LL4681-4    CMS_LCDS v4 Functional abilities & goals / Answers: 10; Scale: Ord; Code: 1-88; Score: -

BASIC PROPERTIES
  Answer List num: LL4681-4
  OID: 1.3.6.1.4.1.12009.10.1.3590
  Status: ACTIVE
  Description: Answers: 10; Scale: Ord; Code: 1-88; Score: -
  Externally Defined: False
  Name: CMS_LCDS v4 Functional abilities & goals
  # of Answers Shown: 10
  # of LOINCs Using This List: 44
  Source Name: Centers for Medicare & Medicaid Services

ANSWER LIST    (LL4681-4)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Independent - Patient completes the activity by him/herself with no assistance from a helper.       06       LA9983-3  
  2       Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity.       05       LA10073-7  
  3       Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently.       04       LA28225-3  
  4       Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort.       03       LA10055-4  
  5       Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.       02       LA11759-0  
  6       Dependent - Helper does all of the effort. Patient does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the patient to complete the activity.       01       LA27665-1  
  7       Patient refused       07       LA10058-8  
  8       Not applicable - Not attempted and the patient did not perform this activity prior to the current illness, exacerbation, or injury.       09       LA28226-1  
  9       Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).       10       LA28227-9  
  10       Not attempted due to medical condition or safety concerns       88       LA26735-3  

LOINCS THAT USE THIS ANSWER LIST
  89375-0    Wheel 50 feet with two turns - functional goal [CMS Assessment]
  89376-8    Wheel 50 feet with two turns - functional ability [CMS Assessment]
  89377-6    Wheel 150 feet - functional goal [CMS Assessment]
  89378-4    Wheel 150 feet - functional ability [CMS Assessment]
  89379-2    Walking 10 feet on uneven surfaces - functional goal [CMS Assessment]
  89380-0    Walking 10 feet on uneven surfaces - functional ability [CMS Assessment]
  89381-8    Walk 50 feet with two turns - functional goal [CMS Assessment]
  89382-6    Walk 50 feet with two turns - functional ability [CMS Assessment]
  89383-4    Walk 150 feet - functional goal [CMS Assessment]
  89384-2    Walk 150 feet - functional ability [CMS Assessment]
  89385-9    Walk 10 feet - functional goal [CMS Assessment]
  89386-7    Walk 10 feet - functional ability [CMS Assessment]
  89387-5    Upper body dressing - functional goal [CMS Assessment]
  89388-3    Upper body dressing - functional ability [CMS Assessment]
  89389-1    Toileting hygiene - functional goal [CMS Assessment]
  89390-9    Toilet transfer - functional goal [CMS Assessment]
  89392-5    Sit to stand - functional goal [CMS Assessment]
  89393-3    Sit to stand - functional ability [CMS Assessment]
  89394-1    Sit to lying - functional goal [CMS Assessment]
  89395-8    Sit to lying - functional ability [CMS Assessment]
  89396-6    Shower/bathe self - functional goal [CMS Assessment]
  89397-4    Shower/bathe self - functional ability [CMS Assessment]
  89398-2    Roll left and right - functional goal [CMS Assessment]
  89399-0    Roll left and right - functional ability [CMS Assessment]
  89400-6    Putting on and taking off footwear - functional goal [CMS Assessment]
  89401-4    Putting on and taking off footwear - functional ability [CMS Assessment]
  89402-2    Picking up object - functional goal [CMS Assessment]
  89403-0    Picking up object - functional ability [CMS Assessment]
  89404-8    Oral hygiene - functional goal [CMS Assessment]
  89405-5    Oral hygiene - functional ability [CMS Assessment]
  89406-3    Lower body dressing - functional goal [CMS Assessment]
  89407-1    Lower body dressing - functional ability [CMS Assessment]
  89409-7    Eating - functional goal [CMS Assessment]
  89410-5    Eating - functional ability [CMS Assessment]
  89412-1    Car transfer - functional goal [CMS Assessment]
  89413-9    Car transfer - functional ability [CMS Assessment]
  89414-7    Bed-to-chair transfer - functional goal [CMS Assessment]
  89415-4    Bed-to-chair transfer - functional ability [CMS Assessment]
  89416-2    4 steps - functional goal [CMS Assessment]
  89417-0    4 steps - functional ability [CMS Assessment]
  89418-8    12 steps - functional goal [CMS Assessment]
  89419-6    12 steps - functional ability [CMS Assessment]
  89420-4    1 step (curb) - functional goal [CMS Assessment]
  89421-2    1 step (curb) - functional ability [CMS Assessment]