57192-7  Outcome and assessment information set (OASIS) form - version C - Follow-UpOutcome and assessment information set (OASIS) form - version C - Follow-UpOutcome and assessment information set (OASIS) form - version C - Follow-Up: -: Pt: ^Patient: -:  

PANEL HIERARCHY

  LOINC#   LOINC Name R/O/C  Cardinality  Ex. UCUM Units 
  57192-7   Outcome and assessment information set (OASIS) form - version C - Follow-UpOutcome and assessment information set (OASIS) form - version C - Follow-UpOutcome and assessment information set (OASIS) form - version C - Follow-Up: -: Pt: ^Patient: -:    
       57040-8   Clinical Record Items [CMS Assessment]Clinical Record Items [CMS Assessment]Clinical record items: -: Pt: ^Patient: -: CMS Assessment    
            46500-5   Discipline of Person Completing Assessment    
            46501-3   Date Assessment Completed   {mm/dd/yyyy} 
            57200-8   This Assessment is Currently Being Completed for the Following Reason:    
            57201-6   Date of Physician-ordered Start of Care (Resumption of Care) [CMS Assessment]Date of Physician-ordered Start of Care (Resumption of Care) [CMS Assessment]Date of Physician-ordered Start of Care (Resumption of Care): Date: Pt: ^Patient: Qn: CMS Assessment   {mm/dd/yyyy} 
            57202-4   Date of ReferralDate of ReferralDate of Referral: Date: Pt: ^Patient: Qn:   {mm/dd/yyyy} 
            57203-2   Episode Timing: Is the Medicare home health payment episode for which this assessment will define a case mix group an "early" episode or a "later" episode in the patient's current sequence of adjacent Medicare home health payment episodes?    
       69327-5   Patient history and diagnosis    
            46609-4   Diagnosis and severity indexDiagnosis and severity indexDiagnosis and severity index: -: Pt: ^Patient: -:    
                 46511-2   Primary diagnosis    
                 46512-0   Primary Diagnosis Symptom Control Rating    
                 46513-8   Other diagnosis 1 - ICD code [OASIS]Other diagnosis 1 - ICD code [OASIS]Other diagnosis 1 - ICD code: Prid: Pt: ^Patient: Nom: OASIS    
                 46514-6   Other diagnosis 1: Symptom Control Rating    
                 46515-3   Other diagnosis 2 - ICD code [OASIS]Other diagnosis 2 - ICD code [OASIS]Other diagnosis 2 - ICD code: Prid: Pt: ^Patient: Nom: OASIS    
                 46516-1   Other diagnosis 2: Symptom Control Rating    
                 46517-9   Other diagnosis 3 - ICD code [OASIS]Other diagnosis 3 - ICD code [OASIS]Other diagnosis 3 - ICD code: Prid: Pt: ^Patient: Nom: OASIS    
                 46518-7   Other diagnosis 3: Symptom Control Rating    
                 46519-5   Other diagnosis 4 - ICD code [OASIS]Other diagnosis 4 - ICD code [OASIS]Other diagnosis 4 - ICD code: Prid: Pt: ^Patient: Nom: OASIS    
                 46520-3   Other diagnosis 4: Symptom Control Rating    
                 46521-1   Other diagnosis 5 - ICD code [OASIS]Other diagnosis 5 - ICD code [OASIS]Other diagnosis 5 - ICD code: Prid: Pt: ^Patient: Nom: OASIS    
                 46522-9   Other diagnosis 5: Symptom Control Rating    
            58051-4   Payment diagnosis [OASIS-C]Payment diagnosis [OASIS-C]Payment diagnosis: -: Pt: ^Patient: -: OASIS-C R 1..12   
                 49561-4   Payment diagnosis [identifier]Payment diagnosis [identifier]Payment diagnosis: Prid: Pt: ^Patient: Nom: R 0..12   
            46466-9   Therapies the patient receives at home 1..3   
       57042-4   Sensory status [CMS Assessment]Sensory status [CMS Assessment]Sensory status: -: Pt: ^Patient: -: CMS Assessment    
            57215-6   Vision    
            57216-4   Ability to hear (with hearing aid or hearing appliance if normally used):    
            57217-2   Understanding of verbal content in patient's own language (with hearing aid or device if used)    
            57218-0   Speech and oral expression of language [CMS Assessment]Speech and oral expression of language [CMS Assessment]Speech and oral expression of language: Find: Pt: ^Patient: Ord: CMS Assessment    
            57219-8   Has this patient had a formal Pain Assessment using a standardized, validated pain assessment tool (appropriate to the patient’s ability to communicate the severity of pain)?    
            57220-6   Frequency of pain interfering with patient's activity or movement:    
       57044-0   Integumentary statusIntegumentary statusIntegumentary status: -: Pt: ^Patient: -:    
            57307-1   Does this patient have at lease one Unhealed Pressure Ulcer at Stage II or Higher or designated as "unstageable"    
            58102-5   Current number of unhealed (non-epithelialized) pressure ulcers at each stage    
                 57186-9   Number currently present    
                      55124-2   Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.   {#} 
                      55125-9   Stage III: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscles are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.   {#} 
                      55126-7   Stage IV: Full thickness tissue loss with visible bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling.   {#} 
                      54893-3   Unstageable: Known or likely but unstageable due to non-removable dressing or device   {#} 
                      54946-9   Unstageable: Known or likely but unstageable due to coverage of wound bed by slough and/or eschar.   {#} 
                      54950-1   Unstageable: Suspected deep tissue injury in evolution.   {#} 
                 57187-7   Number of those listed in Column 1 that were present on admission (most recent SOC/ROC)    
                      54886-7   Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.   {#} 
                      54887-5   Stage III: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscles are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.   {#} 
                      54890-9   Stage IV: Full thickness tissue loss with visible bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling.   {#} 
                      54894-1   Unstageable: Known or likely but unstageable due to non-removable dressing or device   {#} 
                      54947-7   Unstageable: Known or likely but unstageable due to coverage of wound bed by slough and/or eschar.   {#} 
                      54951-9   Unstageable: Suspected deep tissue injury in evolution.   {#} 
            57188-5   Stage III and IV pressure ulcer with the largest surface dimension (length x width)    
                 57226-3   Pressure Ulcer Length: Longest length "head to toe"   cm 
                 52729-1   Pressure Ulcer Width: Width of the same pressure ulcer; greatest width perpendicular to the length   cm 
                 57228-9   Pressure Ulcer Depth: Depth of the same pressure ulcer; from visible surface to the depth of the deepest area   cm 
            46536-9   Current Number of Stage I Pressure Ulcers:   {#} 
            57231-3   Status of most problematic unhealed (observable) pressure ulcer:    
            57232-1   Does the patient have a Stasis Ulcer?    
            57233-9   Current Number of (Observable) Stasis Ulcer(s):   {#} 
            57234-7   Status of most problematic (observable) stasis ulcer:    
            57235-4   Does this patient have a Surgical Wound?    
            57236-2   Status of most problematic (observable) surgical wound:    
            46534-4   Does this patient have a Skin Lesion or Open Wound (excluding bowel ostomy), other than those described above, that is receiving intervention by the home health agency?    
       52510-5   Respiratory statusRespiratory statusRespiratory status: -: Pt: ^Patient: -:    
            57237-0   When is the patient dyspneic or noticeably Short of Breath?    
       57046-5   Elimination statusElimination statusElimination status: -: Pt: ^Patient: -:    
            46553-4   Urinary incontinence or urinary catheter present [CMS Assessment]Urinary incontinence or urinary catheter present [CMS Assessment]Urinary incontinence or urinary catheter present: Find: Pt: ^Patient: Ord: CMS Assessment    
            46587-2   Bowel incontinence frequency [CMS Assessment]Bowel incontinence frequency [CMS Assessment]Bowel incontinence frequency: Find: Pt: ^Patient: Ord: CMS Assessment    
            46588-0   Does this patient have an ostomy for bowel elimination that (within the last 14 days): a) was related to an inpatient facility stay, or b) necessitated a change in medical or treatment regimen?    
       69336-6   ADL and IALs    
            46597-1   Ability to dress upper body:    
            46599-7   Ability to dress lower body:    
            57243-8   Bathing:    
            57244-6   Toileting transferring:    
            57246-1   Transferring:    
            57247-9   Ambulation/Locomotion:    
       52471-0   MedicationsMedicationsMedications: -: Pt: ^Patient: -:    
            57284-2   Management of injectable medications:    
       69335-8   Therapy need and plan of care    
            57268-5   Therapy need # [CMS Assessment]Therapy need # [CMS Assessment]Therapy need: Num: Pt: ^Patient: Qn: CMS Assessment   {#} 
 

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Outcome and assessment information set (OASIS) form - version C - Follow-Up  Pt  ^Patient 
  Long Common Name:  Outcome and assessment information set (OASIS) form - version C - Follow-Up

FORM DATA DESCRIPTION
  Description: The OASIS is a core set of screening and assessment elements, including standardized definitions and coding categories that form the foundation of the comprehensive assessment for all clients of home health agencies certified to participate in the Medicare or Medicaid program. OASIS-C is a modification to the Outcome and Assessment Information Set (OASIS) that Home Health Agencies (HHAs) must collect in order to participate in the Medicare program. Implementation of OASIS-C, OMB #0938-0760, is required effective January 1, 2010.
 
 

TERM DEFINITION/DESCRIPTION(S)
  The OASIS is a core set of screening and assessment elements, including standardized definitions and coding categories that form the foundation of the comprehensive assessment for all clients of home health agencies certified to participate in the Medicare or Medicaid program. OASIS-C is a modification to the Outcome and Assessment Information Set (OASIS) that Home Health Agencies (HHAs) must collect in order to participate in the Medicare program. Implementation of OASIS-C, OMB #0938-0760, is required effective January1, 2010.
 
 

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.29
  Last Updated in Version: 2.29
  Status: Active

PARTS

Part Type    Part No.  Part Name   
Component   LP97357-5  Outcome and assessment information set (OASIS) form - version C - Follow-Up 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Fragments for synonyms   LP21059-8  Panel 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Form version PANEL.SURVEY.OASIS Survey
  OASIS-C Panl Survey.OASIS
  Outcome and assessment information set Pnl  
  Pan Point in time  
  Panel Random  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Outcome and assessment information set (OASIS) form - version C - Follow-Up
  Fully Specified Name: Outcome and assessment information set (OASIS) form - version C - Follow-Up: -: Pt: ^Patient: -:
     
  Component Word Count: 11
  ID: 51822
  # of Panel Elements: 78
  Status (Raw): ACTIVE



Selected information about each LOINC that is part of this panel



57040-8   Clinical Record Items [CMS Assessment]Clinical Record Items [CMS Assessment]Clinical record items: -: Pt: ^Patient: -: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Clinical record items  Pt  ^Patient  CMS Assessment
  Long Common Name:  Clinical Record Items [CMS Assessment]

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.CMS/Survey
  Panel Type: Organizer
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Subset
  Status: Active.
Change Reason: Added METHOD of CMS Assessments because this unique panel originates from CMS instruments.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP96866-6  Clinical record items 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP21059-8  Panel 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment PANEL.SURVEY.CMS Point in time
  Pan Panl Random
  Panel Pnl Survey

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Clinical Record Items [CMS Assessment]
  Fully Specified Name: Clinical record items: -: Pt: ^Patient: -: CMS Assessment
     
  Component Word Count: 3
  ID: 51662
  Status (Raw): ACTIVE


46500-5   Discipline of Person Completing Assessment Provider [CMS Assessment]Discipline of Person Completing Assessment Provider [CMS Assessment]Discipline of person completing assessment: Type: Pt: Provider: Nom: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Discipline of person completing assessment  Type  Pt  Provider  Nom  CMS Assessment
  Override Display Name for Form:  Discipline of Person Completing Assessment
  Long Common Name:  Discipline of Person Completing Assessment Provider [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  Identifies the discipline of the clinician completing the comprehensive assessment at the specified time points or the clinician reporting the transfer to an inpatient facility, death at home, or discharge (no further visits after start of care).
 
 

OBSERVATION ID IN FORM
M0080

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL245-2)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       RN       1       LA6367-2  
  2       PT       2       LA6353-2  
  3       SLP/ST       3       LA6378-9  
  4       OT       4       LA6309-4  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86259-9 Outcome and assessment information set (OASIS) form - version C2 - Transfer To inpatient facility - patient discharged or not discharged [CMS Assessment]
  86261-5 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency - death at home [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  88367-8 Outcome and assessment information set (OASIS) form - version D - Transfer to inpatient facility - patient discharged or not discharged [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88370-2 Outcome and assessment information set (OASIS) form - version D - Discharged from agency - death at home [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP74749-0  Discipline of person completing assessment 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7504-6  Provider 
Scale   LP7750-5  Nom 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP91379-5  Person 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Typ
  Nominal Random  
  Persons Survey  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0080     D 
   CMS OASIS   M0080     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Discipline of Person Completing Assessment Provider [CMS Assessment]
  Fully Specified Name: Discipline of person completing assessment: Type: Pt: Provider: Nom: CMS Assessment
     
  Component Word Count: 5
  ID: 38414
  Status (Raw): ACTIVE


46501-3   Date assessment information completed [CMS Assessment]Date assessment information completed [CMS Assessment]Date assessment information completed: Date: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Date assessment information completed  Date  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Date Assessment Completed
  Long Common Name:  Date assessment information completed [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  The actual date the assessment is completed, except if agency policy allows assessments to be performed over more than one visit date, in which case the last date (when the assessment is finished) is the appropriate date to record.
 
 

OBSERVATION ID IN FORM
M0090

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS to CMS Assessment to use across CMS instruments as approved by the Clinical LOINC committee.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  62812-3 PhenX domain - Physical activity and physical fitness
  62863-6 PhenX domain - Infectious diseases and immunity
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86259-9 Outcome and assessment information set (OASIS) form - version C2 - Transfer To inpatient facility - patient discharged or not discharged [CMS Assessment]
  86261-5 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency - death at home [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  88367-8 Outcome and assessment information set (OASIS) form - version D - Transfer to inpatient facility - patient discharged or not discharged [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88370-2 Outcome and assessment information set (OASIS) form - version D - Discharged from agency - death at home [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP74694-8  Date assessment information completed 
Property   LP182451-7  Date 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Quan Random
  Point in time Quant Survey
  QNT Quantitative  

EXAMPLE UNITS
  Unit  Source Type
  {mm/dd/yyyy}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {mm/dd/yyyy} 

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0090     C2 
   CMS OASIS   M0090     D 
   https://www.phenxtoolkit.org   PX150801290101   PX150801_Diary_Day1_Date_Month   
   https://www.phenxtoolkit.org   PX150801290102   PX150801_Diary_Day1_Date_Day   
   https://www.phenxtoolkit.org   PX150801290103   PX150801_Diary_Day1_Date_Year   
   https://www.phenxtoolkit.org   PX150801300101   PX150801_Diary_Day2_Date_Month   
   https://www.phenxtoolkit.org   PX150801300102   PX150801_Diary_Day2_Date_Day   
   https://www.phenxtoolkit.org   PX150801300103   PX150801_Diary_Day2_Date_Year   
   https://www.phenxtoolkit.org   PX150801310101   PX150801_Diary_Day3_Date_Month   
   https://www.phenxtoolkit.org   PX150801310102   PX150801_Diary_Day3_Date_Day   
   https://www.phenxtoolkit.org   PX150801310103   PX150801_Diary_Day3_Date_Year   
   https://www.phenxtoolkit.org   PX150801320101   PX150801_Diary_Day4_Date_Month   
   https://www.phenxtoolkit.org   PX150801320102   PX150801_Diary_Day4_Date_Day   
   https://www.phenxtoolkit.org   PX150801320103   PX150801_Diary_Day4_Date_Year   
   https://www.phenxtoolkit.org   PX150801330101   PX150801_Diary_Day5_Date_Month   
   https://www.phenxtoolkit.org   PX150801330102   PX150801_Diary_Day5_Date_Day   
   https://www.phenxtoolkit.org   PX150801330103   PX150801_Diary_Day5_Date_Year   
   https://www.phenxtoolkit.org   PX150801340101   PX150801_Diary_Day6_Date_Month   
   https://www.phenxtoolkit.org   PX150801340102   PX150801_Diary_Day6_Date_Day   
   https://www.phenxtoolkit.org   PX150801340103   PX150801_Diary_Day6_Date_Year   
   https://www.phenxtoolkit.org   PX150801350101   PX150801_Diary_Day7_Date_Month   
   https://www.phenxtoolkit.org   PX150801350102   PX150801_Diary_Day7_Date_Day   
   https://www.phenxtoolkit.org   PX150801350103   PX150801_Diary_Day7_Date_Year   
   https://www.phenxtoolkit.org   PX161201030100   PX161201_Date_Month   
   https://www.phenxtoolkit.org   PX161201030200   PX161201_Date_Day   
   https://www.phenxtoolkit.org   PX161201030300   PX161201_Date_Year   
   https://www.phenxtoolkit.org   PX161201040000   PX161201_Country_Of_Birth   

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Date assessment information completed [CMS Assessment]
  Fully Specified Name: Date assessment information completed: Date: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 4
  ID: 38415
  Status (Raw): ACTIVE


57200-8   Reason for assessment [CMS Assessment]Reason for assessment [CMS Assessment]Reason for assessment: Find: Pt: ^Patient: Nom: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Reason for assessment  Find  Pt  ^Patient  Nom  CMS Assessment
  Override Display Name for Form:  This Assessment is Currently Being Completed for the Following Reason:
  Long Common Name:  Reason for assessment [CMS Assessment]

OBSERVATION ID IN FORM
M0100

SKIP LOGIC
If Yes to "4 - Recertification (follow-up reassessment" , then go to M0110. If Yes to "5 - Other follow-up", then go to M0110. If Yes to "6 - Transferred to an inpatient facility - patient not discharged from agency", then go to M1040. If Yes to"7 - Transferred to an inpatient facility - patient discharged from agency", then go to M1040. If "Yes to 8 - Death at home", then go to M0903. If " Yes to 9 - Discharge from agency", then go to M1040.

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL773-3)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Start of care - further visits planned       1       LA6390-4  
  2       Resumption of care (after inpatient stay)       3       LA6366-4  
  3       Recertification (follow-up) reassessment       4       LA6355-7  
  4       Other follow-up       5       LA6312-8  
  5       Transferred to an inpatient facility - patient not discharged from agency       6       LA6402-7  
  6       Transferred to an inpatient facility - patient discharged from agency       7       LA6401-9  
  7       Death at home       8       LA6179-1  
  8       Discharge from agency       9       LA6184-1  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86259-9 Outcome and assessment information set (OASIS) form - version C2 - Transfer To inpatient facility - patient discharged or not discharged [CMS Assessment]
  86261-5 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency - death at home [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  88367-8 Outcome and assessment information set (OASIS) form - version D - Transfer to inpatient facility - patient discharged or not discharged [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88370-2 Outcome and assessment information set (OASIS) form - version D - Discharged from agency - death at home [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75490-0  Reason for assessment 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Nominal Survey
  Finding Point in time  
  Findings Random  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0100     D 
   CMS OASIS   M0100     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Reason for assessment [CMS Assessment]
  Fully Specified Name: Reason for assessment: Find: Pt: ^Patient: Nom: CMS Assessment
     
  Component Word Count: 3
  ID: 51830
  Status (Raw): ACTIVE


57201-6   Date of Physician-ordered Start of Care (Resumption of Care) [CMS Assessment]Date of Physician-ordered Start of Care (Resumption of Care) [CMS Assessment]Date of Physician-ordered Start of Care (Resumption of Care): Date: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Date of Physician-ordered Start of Care (Resumption of Care)  Date  Pt  ^Patient  Qn  CMS Assessment
  Long Common Name:  Date of Physician-ordered Start of Care (Resumption of Care) [CMS Assessment]

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use across CMS instruments as approved by the Clinical LOINC committee.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP97134-8  Date of Physician-ordered Start of Care (Resumption of Care) 
Property   LP182451-7  Date 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP21371-7  Start 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Quan Random
  Point in time Quant Started
  QNT Quantitative Survey

EXAMPLE UNITS
  Unit  Source Type
  {mm/dd/yyyy}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {mm/dd/yyyy} 

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0102     D 
   CMS OASIS   M0102     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Date of Physician-ordered Start of Care (Resumption of Care) [CMS Assessment]
  Fully Specified Name: Date of Physician-ordered Start of Care (Resumption of Care): Date: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 10
  ID: 51831
  Status (Raw): ACTIVE


57202-4   Date of ReferralDate of ReferralDate of Referral: Date: Pt: ^Patient: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Date of Referral  Date  Pt  ^Patient  Qn 
  Long Common Name:  Date of Referral

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from CMS assessment to method-less since this is a general concept and not specific to CMS assessments.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86636-8 Family planning report - FPAR 2.0 set
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP97188-4  Date of Referral 
Property   LP182451-7  Date 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 

RELATED NAMES
  Point in time Quant Survey
  QNT Quantitative  
  Quan Random  

EXAMPLE UNITS
  Unit  Source Type
  {mm/dd/yyyy}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {mm/dd/yyyy} 

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0104     D 
   CMS OASIS   M0104     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:36 PM
  Attachment Units Required: N
  Long Common Name: Date of Referral
  Fully Specified Name: Date of Referral: Date: Pt: ^Patient: Qn:
     
  Component Word Count: 3
  ID: 51832
  Status (Raw): ACTIVE


57203-2   Episode Timing [CMS Assessment]Episode Timing [CMS Assessment]Episode Timing: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Episode Timing  Find  Pt  ^Patient  Ord  CMS Assessment
  Override Display Name for Form:  Episode Timing: Is the Medicare home health payment episode for which this assessment will define a case mix group an "early" episode or a "later" episode in the patient's current sequence of adjacent Medicare home health payment episodes?
  Long Common Name:  Episode Timing [CMS Assessment]

OBSERVATION ID IN FORM
M0110

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Moved Survey Question text to Override Display Name for consistent modeling across CMS forms.

NORMATIVE ANSWER LIST    (LL774-1)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Early       1       LA12111-3  
  2       Later       2       LA12112-1  
  3       Unknown
http://snomed.info/sct ©: 261665006 Unknown (qualifier value)    
  UK       LA4489-6  
  4       Not Applicable: No Medicare case mix group to be defined by this assessment.       NA       LA12114-7  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57193-5 Outcome and assessment information set (OASIS) form - version C - Transfer to facility
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  57459-0 Outcome and assessment information set (OASIS) form - version C - Death at home
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP97189-2  Episode Timing 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Random
  Finding QL Screen
  Findings Qual Survey
  Ordinal Qualitative  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0110     D 
   CMS OASIS   M0110     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Episode Timing [CMS Assessment]
  Fully Specified Name: Episode Timing: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 2
  ID: 51833
  Status (Raw): ACTIVE


69327-5   Patient history and diagnosis - follow-up [OASIS-C]Patient history and diagnosis - follow-up [OASIS-C]Patient history and diagnosis - follow-up: -: Pt: ^Patient: -: OASIS-C  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Patient history and diagnosis - follow-up  Pt  ^Patient  OASIS-C
  Override Display Name for Form:  Patient history and diagnosis
  Long Common Name:  Patient history and diagnosis - follow-up [OASIS-C]

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP135989-4  Patient history and diagnosis - follow-up 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Method   LP97133-0  OASIS-C 
Fragments for synonyms   LP91302-7  History 
Fragments for synonyms   LP21059-8  Panel 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Dx PANEL.SURVEY.OASIS Point in time
  Hx Panl Random
  Outcome and assessment information set Patient Hx Survey
  Pan Patient hx & Dx - follow-up Survey.OASIS
  Panel Pnl  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Patient history and diagnosis - follow-up [OASIS-C]
  Fully Specified Name: Patient history and diagnosis - follow-up: -: Pt: ^Patient: -: OASIS-C
     
  Component Word Count: 6
  ID: 68638
  Status (Raw): ACTIVE


46609-4   Diagnosis and severity indexDiagnosis and severity indexDiagnosis and severity index: -: Pt: ^Patient: -:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Diagnosis and severity index  Pt  ^Patient 
  Long Common Name:  Diagnosis and severity index

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

FORM CODING INSTRUCTIONS
(M1020/1022/1024) Diagnoses, Symptom Control, and Payment Diagnoses: List each diagnosis for which the patient is receiving home care (Column 1) and enter its ICD-9-C M code at the level of highest specificity (no surgical/procedure codes) (Column 2). Diagnoses are listed in the order that best reflect the seriousness of each condition and support the disciplines and services provided. Rate the degree of symptom control for each condition (Column 2). Choose one value that represents the degree of symptom control appropriate for each diagnosis: V-codes (for M1020 or M1022) or E-codes (for M1022 only) may be used. ICD-9-C M sequencing requirements must be followed if multiple coding is indicated for any diagnoses. If a V-code is reported in place of a case mix diagnosis, then optional item M1024 Payment Diagnoses (Columns 3 and 4) may be completed. A case mix diagnosis is a diagnosis that determines the Medicare P P S case mix group. Do not assign symptom control ratings for V- or E-codes.
Code each row according to the following directions for each column:
Column 1: Enter the description of the diagnosis.Diagnoses (Sequencing of diagnoses should reflect the seriousness of each condition and support the disciplines and services provided.)
Column 2: Enter the ICD-9-C M code for the diagnosis described in Column 1;
Rate the degree of symptom control for the condition listed in Column 1 using the following scale:
0 - Asymptomatic, no treatment needed at this time
1 - Symptoms well controlled with current therapy
2 - Symptoms controlled with difficulty, affecting daily functioning; patient needs ongoing monitoring
3 - Symptoms poorly controlled; patient needs frequent adjustment in treatment and dose monitoring
4 - Symptoms poorly controlled; history of re-hospitalizations
Note that in Column 2 the rating for symptom control of each diagnosis should not be used to determine the sequencing of the diagnoses listed in Column 1. These are separate items and sequencing may not coincide. Sequencing of diagnoses should reflect the seriousness of each condition and support the disciplines and services provided.ICD-9-C M and symptom control rating for each condition.
Note that the sequencing of these ratings may not match the sequencing of
Column 3: (OPTIONAL) If a V-code is assigned to any row in Column 2, in place of a case mix diagnosis, it may be necessary to complete optional item M1024 Payment Diagnoses (Columns 3 and 4). See OASIS-C Guidance Manual.Complete if a V-code is assigned under certain circumstances to Column 2 in place of a case mix diagnosis.
Column 4: (OPTIONAL) If a V-code in Column 2 is reported in place of a case mix diagnosis that requires multiple diagnosis codes under ICD-9-C M coding guidelines, enter the diagnosis descriptions and the ICD-9-C M codes in the same row in Columns 3 and 4. For example, if the case mix diagnosis is a manifestation code, record the diagnosis description and ICD-9-C M code for the underlying condition in Column 3 of that row and the diagnosis description and ICD-9-C M code for the manifestation in Column 4 of that row. Otherwise, leave Column 4 blank in that row.Complete only if the V-code in Column 2 is reported in place of a case mix diagnosis that is a multiple coding situation (e.g., a manifestation code).

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.19
  Last Updated in Version: 2.50
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP74725-0  Diagnosis and severity index 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Dx Point in time Survey.OASIS
  Dx and severity index Random  
  Outcome and assessment information set Survey  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Diagnosis and severity index
  Fully Specified Name: Diagnosis and severity index: -: Pt: ^Patient: -:
     
  Component Word Count: 4
  ID: 40037
  Status (Raw): ACTIVE


46511-2   Primary diagnosis ICD code [CMS Assessment]Primary diagnosis ICD code [CMS Assessment]Primary diagnosis ICD code: Prid: Pt: ^Patient: Nom: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Primary diagnosis ICD code  Prid  Pt  ^Patient  Nom  CMS Assessment
  Override Display Name for Form:  Primary diagnosis
  Long Common Name:  Primary diagnosis ICD code [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  Identifies diagnosis for which the patient is receiving care and its ICD code. The primary diagnosis should be the condition that is the chief reason for providing care.
 
 

OBSERVATION ID IN FORM
M1020

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  52743-2 Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
  52744-0 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission
  52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
  52746-5 Continuity Assessment Record and Evaluation (CARE) tool - Interim
  52747-3 Continuity Assessment Record and Evaluation (CARE) tool - Expired
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75422-3  Primary diagnosis ICD code 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment International Classification of Diseases Random
  Dx Nominal Survey
  Dx ICD code Point in time  
  Identity or presence Primary Dx ICD code  

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Primary diagnosis ICD code [CMS Assessment]
  Fully Specified Name: Primary diagnosis ICD code: Prid: Pt: ^Patient: Nom: CMS Assessment
     
  Component Word Count: 4
  ID: 38426
  Status (Raw): ACTIVE


46512-0   Primary diagnosis severity rating [OASIS]Primary diagnosis severity rating [OASIS]Primary diagnosis severity rating: Find: Pt: ^Patient: Ord: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Primary diagnosis severity rating  Find  Pt  ^Patient  Ord  OASIS
  Override Display Name for Form:  Primary Diagnosis Symptom Control Rating
  Long Common Name:  Primary diagnosis severity rating [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Severity category for diagnosis.
 
 

OBSERVATION ID IN FORM
M1020

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.50
  Status: Active

NORMATIVE ANSWER LIST    (LL253-6)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       0       0       LA6111-4  
  2       1       1       LA6112-2  
  3       2       2       LA6113-0  
  4       3       3       LA6114-8  
  5       4       4       LA6115-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75423-1  Primary diagnosis severity rating 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Dx Point in time Random
  Finding Primary Dx severity rating Screen
  Findings Ql Survey
  Ordinal Qual Survey.OASIS
  Outcome and assessment information set Qualitative  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Primary diagnosis severity rating [OASIS]
  Fully Specified Name: Primary diagnosis severity rating: Find: Pt: ^Patient: Ord: OASIS
     
  Component Word Count: 4
  ID: 38427
  Status (Raw): ACTIVE


46513-8   Other diagnosis 1 - ICD code [OASIS]Other diagnosis 1 - ICD code [OASIS]Other diagnosis 1 - ICD code: Prid: Pt: ^Patient: Nom: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 1 - ICD code  Prid  Pt  ^Patient  Nom  OASIS
  Long Common Name:  Other diagnosis 1 - ICD code [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Identifies diagnosis for which the patient is receiving care and its ICD-9-CM code.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75293-8  Other diagnosis 1 - ICD code 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP21265-1 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Dx Other Dx 1- ICD code Survey
  i Othr Survey.OASIS
  Identity or presence Outcome and assessment information set  
  International Classification of Diseases Point in time  
  Nominal Random  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 1 - ICD code [OASIS]
  Fully Specified Name: Other diagnosis 1 - ICD code: Prid: Pt: ^Patient: Nom: OASIS
     
  Component Word Count: 5
  ID: 38428
  Status (Raw): ACTIVE


46514-6   Other diagnosis 1 - severity rating [OASIS]Other diagnosis 1 - severity rating [OASIS]Other diagnosis 1 - severity rating: Find: Pt: ^Patient: Ord: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 1 - severity rating  Find  Pt  ^Patient  Ord  OASIS
  Override Display Name for Form:  Other diagnosis 1: Symptom Control Rating
  Long Common Name:  Other diagnosis 1 - severity rating [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Severity category for diagnosis.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL253-6)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       0       0       LA6111-4  
  2       1       1       LA6112-2  
  3       2       2       LA6113-0  
  4       3       3       LA6114-8  
  5       4       4       LA6115-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75294-6  Other diagnosis 1 - severity rating 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP21265-1 

RELATED NAMES
  Dx Othr Random
  Finding Outcome and assessment information set Screen
  Findings Point in time Survey
  i QL Survey.OASIS
  Ordinal Qual  
  Other Dx 1- severity rating Qualitative  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 1 - severity rating [OASIS]
  Fully Specified Name: Other diagnosis 1 - severity rating: Find: Pt: ^Patient: Ord: OASIS
     
  Component Word Count: 5
  ID: 38429
  Status (Raw): ACTIVE


46515-3   Other diagnosis 2 - ICD code [OASIS]Other diagnosis 2 - ICD code [OASIS]Other diagnosis 2 - ICD code: Prid: Pt: ^Patient: Nom: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 2 - ICD code  Prid  Pt  ^Patient  Nom  OASIS
  Long Common Name:  Other diagnosis 2 - ICD code [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Identifies diagnosis for which the patient is receiving care and its ICD-9-CM code.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75295-3  Other diagnosis 2 - ICD code 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP20740-4 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Dx Other Dx 2- ICD code Survey
  Identity or presence Othr Survey.OASIS
  II Outcome and assessment information set  
  International Classification of Diseases Point in time  
  Nominal Random  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 2 - ICD code [OASIS]
  Fully Specified Name: Other diagnosis 2 - ICD code: Prid: Pt: ^Patient: Nom: OASIS
     
  Component Word Count: 5
  ID: 38430
  Status (Raw): ACTIVE


46516-1   Other diagnosis 2 - severity rating [OASIS]Other diagnosis 2 - severity rating [OASIS]Other diagnosis 2 - severity rating: Find: Pt: ^Patient: Ord: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 2 - severity rating  Find  Pt  ^Patient  Ord  OASIS
  Override Display Name for Form:  Other diagnosis 2: Symptom Control Rating
  Long Common Name:  Other diagnosis 2 - severity rating [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Severity category for diagnosis.
 
 

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL253-6)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       0       0       LA6111-4  
  2       1       1       LA6112-2  
  3       2       2       LA6113-0  
  4       3       3       LA6114-8  
  5       4       4       LA6115-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75296-1  Other diagnosis 2 - severity rating 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP20740-4 
Fragments for synonyms   LP21049-9  Other 

RELATED NAMES
  Dx Othr Random
  Finding Outcome and assessment information set Screen
  Findings Point in time Survey
  II QL Survey.OASIS
  Ordinal Qual  
  Other Dx 2- severity rating Qualitative  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 2 - severity rating [OASIS]
  Fully Specified Name: Other diagnosis 2 - severity rating: Find: Pt: ^Patient: Ord: OASIS
     
  Component Word Count: 5
  ID: 38432
  Status (Raw): ACTIVE


46517-9   Other diagnosis 3 - ICD code [OASIS]Other diagnosis 3 - ICD code [OASIS]Other diagnosis 3 - ICD code: Prid: Pt: ^Patient: Nom: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 3 - ICD code  Prid  Pt  ^Patient  Nom  OASIS
  Long Common Name:  Other diagnosis 3 - ICD code [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Identifies diagnosis for which the patient is receiving care and its ICD-9-CM code.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75297-9  Other diagnosis 3 - ICD code 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP21267-7 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Dx Other Dx 3- ICD code Survey
  Identity or presence Othr Survey.OASIS
  III Outcome and assessment information set  
  International Classification of Diseases Point in time  
  Nominal Random  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:37 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 3 - ICD code [OASIS]
  Fully Specified Name: Other diagnosis 3 - ICD code: Prid: Pt: ^Patient: Nom: OASIS
     
  Component Word Count: 5
  ID: 38433
  Status (Raw): ACTIVE


46518-7   Other diagnosis 3 - severity rating [OASIS]Other diagnosis 3 - severity rating [OASIS]Other diagnosis 3 - severity rating: Find: Pt: ^Patient: Ord: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 3 - severity rating  Find  Pt  ^Patient  Ord  OASIS
  Override Display Name for Form:  Other diagnosis 3: Symptom Control Rating
  Long Common Name:  Other diagnosis 3 - severity rating [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Severity category for diagnosis.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL253-6)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       0       0       LA6111-4  
  2       1       1       LA6112-2  
  3       2       2       LA6113-0  
  4       3       3       LA6114-8  
  5       4       4       LA6115-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75298-7  Other diagnosis 3 - severity rating 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP21267-7 

RELATED NAMES
  Dx Othr Random
  Finding Outcome and assessment information set Screen
  Findings Point in time Survey
  III QL Survey.OASIS
  Ordinal Qual  
  Other Dx 3- severity rating Qualitative  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 3 - severity rating [OASIS]
  Fully Specified Name: Other diagnosis 3 - severity rating: Find: Pt: ^Patient: Ord: OASIS
     
  Component Word Count: 5
  ID: 38434
  Status (Raw): ACTIVE


46519-5   Other diagnosis 4 - ICD code [OASIS]Other diagnosis 4 - ICD code [OASIS]Other diagnosis 4 - ICD code: Prid: Pt: ^Patient: Nom: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 4 - ICD code  Prid  Pt  ^Patient  Nom  OASIS
  Long Common Name:  Other diagnosis 4 - ICD code [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Identifies diagnosis for which the patient is receiving care and its ICD-9-CM code.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75299-5  Other diagnosis 4 - ICD code 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Dx Other Dx 4- ICD code Random
  Identity or presence Othr Survey
  International Classification of Diseases Outcome and assessment information set Survey.OASIS
  Nominal Point in time  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 4 - ICD code [OASIS]
  Fully Specified Name: Other diagnosis 4 - ICD code: Prid: Pt: ^Patient: Nom: OASIS
     
  Component Word Count: 5
  ID: 38435
  Status (Raw): ACTIVE


46520-3   Other diagnosis 4 - severity rating [OASIS]Other diagnosis 4 - severity rating [OASIS]Other diagnosis 4 - severity rating: Find: Pt: ^Patient: Ord: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 4 - severity rating  Find  Pt  ^Patient  Ord  OASIS
  Override Display Name for Form:  Other diagnosis 4: Symptom Control Rating
  Long Common Name:  Other diagnosis 4 - severity rating [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Severity category for diagnosis.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL253-6)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       0       0       LA6111-4  
  2       1       1       LA6112-2  
  3       2       2       LA6113-0  
  4       3       3       LA6114-8  
  5       4       4       LA6115-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75300-1  Other diagnosis 4 - severity rating 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 

RELATED NAMES
  Dx Outcome and assessment information set Screen
  Finding Point in time Survey
  Findings QL Survey.OASIS
  Ordinal Qual  
  Other Dx 4- severity rating Qualitative  
  Othr Random  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 4 - severity rating [OASIS]
  Fully Specified Name: Other diagnosis 4 - severity rating: Find: Pt: ^Patient: Ord: OASIS
     
  Component Word Count: 5
  ID: 39938
  Status (Raw): ACTIVE


46521-1   Other diagnosis 5 - ICD code [OASIS]Other diagnosis 5 - ICD code [OASIS]Other diagnosis 5 - ICD code: Prid: Pt: ^Patient: Nom: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 5 - ICD code  Prid  Pt  ^Patient  Nom  OASIS
  Long Common Name:  Other diagnosis 5 - ICD code [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Identifies diagnosis for which the patient is receiving care and its ICD-9-CM code.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75301-9  Other diagnosis 5 - ICD code 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Dx Other Dx 5- ICD code Random
  Identity or presence Othr Survey
  International Classification of Diseases Outcome and assessment information set Survey.OASIS
  Nominal Point in time  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 5 - ICD code [OASIS]
  Fully Specified Name: Other diagnosis 5 - ICD code: Prid: Pt: ^Patient: Nom: OASIS
     
  Component Word Count: 5
  ID: 39939
  Status (Raw): ACTIVE


46522-9   Other diagnosis 5 - severity rating [OASIS]Other diagnosis 5 - severity rating [OASIS]Other diagnosis 5 - severity rating: Find: Pt: ^Patient: Ord: OASIS  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Other diagnosis 5 - severity rating  Find  Pt  ^Patient  Ord  OASIS
  Override Display Name for Form:  Other diagnosis 5: Symptom Control Rating
  Long Common Name:  Other diagnosis 5 - severity rating [OASIS]

COPYRIGHT NOTICE
Center for Health Policy Research, UCHSC, Denver, CO Copyright notice;

TERM DEFINITION/DESCRIPTION(S)
  Severity category for diagnosis.
 
 

OBSERVATION ID IN FORM
M1022

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.54
  Status: Active

NORMATIVE ANSWER LIST    (LL253-6)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       0       0       LA6111-4  
  2       1       1       LA6112-2  
  3       2       2       LA6113-0  
  4       3       3       LA6114-8  
  5       4       4       LA6115-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75302-7  Other diagnosis 5 - severity rating 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP40480-3  OASIS 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP21049-9  Other 

RELATED NAMES
  Dx Outcome and assessment information set Screen
  Finding Point in time Survey
  Findings QL Survey.OASIS
  Ordinal Qual  
  Other Dx 5- severity rating Qualitative  
  Othr Random  

CHANGE HISTORY
  Change Type: MIN

OBSOLETE FIELDS
  External Copyright Notice: Copyright © 2002 Center for Health Services Research, UCHSC, Denver, CO. Used with permission.

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Other diagnosis 5 - severity rating [OASIS]
  Fully Specified Name: Other diagnosis 5 - severity rating: Find: Pt: ^Patient: Ord: OASIS
     
  Component Word Count: 5
  ID: 39940
  Status (Raw): ACTIVE


58051-4   Payment diagnosis [OASIS-C]Payment diagnosis [OASIS-C]Payment diagnosis: -: Pt: ^Patient: -: OASIS-C  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Payment diagnosis  Pt  ^Patient  OASIS-C
  Long Common Name:  Payment diagnosis [OASIS-C]

QUESTION CARDINALITY
1..12

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.29
  Last Updated in Version: 2.44
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP73080-1  Payment diagnosis 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Method   LP97133-0  OASIS-C 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Dx Point in time Survey.OASIS
  Outcome and assessment information set Random  
  Payment Dx Survey  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Payment diagnosis [OASIS-C]
  Fully Specified Name: Payment diagnosis: -: Pt: ^Patient: -: OASIS-C
     
  Component Word Count: 2
  ID: 52793
  Status (Raw): ACTIVE


49561-4   Payment diagnosis [identifier]Payment diagnosis [identifier]Payment diagnosis: Prid: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Payment diagnosis  Prid  Pt  ^Patient  Nom 
  Long Common Name:  Payment diagnosis [identifier]
  Short Name:  Payment Dx

OBSERVATION ID IN FORM
M1024

ANSWER CARDINALITY
0..12

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: CLIN/Clinical
  First Released in Version: 2.22
  Last Updated in Version: 2.40
  Status: Active

EXAMPLE ANSWER LIST    (LL343-5)  
 
Externally Defined: Y
Source: National Center for Health Statistics

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  55168-9 Data Elements for Emergency Department Systems (DEEDS) Release 1.1
  55169-7 Data Elements for Emergency Department Systems (DEEDS) Release 1.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  

PARTS

Part Type    Part No.  Part Name   
Component   LP73080-1  Payment diagnosis 
Property   LP6850-4  Prid   [Presence or Identity] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  支付诊断:存在与否或特征标识:时间点:^患者:名义型:支付诊断:存在与否或特征标识:时间点:^患者:名义型:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Diagnosi di pagamento:Prid:Pt:^Paziente:Nom:Diagnosi di pagamento:Prid:Pt:^Paziente:Nom:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Pagamento de diagnóstico:Ident:Pt:^Paciente:Nom:Pagamento de diagnóstico:Ident:Pt:^Paciente:Nom:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Оплата диагноз:ПрИд:ТчкВрм:^Пациент:Ном:Оплата диагноз:ПрИд:ТчкВрм:^Пациент:Ном:

RELATED NAMES
  CLIN Nominal Random
  Dx Payment Dx  
  Identity or presence Point in time  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Payment diagnosis [identifier]
  Shortname: Payment Dx
  Fully Specified Name: Payment diagnosis: Prid: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 43320
  Status (Raw): ACTIVE


46466-9   Therapeutic substance administered at home [CMS Assessment]Therapeutic substance administered at home [CMS Assessment]Therapeutic substance administered at home: Find: Pt: ^Patient: Nom: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Therapeutic substance administered at home  Find  Pt  ^Patient  Nom  CMS Assessment
  Override Display Name for Form:  Therapies the patient receives at home
  Long Common Name:  Therapeutic substance administered at home [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  Identifies whether the patient is receiving intravenous, parenteral nutrition, or enteral nutrition therapy at home.
 
 

OBSERVATION ID IN FORM
M1030

ANSWER CARDINALITY
1..3

FORM CODING INSTRUCTIONS
Therapies are patient receives at home: (Mark all that apply.)

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.19
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to the Component to clarify the concept.

NORMATIVE ANSWER LIST    (LL254-4)  
 
Source: 
  SEQ#        Answer        Code         Answer ID    
  1       Intravenous or infusion therapy (excludes TPN)       1       LA6244-3  
  2       Parenteral nutrition (TPN or lipids)       2       LA6321-9  
  3       Enteral nutrition (nasogastric, gastrostomy, jejunostomy, or any other artificial entry into the alimentary canal)       3       LA6194-0  
  4       None of the above       4       LA9-3  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP253568-2  Therapeutic substance administered at home 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP20778-4  Substance 
Fragments for synonyms   LP21090-3  Therapeutic 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Nominal Subs
  Finding Point in time Survey
  Findings Random Ther

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1030     D 
   CMS OASIS   M1030     C2 

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Therapeutic substance administered at home [CMS Assessment]
  Fully Specified Name: Therapeutic substance administered at home: Find: Pt: ^Patient: Nom: CMS Assessment
     
  Component Word Count: 5
  ID: 39902
  Status (Raw): ACTIVE


57042-4   Sensory status [CMS Assessment]Sensory status [CMS Assessment]Sensory status: -: Pt: ^Patient: -: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Sensory status  Pt  ^Patient  CMS Assessment
  Long Common Name:  Sensory status [CMS Assessment]

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.CMS/Survey
  Panel Type: Organizer
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Subset
  Status: Active.
Change Reason: Added METHOD of CMS Assessments because this unique panel originates from CMS instruments.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP96868-2  Sensory status 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP21059-8  Panel 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment PANEL.SURVEY.CMS Point in time
  Pan Panl Random
  Panel Pnl Survey

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Sensory status [CMS Assessment]
  Fully Specified Name: Sensory status: -: Pt: ^Patient: -: CMS Assessment
     
  Component Word Count: 2
  ID: 51665
  Status (Raw): ACTIVE


57215-6   Vision [CMS Assessment]Vision [CMS Assessment]Vision: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Vision  Find  Pt  ^Patient  Ord  CMS Assessment
  Override Display Name for Form:  Vision
  Long Common Name:  Vision [CMS Assessment]

OBSERVATION ID IN FORM
M1200

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL784-0)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Normal vision: sees adequately in most situations; can see medication labels, newsprint.       0       LA12168-3  
  2       Partially impaired: cannot see medication labels or newsprint, but can see obstacles in path, and the surrounding layout; can count fingers at arm's length.       1       LA12169-1  
  3       Severely impaired: cannot locate objects without hearing or touching them or patient nonresponsive.       2       LA6375-5  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75855-4  Vision 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Random
  Finding QL Screen
  Findings Qual Survey
  Ordinal Qualitative  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1200     D 
   CMS OASIS   M1200     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:38 PM
  Attachment Units Required: N
  Long Common Name: Vision [CMS Assessment]
  Fully Specified Name: Vision: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 1
  ID: 51846
  Status (Raw): ACTIVE


57216-4   Ability to hear [CMS Assessment]Ability to hear [CMS Assessment]Ability to hear: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Ability to hear  Find  Pt  ^Patient  Ord  CMS Assessment
  Override Display Name for Form:  Ability to hear (with hearing aid or hearing appliance if normally used):
  Long Common Name:  Ability to hear [CMS Assessment]

OBSERVATION ID IN FORM
M1210

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL785-7)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Adequate: hears normal conversation without difficulty.       0       LA12123-8  
  2       Mildly to Moderately Impaired: difficulty hearing in some environments or speaker may need to increase volume or speak distinctly.       1       LA12124-6  
  3       Severely Impaired: absence of useful hearing.       2       LA12125-3  
  4       Unable to assess hearing.       UK       LA12174-1  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP98015-8  Ability to hear 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Random
  Finding QL Screen
  Findings Qual Survey
  Ordinal Qualitative  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1210     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Ability to hear [CMS Assessment]
  Fully Specified Name: Ability to hear: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 3
  ID: 51848
  Status (Raw): ACTIVE


57217-2   Understanding of verbal content [CMS Assessment]Understanding of verbal content [CMS Assessment]Understanding of verbal content: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Understanding of verbal content  Find  Pt  ^Patient  Ord  CMS Assessment
  Override Display Name for Form:  Understanding of verbal content in patient's own language (with hearing aid or device if used)
  Long Common Name:  Understanding of verbal content [CMS Assessment]

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL786-5)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Understands: clear comprehension without cues or repetitions.       0       LA12175-8  
  2       Usually understands: understands most conversations, but misses some part/intent of message. Requires cues at times to understand.       1       LA12176-6  
  3       Sometimes understands: understands only basic conversations or simple, direct phrases. Frequently requires cues to understand.       2       LA12177-4  
  4       Rarely/never understands.       3       LA27670-1  
  5       Unable to assess understanding.       UK       LA12179-0  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP98016-6  Understanding of verbal content 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Random
  Finding QL Screen
  Findings Qual Survey
  Ordinal Qualitative  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1220     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Understanding of verbal content [CMS Assessment]
  Fully Specified Name: Understanding of verbal content: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 4
  ID: 51849
  Status (Raw): ACTIVE


57218-0   Speech and oral expression of language [CMS Assessment]Speech and oral expression of language [CMS Assessment]Speech and oral expression of language: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Speech and oral expression of language  Find  Pt  ^Patient  Ord  CMS Assessment
  Long Common Name:  Speech and oral expression of language [CMS Assessment]

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee.

NORMATIVE ANSWER LIST    (LL787-3)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       Expresses complex ideas, feelings, and needs clearly, completely, and easily in all situations with no observable impairment.       0       LA6197-3  
  2       Minimal difficulty in expressing ideas and needs (may take extra time; makes occasional errors in word choice, grammar or speech intelligibility; needs minimal prompting or assistance).       1       LA12181-6  
  3       Expresses simple ideas or needs with moderate difficulty (needs prompting or assistance, errors in word choice, organization or speech intelligibility). Speaks in phrases or short sentences.       2       LA12182-4  
  4       Has severe difficulty expressing basic ideas or needs and requires maximal assistance or guessing by listener. Speech limited to single words or short phrases.       3       LA12183-2  
  5       Unable to express basic needs even with maximal prompting or assistance but is not comatose or unresponsive (for example, speech is nonsensical or unintelligible).       4       LA12184-0  
  6       Patient nonresponsive or unable to speak.       5       LA6336-7  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP98017-4  Speech and oral expression of language 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Random
  Finding QL Screen
  Findings Qual Survey
  Ordinal Qualitative  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1230     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Speech and oral expression of language [CMS Assessment]
  Fully Specified Name: Speech and oral expression of language: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 6
  ID: 51850
  Status (Raw): ACTIVE


57219-8   Formal pain assessment using standardized tool [CMS Assessment]Formal pain assessment using standardized tool [CMS Assessment]Formal pain assessment using standardized tool: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Formal pain assessment using standardized tool  Find  Pt  ^Patient  Ord  CMS Assessment
  Override Display Name for Form:  Has this patient had a formal Pain Assessment using a standardized, validated pain assessment tool (appropriate to the patient’s ability to communicate the severity of pain)?
  Long Common Name:  Formal pain assessment using standardized tool [CMS Assessment]

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.61
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Moved Survey Question text to Override Display Name for consistent modeling across CMS forms.

NORMATIVE ANSWER LIST    (LL788-1)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       No standardized, validated assessment conducted       0       LA27671-9  
  2       Yes, and it does not indicate severe pain       1       LA12187-3  
  3       Yes, and it indicates severe pain       2       LA12188-1  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP97194-2  Formal pain assessment using standardized tool 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Random
  Finding QL Screen
  Findings Qual Survey
  Ordinal Qualitative  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1240     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Formal pain assessment using standardized tool [CMS Assessment]
  Fully Specified Name: Formal pain assessment using standardized tool: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 6
  ID: 51851
  Status (Raw): ACTIVE


57220-6   Frequency of pain interfering with activity or movement [CMS Assessment]Frequency of pain interfering with activity or movement [CMS Assessment]Frequency of pain interfering with activity or movement: Find: Pt: ^Patient: Ord: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Frequency of pain interfering with activity or movement  Find  Pt  ^Patient  Ord  CMS Assessment
  Override Display Name for Form:  Frequency of pain interfering with patient's activity or movement:
  Long Common Name:  Frequency of pain interfering with activity or movement [CMS Assessment]

OBSERVATION ID IN FORM
M1242

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed Property to NRat because this is a frequency term; Changed Property from NRat to Find because the answer list does not reflect Nrat.

NORMATIVE ANSWER LIST    (LL789-9)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  0       Patient has no pain       0       LA12189-9  
  1       Patient has pain that does not interfere with activity or movement       1       LA12190-7  
  2       Less often than daily       2       LA6249-2  
  3       Daily, but not constantly       3       LA6177-5  
  4       All of the time       4       LA6154-4  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP98018-2  Frequency of pain interfering with activity or movement 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP21325-3  Activity 

RELATED NAMES
  Activ Movements Qualitative
  Actvty Ordinal Random
  Centers for Medicare and Medicaid Assessment Point in time Screen
  Finding QL Survey
  Findings Qual  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M1242     D 
   CMS OASIS   M1242     C2 

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Frequency of pain interfering with activity or movement [CMS Assessment]
  Fully Specified Name: Frequency of pain interfering with activity or movement: Find: Pt: ^Patient: Ord: CMS Assessment
     
  Component Word Count: 8
  ID: 51852
  Status (Raw): ACTIVE


57044-0   Integumentary statusIntegumentary statusIntegumentary status: -: Pt: ^Patient: -:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Integumentary status  Pt  ^Patient 
  Long Common Name:  Integumentary status

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.29
  Last Updated in Version: 2.29
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  

PARTS

Part Type    Part No.  Part Name   
Component   LP96882-3  Integumentary status 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Outcome and assessment information set Survey  
  Point in time Survey.OASIS  
  Random    

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Integumentary status
  Fully Specified Name: Integumentary status: -: Pt: ^Patient: -:
     
  Component Word Count: 2
  ID: 51667
  Status (Raw): ACTIVE


57307-1   Unhealed pressure injury at stage 2 or higher or designated as unstageable [OASIS-C]Unhealed pressure injury at stage 2 or higher or designated as unstageable [OASIS-C]Unhealed pressure injury at Stage 2 or higher or designated as unstageable: Find: Pt: ^Patient: Nom: OASIS-C  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Unhealed pressure injury at Stage 2 or higher or designated as unstageable  Find  Pt  ^Patient  Nom  OASIS-C
  Long Common Name:  Unhealed pressure injury at stage 2 or higher or designated as unstageable [OASIS-C]

OBSERVATION ID IN FORM
M1306

SKIP LOGIC
If "0 - No", then go to M1322.

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  First Released in Version: 2.29
  Last Updated in Version: 2.64
  Status: Active.
Change Reason: "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

NORMATIVE ANSWER LIST    (LL251-0)  
 
Source: Regenstrief LOINC
  SEQ#        Answer        Code         Answer ID    
  1       No
http://snomed.info/sct ©: 373067005 No (qualifier value)    
  0       LA32-8  
  2       Yes
http://snomed.info/sct ©: 373066001 Yes (qualifier value)    
  1       LA33-6  

SURVEY QUESTION
Text: Does this patient have at lease one Unhealed Pressure Ulcer at Stage II or Higher or designated as "unstageable"
Source: OASIS-C.M1306

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263729-8  Unhealed pressure injury at stage 2 or higher or designated as unstageable 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP97133-0  OASIS-C 
Fragments for synonyms   LP20740-4 
Fragments for synonyms   LP266930-9  Pressure injury 
Fragments for synonyms   LP267481-2  Injury 
Fragments for synonyms   LP57601-4  As 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  Arterial Stenosis Outcome and assessment information set Random
  Finding Point in time Survey
  Findings pressure injury Survey.OASIS
  II Pressure ulcer Ulcer
  Nominal Pressure Ulcers  

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Unhealed pressure injury at stage 2 or higher or designated as unstageable [OASIS-C]
  Fully Specified Name: Unhealed pressure injury at Stage 2 or higher or designated as unstageable: Find: Pt: ^Patient: Nom: OASIS-C
     
  Component Word Count: 12
  ID: 51949
  Status (Raw): ACTIVE


58102-5   Current number of unhealed (non-epithelialized) pressure injuries at each stage [OASIS-C]Current number of unhealed (non-epithelialized) pressure injuries at each stage [OASIS-C]Current number of unhealed (non-epithelialized) pressure injuries at each stage: -: Pt: ^Patient: -: OASIS-C  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Current number of unhealed (non-epithelialized) pressure injuries at each stage  Pt  ^Patient  OASIS-C
  Override Display Name for Form:  Current number of unhealed (non-epithelialized) pressure ulcers at each stage
  Long Common Name:  Current number of unhealed (non-epithelialized) pressure injuries at each stage [OASIS-C]

OBSERVATION ID IN FORM
M1308

FORM CODING INSTRUCTIONS
Enter “0” if none; excludes Stage I pressure ulcers

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.29
  Last Updated in Version: 2.64
  Status: Active.
Change Reason: "Pressure ulcers" has been updated to "pressure injuries" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  

PARTS

Part Type    Part No.  Part Name   
Component   LP89807-9  Current number of unhealed (non-epithelialized) pressure injuries at each stage 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7747-1 
Method   LP97133-0  OASIS-C 
Fragments for synonyms   LP266931-7  Pressure injuries 
Fragments for synonyms   LP57618-8  OASIS 

RELATED NAMES
  No Point in time Random
  Num Pressure ulcer Survey
  Outcome and assessment information set Pressure Ulcers Survey.OASIS

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Current number of unhealed (non-epithelialized) pressure injuries at each stage [OASIS-C]
  Fully Specified Name: Current number of unhealed (non-epithelialized) pressure injuries at each stage: -: Pt: ^Patient: -: OASIS-C
     
  Component Word Count: 11
  ID: 52849
  Status (Raw): ACTIVE


57186-9   Number of pressure injuries at each stage SetNumber of pressure injuries at each stage SetNumber of pressure injuries at each stage: -: Pt: ^Patient: Set:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries at each stage  Pt  ^Patient  Set 
  Override Display Name for Form:  Number currently present
  Long Common Name:  Number of pressure injuries at each stage Set

OBSERVATION ID IN FORM
M1308.1

FORM CODING INSTRUCTIONS
Column 1 Complete at SOC/ROC/FU & D/C.

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.29
  Last Updated in Version: 2.64
  Status: Active.
Change Reason: "Pressure ulcers" has been updated to "pressure injuries" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  

PARTS

Part Type    Part No.  Part Name   
Component   LP75240-9  Number of pressure injuries at each stage 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7754-7  Set 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  No Point in time Random
  Num Pressure ulcer Survey
  Outcome and assessment information set Pressure Ulcers Survey.OASIS

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries at each stage Set
  Fully Specified Name: Number of pressure injuries at each stage: -: Pt: ^Patient: Set:
     
  Component Word Count: 7
  ID: 51815
  Status (Raw): ACTIVE


55124-2   Number of pressure injuries - stage 2 [CMS Assessment]Number of pressure injuries - stage 2 [CMS Assessment]Number of pressure injuries - stage 2: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries - stage 2  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.
  Long Common Name:  Number of pressure injuries - stage 2 [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  A stage 2 pressure ulcer is defined as partial thickness loss of dermis presenting as a shallow open ulcer with a red or pink wound bed, without slough. May also present as an intact or open/ruptured blister.
 
 

OBSERVATION ID IN FORM
M1308.1a

FORM CONTEXT
Stage 2: Partial thickness loss of dermis presenting as a shallow open ulcer with a red or pink wound bed, without slough. May also present as an intact or open/ruptured blister.

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from MDSv3 to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Removed "at assessment" from COMPONENT because it is implied by the TIMING=Pt; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86870-3 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA (NO/SO) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment]
  88279-5 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88951-9 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  90480-5 MDS v3.0 - RAI v1.17.1 - Interim Payment Assessment (IPA) item set [CMS Assessment]
  90481-3 MDS v3.0 - RAI v1.17.1 - Optional State Assessment (OSA) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263748-8  Number of pressure injuries - stage 2 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP20740-4 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Number Quant
  Cnt Point in time Quantitative
  Count Pressure ulcer Random
  II Pressure Ulcers Survey
  No QNT  
  Num Quan  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300B1     2.0 
   CMS IRF-PAI   M0300B1     3.0 
   CMS IRF-PAI   M0300B1     1.5 
   CMS IRF-PAI   M0300B1     1.4 
   CMS LCDS   M0300B1     3.00 
   CMS LCDS   M0300B1     4.00 
   CMS MDS   M0300B1     1.16.1 
   CMS MDS   M0300B1     1.15.1 
   CMS MDS   M0300B1     1.14.1 
   CMS MDS   M0300B1     1.17.1 
   CMS OASIS   M1311A1     D 
   CMS OASIS   M1311A1     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries - stage 2 [CMS Assessment]
  Fully Specified Name: Number of pressure injuries - stage 2: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 6
  ID: 49485
  Status (Raw): ACTIVE


55125-9   Number of pressure injuries - stage 3 [CMS Assessment]Number of pressure injuries - stage 3 [CMS Assessment]Number of pressure injuries - stage 3: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries - stage 3  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Stage III: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscles are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.
  Long Common Name:  Number of pressure injuries - stage 3 [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  A stage 3 pressure ulcer is defined as full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.
 
 

OBSERVATION ID IN FORM
M1800.1b

FORM CONTEXT
Stage 3: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.

SKIP LOGIC
If 0, skip to M0400C, Stage 4.

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from MDSv3 to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Removed "at assessment" from COMPONENT because it is implied by the TIMING=Pt; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86870-3 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA (NO/SO) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment]
  88279-5 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88951-9 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  90480-5 MDS v3.0 - RAI v1.17.1 - Interim Payment Assessment (IPA) item set [CMS Assessment]
  90481-3 MDS v3.0 - RAI v1.17.1 - Optional State Assessment (OSA) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263749-6  Number of pressure injuries - stage 3 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP21267-7 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Number Quant
  Cnt Point in time Quantitative
  Count Pressure ulcer Random
  III Pressure Ulcers Survey
  No QNT  
  Num Quan  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300C1     2.0 
   CMS IRF-PAI   M0300C1     3.0 
   CMS IRF-PAI   M0300C1     1.5 
   CMS IRF-PAI   M0300C1     1.4 
   CMS LCDS   M0300C1     3.00 
   CMS LCDS   M0300C1     4.00 
   CMS MDS   M0300C1     1.16.1 
   CMS MDS   M0300C1     1.15.1 
   CMS MDS   M0300C1     1.14.1 
   CMS MDS   M0300C1     1.17.1 
   CMS OASIS   M1311B1     D 
   CMS OASIS   M1311B1     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries - stage 3 [CMS Assessment]
  Fully Specified Name: Number of pressure injuries - stage 3: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 6
  ID: 49486
  Status (Raw): ACTIVE


55126-7   Number of pressure injuries - stage 4 [CMS Assessment]Number of pressure injuries - stage 4 [CMS Assessment]Number of pressure injuries - stage 4: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries - stage 4  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Stage IV: Full thickness tissue loss with visible bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling.
  Long Common Name:  Number of pressure injuries - stage 4 [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  A stage 4 pressure ulcer is defined as full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling.
 
 

OBSERVATION ID IN FORM
M1308.1c

FORM CONTEXT
Stage 4: Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling.

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Updated METHOD from MDSv3 to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Removed "at assessment" from COMPONENT because it is implied by the TIMING=Pt; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86870-3 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA (NO/SO) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment]
  88279-5 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88951-9 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  90480-5 MDS v3.0 - RAI v1.17.1 - Interim Payment Assessment (IPA) item set [CMS Assessment]
  90481-3 MDS v3.0 - RAI v1.17.1 - Optional State Assessment (OSA) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263750-4  Number of pressure injuries - stage 4 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT  
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300D1     2.0 
   CMS IRF-PAI   M0300D1     3.0 
   CMS IRF-PAI   M0300D1     1.5 
   CMS IRF-PAI   M0300D1     1.4 
   CMS LCDS   M0300D1     3.00 
   CMS LCDS   M0300D1     4.00 
   CMS MDS   M0300D1     1.16.1 
   CMS MDS   M0300D1     1.15.1 
   CMS MDS   M0300D1     1.14.1 
   CMS MDS   M0300D1     1.17.1 
   CMS OASIS   M1311C1     D 
   CMS OASIS   M1311C1     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:39 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries - stage 4 [CMS Assessment]
  Fully Specified Name: Number of pressure injuries - stage 4: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 6
  ID: 49487
  Status (Raw): ACTIVE


54893-3   Number of pressure injuries - unstageable due to non-removable dressing or device [CMS Assessment]Number of pressure injuries - unstageable due to non-removable dressing or device [CMS Assessment]Number of pressure injuries - unstageable due to non-removable dressing or device: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries - unstageable due to non-removable dressing or device  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Unstageable: Known or likely but unstageable due to non-removable dressing or device
  Long Common Name:  Number of pressure injuries - unstageable due to non-removable dressing or device [CMS Assessment]

FORM DATA DESCRIPTION
  Description: Unstageable: Known or likely but unstageable due to non-removable dressing or device
 
 

TERM DEFINITION/DESCRIPTION(S)
  A pressure ulcer that is unstageable due to a non-removable dressing is defined as a known pressure ulcer that is covered by a non-removable dressing or device, such as a surgical dressing, cast, other orthopedic device, or dressing not to be removed per physician's order.
 
 

OBSERVATION ID IN FORM
M1308.1d1

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; Removed "at assessment" from COMPONENT because it is implied by TIMING of "Pt".; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263735-5  Number of pressure injuries - unstageable due to non-removable dressing or device 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT  
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300E1     2.0 
   CMS IRF-PAI   M0300E1     3.0 
   CMS IRF-PAI   M0300E1     1.5 
   CMS IRF-PAI   M0300E1     1.4 
   CMS LCDS   M0300E1     3.00 
   CMS LCDS   M0300E1     4.00 
   CMS MDS   M0300E1     1.16.1 
   CMS MDS   M0300E1     1.15.1 
   CMS MDS   M0300E1     1.14.1 
   CMS MDS   M0300E1     1.17.1 
   CMS OASIS   M1311D1     D 
   CMS OASIS   M1311D1     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries - unstageable due to non-removable dressing or device [CMS Assessment]
  Fully Specified Name: Number of pressure injuries - unstageable due to non-removable dressing or device: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 12
  ID: 49230
  Status (Raw): ACTIVE


54946-9   Number of pressure injuries - unstageable due to coverage of wound bed by slough/​eschar [CMS Assessment]Number of pressure injuries - unstageable due to coverage of wound bed by slough/​eschar [CMS Assessment]Number of pressure injuries - unstageable due to coverage of wound bed by slough &or eschar: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries - unstageable due to coverage of wound bed by slough &or eschar  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Unstageable: Known or likely but unstageable due to coverage of wound bed by slough and/or eschar.
  Long Common Name:  Number of pressure injuries - unstageable due to coverage of wound bed by slough/eschar [CMS Assessment]

FORM DATA DESCRIPTION
  Description: Unstageable: Known or likely but unstageable due to coverage of wound bed by slough and/or eschar.
 
 

TERM DEFINITION/DESCRIPTION(S)
  Slough tissue is defined as non-viable yellow, tan, gray, green or brown tissue; usually moist, can be soft, stringy and mucinous in texture. Eschar tissue is defined as dead or devitalized tissue that is hard or soft in texture; usually black, brown, or tan in color, and may appear scablike.
 
 

OBSERVATION ID IN FORM
M1308.1d2

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; Removed "at assessment" from COMPONENT because it is implied by TIMING of "Pt";Updated COMPONENT from "and or" to "&or" to match convention; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86870-3 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA (NO/SO) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment]
  88279-5 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88951-9 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  90480-5 MDS v3.0 - RAI v1.17.1 - Interim Payment Assessment (IPA) item set [CMS Assessment]
  90481-3 MDS v3.0 - RAI v1.17.1 - Optional State Assessment (OSA) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263737-1  Number of pressure injuries - unstageable due to coverage of wound bed by slough &or eschar   [Number of pressure injuries - unstageable due to coverage of wound bed by slough/eschar] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT  
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300F1     2.0 
   CMS IRF-PAI   M0300F1     3.0 
   CMS IRF-PAI   M0300F1     1.5 
   CMS IRF-PAI   M0300F1     1.4 
   CMS LCDS   M0300F1     3.00 
   CMS LCDS   M0300F1     4.00 
   CMS MDS   M0300F1     1.16.1 
   CMS MDS   M0300F1     1.15.1 
   CMS MDS   M0300F1     1.14.1 
   CMS MDS   M0300F1     1.17.1 
   CMS OASIS   M1311E1     D 
   CMS OASIS   M1311E1     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries - unstageable due to coverage of wound bed by slough/eschar [CMS Assessment]
  Fully Specified Name: Number of pressure injuries - unstageable due to coverage of wound bed by slough &or eschar: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 15
  ID: 49287
  Status (Raw): ACTIVE


54950-1   Number of pressure injuries - unstageable with suspected deep tissue injury in evolution [CMS Assessment]Number of pressure injuries - unstageable with suspected deep tissue injury in evolution [CMS Assessment]Number of pressure injuries - unstageable with suspected deep tissue injury in evolution: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries - unstageable with suspected deep tissue injury in evolution  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Unstageable: Suspected deep tissue injury in evolution.
  Long Common Name:  Number of pressure injuries - unstageable with suspected deep tissue injury in evolution [CMS Assessment]

TERM DEFINITION/DESCRIPTION(S)
  A pressure ulcer that is unstageable due to deep tissue injury has purple or maroon area of discolored intact skin due to damage of underlying soft tissue. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.
 
 

OBSERVATION ID IN FORM
M1308.1d3

FORM CONTEXT
Unstageable: Suspected deep tissue injury in evolution.

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; Removed "at assessment" from COMPONENT because it is implied by TIMING of "Pt"; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86189-8 Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88368-6 Outcome and assessment information set (OASIS) form - version D - Resumption of care [CMS Assessment]
  88369-4 Outcome and assessment information set (OASIS) form - version D - Follow-up - recertification or other follow-up [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88373-6 Outcome and assessment information set (OASIS) form - version D - Start of care [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263739-7  Number of pressure injuries - unstageable with suspected deep tissue injury in evolution 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 
Fragments for synonyms   LP267481-2  Injury 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT Ulcer
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300G1     2.0 
   CMS IRF-PAI   M0300G1     3.0 
   CMS IRF-PAI   M0300G1     1.5 
   CMS IRF-PAI   M0300G1     1.4 
   CMS LCDS   M0300G1     3.00 
   CMS LCDS   M0300G1     4.00 
   CMS MDS   M0300G1     1.16.1 
   CMS MDS   M0300G1     1.15.1 
   CMS MDS   M0300G1     1.14.1 
   CMS MDS   M0300G1     1.17.1 
   CMS OASIS   M1311F1     D 
   CMS OASIS   M1311F1     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries - unstageable with suspected deep tissue injury in evolution [CMS Assessment]
  Fully Specified Name: Number of pressure injuries - unstageable with suspected deep tissue injury in evolution: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 12
  ID: 49291
  Status (Raw): ACTIVE


57187-7   Number of pressure injuries present at admission SetNumber of pressure injuries present at admission SetNumber of pressure injuries present at admission: -: Pt: ^Patient: Set:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present at admission  Pt  ^Patient  Set 
  Override Display Name for Form:  Number of those listed in Column 1 that were present on admission (most recent SOC/ROC)
  Long Common Name:  Number of pressure injuries present at admission Set

OBSERVATION ID IN FORM
M1308.2

FORM CODING INSTRUCTIONS
Column 2 Complete at FU & D/C. Number of those listed in Column 1 that were present on admission (most recent SOC/ROC)

BASIC ATTRIBUTES
  Class/Type: SURVEY.OASIS/Survey
  Panel Type: Panel
  First Released in Version: 2.29
  Last Updated in Version: 2.64
  Status: Active.
Change Reason: "Pressure ulcers" has been updated to "pressure injuries" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  

PARTS

Part Type    Part No.  Part Name   
Component   LP97307-0  Number of pressure injuries present at admission 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7754-7  Set 
Fragments for synonyms   LP57618-8  OASIS 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  No Point in time Random
  Num Pressure ulcer Survey
  Outcome and assessment information set Pressure Ulcers Survey.OASIS

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries present at admission Set
  Fully Specified Name: Number of pressure injuries present at admission: -: Pt: ^Patient: Set:
     
  Component Word Count: 7
  ID: 51816
  Status (Raw): ACTIVE


54886-7   Number of pressure injuries present upon admission/​reentry - stage 2 [CMS Assessment]Number of pressure injuries present upon admission/​reentry - stage 2 [CMS Assessment]Number of pressure injuries present upon admission &or reentry - stage 2: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present upon admission &or reentry - stage 2  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Stage II: Partial thickness loss of dermis presenting as a shallow open ulcer with red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.
  Long Common Name:  Number of pressure injuries present upon admission/reentry - stage 2 [CMS Assessment]

OBSERVATION ID IN FORM
M1308.2a

FORM CODING INSTRUCTIONS
Enter how many were noted at the time of admission

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263732-2  Number of pressure injuries present upon admission &or reentry - stage 2   [Number of pressure injuries present upon admission/reentry - stage 2] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP20740-4 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Number Quant
  Cnt Point in time Quantitative
  Count Pressure ulcer Random
  II Pressure Ulcers Survey
  No QNT  
  Num Quan  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300B2     2.0 
   CMS IRF-PAI   M0300B2     3.0 
   CMS IRF-PAI   M0300B2     1.5 
   CMS IRF-PAI   M0300B2     1.4 
   CMS LCDS   M0300B2     3.00 
   CMS LCDS   M0300B2     4.00 
   CMS MDS   M0300B2     1.16.1 
   CMS MDS   M0300B2     1.15.1 
   CMS MDS   M0300B2     1.14.1 
   CMS MDS   M0300B2     1.17.1 
   CMS OASIS   M1311A2     D 
   CMS OASIS   M1311A2     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries present upon admission/reentry - stage 2 [CMS Assessment]
  Fully Specified Name: Number of pressure injuries present upon admission &or reentry - stage 2: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 11
  ID: 49222
  Status (Raw): ACTIVE


54887-5   Number of pressure injuries present upon admission/​reentry - stage 3 [CMS Assessment]Number of pressure injuries present upon admission/​reentry - stage 3 [CMS Assessment]Number of pressure injuries present upon admission &or reentry - stage 3: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present upon admission &or reentry - stage 3  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Stage III: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscles are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.
  Long Common Name:  Number of pressure injuries present upon admission/reentry - stage 3 [CMS Assessment]

OBSERVATION ID IN FORM
M1308.2b

FORM CODING INSTRUCTIONS
Enter how many were noted at the time of admission

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263733-0  Number of pressure injuries present upon admission &or reentry - stage 3   [Number of pressure injuries present upon admission/reentry - stage 3] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP21267-7 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Number Quant
  Cnt Point in time Quantitative
  Count Pressure ulcer Random
  III Pressure Ulcers Survey
  No QNT  
  Num Quan  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300C2     2.0 
   CMS IRF-PAI   M0300C2     3.0 
   CMS IRF-PAI   M0300C2     1.5 
   CMS IRF-PAI   M0300C2     1.4 
   CMS LCDS   M0300C2     3.00 
   CMS LCDS   M0300C2     4.00 
   CMS MDS   M0300C2     1.16.1 
   CMS MDS   M0300C2     1.15.1 
   CMS MDS   M0300C2     1.14.1 
   CMS MDS   M0300C2     1.17.1 
   CMS OASIS   M1311B2     D 
   CMS OASIS   M1311B2     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries present upon admission/reentry - stage 3 [CMS Assessment]
  Fully Specified Name: Number of pressure injuries present upon admission &or reentry - stage 3: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 11
  ID: 49223
  Status (Raw): ACTIVE


54890-9   Number of pressure injuries present upon admission/​reentry - stage 4 [CMS Assessment]Number of pressure injuries present upon admission/​reentry - stage 4 [CMS Assessment]Number of pressure injuries present upon admission &or reentry - stage 4: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present upon admission &or reentry - stage 4  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Stage IV: Full thickness tissue loss with visible bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling.
  Long Common Name:  Number of pressure injuries present upon admission/reentry - stage 4 [CMS Assessment]

OBSERVATION ID IN FORM
M1308.2c

FORM CODING INSTRUCTIONS
Enter how many were noted at the time of admission

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263734-8  Number of pressure injuries present upon admission &or reentry - stage 4   [Number of pressure injuries present upon admission/reentry - stage 4] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT  
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300D2     2.0 
   CMS IRF-PAI   M0300D2     3.0 
   CMS IRF-PAI   M0300D2     1.5 
   CMS IRF-PAI   M0300D2     1.4 
   CMS LCDS   M0300D2     3.00 
   CMS LCDS   M0300D2     4.00 
   CMS MDS   M0300D2     1.16.1 
   CMS MDS   M0300D2     1.15.1 
   CMS MDS   M0300D2     1.14.1 
   CMS MDS   M0300D2     1.17.1 
   CMS OASIS   M1311C2     D 
   CMS OASIS   M1311C2     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:40 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries present upon admission/reentry - stage 4 [CMS Assessment]
  Fully Specified Name: Number of pressure injuries present upon admission &or reentry - stage 4: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 11
  ID: 49227
  Status (Raw): ACTIVE


54894-1   Number of pressure injuries present upon admission/​reentry - unstageable due to non-removable dressing [CMS Assessment]Number of pressure injuries present upon admission/​reentry - unstageable due to non-removable dressing [CMS Assessment]Number of pressure injuries present upon admission &or reentry - unstageable due to non-removable dressing: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present upon admission &or reentry - unstageable due to non-removable dressing  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Unstageable: Known or likely but unstageable due to non-removable dressing or device
  Long Common Name:  Number of pressure injuries present upon admission/reentry - unstageable due to non-removable dressing [CMS Assessment]

OBSERVATION ID IN FORM
M1308.2d1

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263736-3  Number of pressure injuries present upon admission &or reentry - unstageable due to non-removable dressing   [Number of pressure injuries present upon admission/reentry - unstageable due to non-removable dressing] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT  
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300E2     2.0 
   CMS IRF-PAI   M0300E2     3.0 
   CMS IRF-PAI   M0300E2     1.5 
   CMS IRF-PAI   M0300E2     1.4 
   CMS LCDS   M0300E2     3.00 
   CMS LCDS   M0300E2     4.00 
   CMS MDS   M0300E2     1.16.1 
   CMS MDS   M0300E2     1.15.1 
   CMS MDS   M0300E2     1.14.1 
   CMS MDS   M0300E2     1.17.1 
   CMS OASIS   M1311D2     D 
   CMS OASIS   M1311D2     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:41 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries present upon admission/reentry - unstageable due to non-removable dressing [CMS Assessment]
  Fully Specified Name: Number of pressure injuries present upon admission &or reentry - unstageable due to non-removable dressing: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 15
  ID: 49231
  Status (Raw): ACTIVE


54947-7   Number of pressure injuries present upon admission/​reentry - unstageable due to coverage of wound bed by slough/​eschar [CMS Assessment]Number of pressure injuries present upon admission/​reentry - unstageable due to coverage of wound bed by slough/​eschar [CMS Assessment]Number of pressure injuries present upon admission &or reentry - unstageable due to coverage of wound bed by slough &or eschar: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present upon admission &or reentry - unstageable due to coverage of wound bed by slough &or eschar  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Unstageable: Known or likely but unstageable due to coverage of wound bed by slough and/or eschar.
  Long Common Name:  Number of pressure injuries present upon admission/reentry - unstageable due to coverage of wound bed by slough/eschar [CMS Assessment]

OBSERVATION ID IN FORM
M1308.2d2

FORM CODING INSTRUCTIONS
Enter how many were noted at the time of admission

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263738-9  Number of pressure injuries present upon admission &or reentry - unstageable due to coverage of wound bed by slough &or eschar   [Number of pressure injuries present upon admission/reentry - unstageable due to coverage of wound bed by slough/eschar] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey
  No QNT  
  Num Quan  
  Number Quant  

EXAMPLE UNITS
  Unit  Source Type
  {#}  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  {#} 

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   M0300F2     2.0 
   CMS IRF-PAI   M0300F2     3.0 
   CMS IRF-PAI   M0300F2     1.5 
   CMS IRF-PAI   M0300F2     1.4 
   CMS LCDS   M0300F2     3.00 
   CMS LCDS   M0300F2     4.00 
   CMS MDS   M0300F2     1.16.1 
   CMS MDS   M0300F2     1.15.1 
   CMS MDS   M0300F2     1.14.1 
   CMS MDS   M0300F2     1.17.1 
   CMS OASIS   M1311E2     D 
   CMS OASIS   M1311E2     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 4:34:41 PM
  Attachment Units Required: N
  Long Common Name: Number of pressure injuries present upon admission/reentry - unstageable due to coverage of wound bed by slough/eschar [CMS Assessment]
  Fully Specified Name: Number of pressure injuries present upon admission &or reentry - unstageable due to coverage of wound bed by slough &or eschar: Num: Pt: ^Patient: Qn: CMS Assessment
     
  Component Word Count: 20
  ID: 49288
  Status (Raw): ACTIVE


54951-9   Number of pressure injuries present upon admission/​reentry - unstageable with suspected deep tissue injury in evolution [CMS Assessment]Number of pressure injuries present upon admission/​reentry - unstageable with suspected deep tissue injury in evolution [CMS Assessment]Number of pressure injuries present upon admission &or reentry - unstageable with suspected deep tissue injury in evolution: Num: Pt: ^Patient: Qn: CMS Assessment  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Number of pressure injuries present upon admission &or reentry - unstageable with suspected deep tissue injury in evolution  Num  Pt  ^Patient  Qn  CMS Assessment
  Override Display Name for Form:  Unstageable: Suspected deep tissue injury in evolution.
  Long Common Name:  Number of pressure injuries present upon admission/reentry - unstageable with suspected deep tissue injury in evolution [CMS Assessment]

OBSERVATION ID IN FORM
M1308.2d3

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.27
  Last Updated in Version: 2.63
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Changed method from MDSv3 so term can be used across CMS assessments per decision by the Clinical LOINC committee and CMS HITWG; "Pressure ulcer" has been updated to "pressure injury" according to the new guidelines by the NPUAP and as approved by the Clinical LOINC.

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54580-6 Minimum Data Set - version 3.0
  57039-0 Outcome and assessment information set (OASIS) form - version C
  57190-1 Outcome and assessment information set (OASIS) form - version C - Start of care
  57191-9 Outcome and assessment information set (OASIS) form - version C - Resumption of Care
  57192-7 Outcome and assessment information set (OASIS) form - version C - Follow-Up
  57194-3 Outcome and assessment information set (OASIS) form - version C - Discharge from agency
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
  86244-1 Outcome and assessment information set (OASIS) form - version C2 - Follow-up - recertification or other follow-up [CMS Assessment]
  86264-9 Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86856-2 MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
  86871-1 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  86872-9 MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  86873-7 MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  86876-0 MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
  86877-8 MDS v3.0 - RAI v1.14.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  87414-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment]
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment]
  88282-9 MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88283-7 MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88284-5 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88285-2 MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88286-0 MDS v3.0 - RAI v1.15.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88287-8 MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88288-6 MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88292-8 MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  88329-8 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
  88371-0 Outcome and assessment information set (OASIS) form - version D - Discharged from agency [CMS Assessment]
  88945-1 MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
  88946-9 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
  88947-7 MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
  88948-5 MDS v3.0 - RAI v1.16.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  88949-3 MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
  88950-1 MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
  88954-3 MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  88955-0 MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment]
  90473-0 MDS v3.0 - RAI v1.17.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  90474-8 MDS v3.0 - RAI v1.17.1 - Nursing home PPS (NP) item set [CMS Assessment]
  90475-5 MDS v3.0 - RAI v1.17.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
  90476-3 MDS v3.0 - RAI v1.17.1 - Swing bed PPS (SP) item set [CMS Assessment]
  90477-1 MDS v3.0 - RAI v1.17.1 - Nursing home discharge (ND) item set [CMS Assessment]
  90478-9 MDS v3.0 - RAI v1.17.1 - Nursing home part A PPS discharge (NPE) item set [CMS Assessment]
  91552-0 MDS v3.0 - RAI v1.17.1 - Swing bed discharge (SD) item set [CMS Assessment]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP263740-5  Number of pressure injuries present upon admission &or reentry - unstageable with suspected deep tissue injury in evolution   [Number of pressure injuries present upon admission/reentry - unstageable with suspected deep tissue injury in evolution] 
Property   LP6841-3  Num   [Number (count)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP230524-3  CMS Assessment   [Centers for Medicare and Medicaid Assessment] 
Fragments for synonyms   LP266931-7  Pressure injuries 
Fragments for synonyms   LP267481-2  Injury 

RELATED NAMES
  Centers for Medicare and Medicaid Assessment Point in time Quantitative
  Cnt Pressure ulcer Random
  Count Pressure Ulcers Survey