while not resident |
O0100J2 | Asmt | Checklist | 1 | 988-988 | Treatment: dialysis - while resident |
O0100M2 | Asmt | Checklist | 1 | 993-993 | Treatment: isolate/quarantine - while resident |
O0100Z1 | Asmt | Checklist | 1 | 994-994 | Treatment: none of above - while not resident |
O0100Z2 | Asmt | Checklist | 1 | 995-995 | Treatment: none of above - while resident |
O0400A1 | Asmt | Number | 4 | 1008-1011 | Speech-language/audiology: individ minutes |
O0400A2 | Asmt | Number | 4 | 1012-1015 | Speech-language/audiology: concur minutes |
O0400A3 | Asmt | Number | 4 | 1016-1019 | Speech-language/audiology: group minutes |
O0400A4 | Asmt | Number | 1 | 1020-1020 | Speech-language/audiology: number of days |
O0400A5 | Asmt | Date | 8 | 1021-1028 | Speech-language/audiology: start date |
O0400A6 | Asmt | Date | 8 | 1029-1036 | Speech-language/audiology: end date |
O0400B1 | Asmt | Number | 4 | 1037-1040 | Occupational therapy: individ minutes |
O0400B2 | Asmt | Number | 4 | 1041-1044 | Occupational therapy: concur minutes |
O0400B3 | Asmt | Number | 4 | 1045-1048 | Occupational therapy: group minutes |
O0400B4 | Asmt | Number | 1 | 1049-1049 | Occupational therapy: number of days |
O0400B5 | Asmt | Date | 8 | 1050-1057 | Occupational therapy: start date |
O0400B6 | Asmt | Date | 8 | 1058-1065 | Occupational therapy: end date |
O0400C1 | Asmt | Number | 4 | 1066-1069 | Physical therapy: individ minutes |
O0400C2 | Asmt | Number | 4 | 1070-1073 | Physical therapy: concur minutes |
O0400C3 | Asmt | Number | 4 | 1074-1077 | Physical therapy: group minutes |
O0400C4 | Asmt | Number | 1 | 1078-1078 | Physical therapy: number of days |
O0400C5 | Asmt | Date | 8 | 1079-1086 | Physical therapy: start date |
O0400C6 | Asmt | Date | 8 | 1087-1094 | Physical therapy: end date |
O0400D2 | Asmt | Number | 1 | 1099-1099 | Respiratory therapy: number of days |
O0420 | Asmt | Number | 1 | 1484-1484 | Distinct calendar days of therapy |
O0450A | Asmt | Code | 1 | 1429-1429 | Has therapy resumed |
O0500A | Asmt | Number | 1 | 1110-1110 | Range of motion (passive): number of days |
O0500B | Asmt | Number | 1 | 1111-1111 | Range of motion (active): number of days |
O0500C | Asmt | Number | 1 | 1112-1112 | Splint or brace assistance: number of days |
O0500D | Asmt | Number | 1 | 1113-1113 | Bed mobility training: number of days |
O0500E | Asmt | Number | 1 | 1114-1114 | Transfer training: number of days |
O0500F | Asmt | Number | 1 | 1115-1115 | Walking training: number of days |
O0500G | Asmt | Number | 1 | 1116-1116 | Dressing and/or grooming training: number of days |
O0500H | Asmt | Number | 1 | 1117-1117 | Eating and/or swallowing training: number of days |
O0500I | Asmt | Number | 1 | 1118-1118 | Amputation/prosthesis training: number of days |
O0500J | Asmt | Number | 1 | 1119-1119 | Communication training: number of days |
O0600 | Asmt | Number | 2 | 1120-1121 | Physician examinations: number of days |
O0700 | Asmt | Number | 2 | 1122-1123 | Physician orders: number of days |
X0150 | Asmt | Code | 1 | 1217-1217 | Correction: type of provider |
X0200A | Asmt | Text | 12 | 1218-1229 | Correction: resident first name |
X0200C | Asmt | Text | 18 | 1230-1247 | Correction: resident last name |
X0300 | Asmt | Code | 1 | 1248-1248 | Correction: resident gender |
X0400 | Asmt | Date | 8 | 1249-1256 | Correction: resident birth date |
X0500 | Asmt | Text | 9 | 1257-1265 | Correction: resident social security number |
X0570A | Asmt | Code | 1 | 1826-1826 | Correction: Optional State Assessment Purpose |
X0570B | Asmt | Code | 1 | 1824-1824 | Correction: Optional State Assessment Type |
X0700A | Asmt | Date | 8 | 1273-1280 | Correction: assessment reference date |
X0800 | Asmt | Number | 2 | 1297-1298 | Correction: correction number |
X0900A | Asmt | Checklist | 1 | 1299-1299 | Correction: modif reasons - transcription error |
X0900B | Asmt | Checklist | 1 | 1300-1300 | Correction: modif reasons - data entry error |
X0900C | Asmt | Checklist | 1 | 1301-1301 | Correction: modif reasons - software error |
X0900D | Asmt | Checklist | 1 | 1302-1302 | Correction: modif reasons - item coding error |
X0900Z | Asmt | Checklist | 1 | 1303-1303 | Correction: modif reasons - other error |
X1050A | Asmt | Checklist | 1 | 1304-1304 | Correction: inact reasons - event did not occur |
X1050Z | Asmt | Checklist | 1 | 1305-1305 | Correction: inact reasons - other reason |
X1100A | Asmt | Text | 12 | 1306-1317 | Correction: attestor first name |
X1100B | Asmt | Text | 18 | 1318-1335 | Correction: attestor last name |
X1100E | Asmt | Date | 8 | 1336-1343 | Correction: attestation date |
Z0200A | Asmt | Text | 10 | 1379-1388 | State case mix: Group |
Z0200B | Asmt | Text | 10 | 1389-1398 | State case mix: Version code |
Z0200C | Asmt | Code | 1 | 1825-1825 | State case mix: Short Stay Assessment |
Z0250A | Asmt | Text | 10 | 1399-1408 | State case mix: Alternate group |
Z0250B | Asmt | Text | 10 | 1409-1418 | State case mix: Alternate version code |
Z0500B | Asmt | Date | 8 | 1419-1426 | Date RN signed assessment as complete |
ASSESSMENT_ID | Calc | Number | 15 | 2951-2965 | Assessment internal ID |
ORIGINAL_ASSESSMENT_ID | Calc | Number | 15 | 2966-2980 | Original assessment ID |
RESIDENT_INTERNAL_ID | Calc | Number | 10 | 2981-2990 | Resident internal ID |
TARGET_DATE | Calc | Date | 8 | 2927-2934 | Target date |
FACILITY_PROVIDER_INTERNAL_ID | Calc | Number | 10 | 3063-3072 | Facility/provider internal ID |
SUBMISSION_ID | Calc | Number | 15 | 3021-3035 | Submission ID |
SUBMISSION_DATE | Calc | Date | 8 | 3036-3043 | Submission date |
SUBMISSION_COMPLETE_DATE | Calc | Date | 8 | 3044-3051 | Submission processing completion date |
SUBMITTING_USER_ID | Calc | Text | 30 | 2991-3020 | Submitter user ID |
RESIDENT_MATCH_CRITERIA | Calc | Number | 2 | 3052-3053 | Resident matching criteria |
RESIDENT_AGE | Calc | Number | 8 | 2935-2942 | Age of resident on the target date |
BIRTHDATE_SUBMIT_CODE | Calc | Code | 1 | 3258-3258 | Birth date submit code |
CBSA_URBAN_RURAL_CODE | Calc | Code | 1 | 3054-3054 | CBSA urban/rural code. |
STATE_EXTRACT_FILE_ID | Calc | Number | 8 | 3055-3062 | State extract file identifier |
RECALCULATED_Z0100A | Calc | Text | 7 | 3073-3079 | Calculated Medicare Part A: HIPPS code |
RECALCULATED_Z0100B | Calc | Text | 10 | 3080-3089 | Calculated Medicare Part A: Version Code |
CALC_ITEM_FILLER_007 | Calc | Text | 10 | 3108-3117 | Item filler: replaces RECALCULATED_Z0150B |
RECALCULATED_Z0200A | Calc | Text | 10 | 3128-3137 | Calculated State case mix: Group |
CMI_VALUE_FOR_RECALC_Z0200A | Calc | Text | 7 | 3148-3154 | CMI value returned for State Group |
CMI_SET_FOR_RECALC_Z0200A | Calc | Text | 3 | 3155-3157 | Set Code used for State Group |
RECALCULATED_Z0200B | Calc | Text | 10 | 3138-3147 | Calculated State case mix: Version code |
RECALCULATED_Z0200C | Calc | Text | 1 | 3296-3296 | Calculated State case mix: Short Stay Assessment |
RECALCULATED_Z0250A | Calc | Text | 10 | 3158-3167 | Calculated State case mix: Alternative group |
CMI_VALUE_FOR_RECALC_Z0250A | Calc | Text | 7 | 3178-3184 | Alternate CMI value returned for State Group |
CMI_SET_FOR_RECALC_Z0250A | Calc | Text | 3 | 3185-3187 | Alternate Set Code used for State Group |
RECALCULATED_Z0250B | Calc | Text | 10 | 3168-3177 | Calculated State case mix: Alt version code |
MEDICARE_RUG4_HIER_GRP | Calc | Text | 10 | 3188-3197 | RUG IV Medicare hierarchical group |
MEDICARE_RUG4_HIER_VERSION | Calc | Text | 10 | 3198-3207 | RUG IV Medicare hierarchical version |
MEDICARE_RUG3_IDX_MAX_GRP | Calc | Text | 10 | 3208-3217 | RUG III Medicare index max group |
MEDICARE_RUG3_IDX_MAX_VERSION | Calc | Text | 10 | 3218-3227 | RUG III Medicare index max version |
MEDICARE_RUG3_IDX_MAX_CMI_VAL | Calc | Text | 7 | 3228-3234 | RUG III Medicare index max case mix index |
MEDICARE_RUG3_IDX_MAX_CMI_SET | Calc | Text | 3 | 3235-3237 | RUG III Medicare index max case mix index set |
MEDICARE_RUG3_HIER_GRP | Calc | Text | 10 | 3238-3247 | RUG III Medicare hierarchical group |
MEDICARE_RUG3_HIER_VERSION | Calc | Text | 10 | 3248-3257 | RUG III Medicare hierarchical version |
C_CCN_NUM | Calc | Text | 12 | 3259-3270 | Calculated facility CMS certification number (CCN) |
C_HICN_MBI_IND | Calc | Text | 1 | 3271-3271 | Calculated HICN MBI Indicator |
C_SSNRI_TRNSLTN_HICN_TXT | Calc | Text | 12 | 3272-3283 | SSNRI Translation HICN Text |
C_SSNRI_TRNSLTN_MBI_TXT | Calc | Text | 12 | 3284-3295 | SSNRI Translation MBI Text |
DATA_END_INDICATOR | Calc | Code | 1 | 3688-3688 | End of data terminator code |
CR | Calc | Code | 1 | 3689-3689 | Carriage return (ASCII 013) |
LF | Calc | Code | 1 | 3690-3690 | Line feed character (ASCII 010) |
NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 06/06/2023 01:46:59 PM