67868-0  End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728End stage renal disease medical evidence report, medicare entitlement &or patient registration - OMB CMS form 2728: -: Pt: ^Patient: -:  

PANEL HIERARCHY  (view this panel in the LForms viewer)

  LOINC#   LOINC Name R/O/C  Cardinality  Ex. UCUM Units 
  67868-0   End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728End stage renal disease medical evidence report, medicare entitlement &or patient registration - OMB CMS form 2728: -: Pt: ^Patient: -:    
       67869-8   Form Type Indicator R    
       67870-6   Patient information    
            45394-4   Last nameLast nameLast name: Pn: Pt: ^Patient: Nom: R    
            45392-8   First nameFirst nameFirst name: Pn: Pt: ^Patient: Nom: R    
            45393-6   Middle initialMiddle initialMiddle initial: Pn: Pt: ^Patient: Nom: O    
            45397-7   Medicare or comparable numberMedicare or comparable numberMedicare or comparable number: ID: Pt: ^Patient: Nom: R    
            45396-9   Social Security number [Identifier]Social Security number [Identifier]Social Security number: ID: Pt: ^Patient: Nom: R    
            21112-8   Birth dateBirth dateBirth date: TmStp: Pt: ^Patient: Qn: R   {mm/dd/yyyy} 
       67871-4   Patient demographics - end stage renal disease form 2728Patient demographics - end stage renal disease form 2728Patient demographics - end stage renal disease form 2728: -: Pt: ^Patient: -:    
            56799-0   AddressAddressAddress: Addr: Pt: ^Patient: Nom: R    
            68997-6   Patient City (Mailing) R    
            46499-0   State of residenceState of residenceState of residence: Loc: Pt: ^Patient: Nom: R    
            45401-7   Postal code [Location]Postal code [Location]Postal code: Loc: Pt: ^Patient: Nom: R    
            42077-8   Patient phone numberPatient phone numberPhone number: Tele: Pt: ^Patient: Nom: R    
            46098-0   SexSexSex: Type: Pt: ^Patient: Nom: R    
            54133-4   Ethnicity [USSG-FHT]Ethnicity [USSG-FHT]Ethnicity: Type: Pt: ^Patient: Nom: USSG-FHT O    
            68329-2   Country of originCountry of originCountry of origin: Loc: Pt: ^Patient: Nom: C    
            54134-2   Race [USSG-FHT]Race [USSG-FHT]Race: Type: Pt: ^Patient: Nom: USSG-FHT R    
            67884-7   Name of Enrolled/Principal Tribe C 0..*   
            67872-2   Is the patient applying for ESRD Medicare coverage? R 1..*   
            52556-8   Payment sourcesPayment sourcesPayment sources: Type: Pt: ^Patient: Nom:    
            8302-2   Body heightBody heightBody height: Len: Pt: ^Patient: Qn: R   [in_i] 
            8340-2   Dry body weight EstimatedDry body weight EstimatedDry body weight: Mass: Pt: ^Patient: Qn: Estimated R   kg;[lb_av] 
            67873-0   Primary Cause of Renal Failure Code C    
            67874-8   Patient Prior Employment Status (6 Months Prior) R    
            67875-5   Patient Current Employment Status (At Onset) R    
            67876-3   Co-Morbid Conditions R    
            67885-4   Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy C    
            67886-2   Care by nephrologist prior to end stage renal disease therapy C    
            67887-0   Care by kidney dietician prior to end stage renal disease therapy C    
            67888-8   Access Type for First Outpatient Dialysis C    
            68449-8   Is maturing AVF present? C    
            68450-6   Is maturing graft present? C    
       68996-8   Laboratory - end stage renal disease form 2728Laboratory - end stage renal disease form 2728Laboratory - end stage renal disease form 2728: -: Pt: ^Patient: -:    
            1751-7   Albumin [Mass/​volume] in Serum or PlasmaAlbumin [Mass/​volume] in Serum or PlasmaAlbumin: MCnc: Pt: Ser/​Plas: Qn: O   g/dL 
            49049-0   Collection time of Unspecified specimenCollection time of Unspecified specimenCollection time: TmStp: Pt: XXX: Qn: C   {clock_time} 
            68900-0   Albumin Lab Method O    
            2160-0   Creatinine [Mass/​volume] in Serum or PlasmaCreatinine [Mass/​volume] in Serum or PlasmaCreatinine: MCnc: Pt: Ser/​Plas: Qn: R   mg/dL 
            718-7   Hemoglobin [Mass/​volume] in BloodHemoglobin [Mass/​volume] in BloodHemoglobin: MCnc: Pt: Bld: Qn: O   g/dL 
            4548-4   Hemoglobin A1c/​Hemoglobin.total in BloodHemoglobin A1c/​Hemoglobin.total in BloodHemoglobin A1c/​Hemoglobin.total: MFr: Pt: Bld: Qn: O  
            2093-3   Cholesterol [Mass/​volume] in Serum or PlasmaCholesterol [Mass/​volume] in Serum or PlasmaCholesterol: MCnc: Pt: Ser/​Plas: Qn: O   mg/dL 
            13457-7   Cholesterol in LDL [Mass/​volume] in Serum or Plasma by calculationCholesterol in LDL [Mass/​volume] in Serum or Plasma by calculationCholesterol.in LDL: MCnc: Pt: Ser/​Plas: Qn: Calculated O   mg/dL 
            2085-9   Cholesterol in HDL [Mass/​volume] in Serum or PlasmaCholesterol in HDL [Mass/​volume] in Serum or PlasmaCholesterol.in HDL: MCnc: Pt: Ser/​Plas: Qn: O   mg/dL 
            2571-8   Triglyceride [Mass/​volume] in Serum or PlasmaTriglyceride [Mass/​volume] in Serum or PlasmaTriglyceride: MCnc: Pt: Ser/​Plas: Qn: O   mg/dL 
       67877-1   End stage renal disease (ESRD) patients in dialysis treatment - end stage renal disease form 2728End stage renal disease (ESRD) patients in dialysis treatment - end stage renal disease form 2728End stage renal disease patients in dialysis treatment - end stage renal disease form 2728: -: Pt: ^Patient: -:    
            67878-9   Dialysis facility name R    
            68330-0   Dialysis facility's CMS Certification Number (CCN) where the patient is receiving care R    
            68442-3   Primary dialysis setting R    
            68443-1   Primary type of dialysis R    
            68448-0   Sessions per Week R   {#}/wk 
            68489-4   Hours per session R   h/{session} 
            68358-1   Date regular chronic dialysis began R    
            68444-9   Date patient started chronic dialysis at current facility R    
            68360-7   Has patient been informed of kidney transplant options? R    
            68361-5   If patient NOT informed of transplant options, please check all that apply. C    
       67883-9   Transplant information - end stage renal disease form 2728Transplant information - end stage renal disease form 2728Transplant information - end stage renal disease form 2728: -: Pt: ^Patient: -:    
            68445-6   Transplant date C    
            68446-4   Transplant facility nameTransplant facility nameTransplant facility name: ID: Pt: Facility: Nom: C    
            67880-5   Transplant Hospital Federal Provider Number C    
            68447-2   Date patient was admitted as an inpatient to a hospital in preparation for, or anticipation of, a kidney transplant prior to the date of the actual tranplantation O    
            68490-2   Name of Preparation Hospital C    
            68456-3   Medicare provider number for item 32 C    
            67882-1   Current status of transplant C    
            68332-6   Type of donor C    
            68333-4   If non-functioning, date of return to regular dialysis C    
            68334-2   Current dialysis treatment site C    
       68451-4   Self-dialysis training program - end stage renal disease form 2728Self-dialysis training program - end stage renal disease form 2728Self-dialysis training program - end stage renal disease form 2728: -: Pt: ^Patient: -:    
            68335-9   Self-dialysis training facility name Dialysis facilitySelf-dialysis training facility name Dialysis facilitySelf-dialysis training facility name: ID: Pt: Dialysis facility: Nom: C    
            67881-3   Self-dialysis Training Facility Federal Provider Number C    
            68362-3   Date training began. C    
            68336-7   Type of training C    
            68337-5   Location of training C    
            68338-3   This patient is expected to complete training and will self-dialyze on a regualr basis C    
            68339-1   Date when patient completed, or is expected to complete training C    
            68491-0   Training Physician Name C    
            68355-7   Date C    
            68357-3   Self-dialysis training physician NPI ProviderSelf-dialysis training physician NPI ProviderSelf-dialysis training physician NPI: ID: Pt: Provider: Nom: C    
       68462-1   Physician information - end stage renal disease form 2728 ProviderPhysician information - end stage renal disease form 2728 ProviderPhysician information - end stage renal disease form 2728: -: Pt: Provider: -:    
            52526-1   Attending physician nameAttending physician nameAttending physician name: Pn: Pt: Provider: Nom: R    
            68340-9   Attending physician phone number R    
            68468-8   Attending physician NPI ProviderAttending physician NPI ProviderAttending physician NPI: ID: Pt: Provider: Nom: R    
            68355-7   Date R    
            8251-1   Service commentService commentService comment: Imp: Pt: XXX: Nom: O    
            68355-7   Date R    
            65838-5   Date submittedDate submittedDate submitted: Date: Pt: Form: Qn: R    
 

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
End stage renal disease medical evidence report, medicare entitlement &or patient registration - OMB CMS form 2728  Pt  ^Patient 
  Long Common Name:  End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728

PART DEFINITION/DESCRIPTION(S)
  Part: End stage renal disease medical evidence report, medicare entitlement &or patient registration - OMB CMS form 2728
  Form CMS-2728-U3 - ESRD Medical Evidence Report, Medicare Entitlement, (Patient Registration) is completed on each incident ESRD patient or each patient re-entering the Medicare program. Dialysis and transplant facilities must submit this form to the Networks within 45 days from the date a patient is diagnosed with ESRD and either has a transplant or begins a regular course of dialysis. This form is also mandatory if a patient loses Medicare coverage and re-applying for benefits.
 
 

ORIGINAL FORM
  Description: CMS-2728-U3 - ESRD Medical Evidence Report, Medicare Entitlement, and/or Patient Registration
 
 

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.ESRD/Survey
  Panel Type: Panel
  First Released in Version: 2.38
  Last Updated in Version: 2.50
  Status: Trial – caution, may change

PARTS

Part Type    Part No.  Part Name   
Component   LP134062-1  End stage renal disease medical evidence report, medicare entitlement &or patient registration - OMB CMS form 2728   [End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728] 
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   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis ESRD survey Point in time
  Dz Kidney Random
  End Stage Renal Disease (ESDR) pnl Pan Survey
  End-stage renal disease Panel  
  ESRD Panl  
  ESRD CMS Form 2728 Pnl  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  Fully Specified Name: End stage renal disease medical evidence report, medicare entitlement &or patient registration - OMB CMS form 2728: -: Pt: ^Patient: -:
     
  Component Word Count: 16
  ID: 63679
  # of Panel Elements: 86
  Status (Raw): TRIAL



Selected information about each LOINC that is part of this panel



67869-8   Reason for medicare entitlementReason for medicare entitlementReason for medicare entitlement: Type: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Reason for medicare entitlement  Type  Pt  ^Patient  Nom 
  Long Common Name:  Reason for medicare entitlement

TERM DEFINITION/DESCRIPTION(S)
  Indicate the type of form being submitted for the patient.
 
 

OBSERVATION ID IN FORM
CMS-2728_A

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1911-8)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Initial       LA6662-6  
  2       Re-entitlement       LA17971-5  
  3       Supplemental       LA17972-3  

SURVEY QUESTION
Text: Form Type Indicator
Source: ESRD.RQMT_292

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134064-7  Reason for medicare entitlement 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

RELATED NAMES
  ESRD Point in time Survey
  ESRD survey Random Typ
  Nominal Reason medicare entitlement  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: Reason for medicare entitlement
  Fully Specified Name: Reason for medicare entitlement: Type: Pt: ^Patient: Nom:
     
  Component Word Count: 4
  ID: 63680
  Status (Raw): TRIAL


67870-6   Patient information - end stage renal disease form 2728Patient information - end stage renal disease form 2728Patient information - end stage renal disease form 2728: -: Pt: ^Patient: -:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Patient information - end stage renal disease form 2728  Pt  ^Patient 
  Override Display Name for Form:  Patient information
  Long Common Name:  Patient information - end stage renal disease form 2728

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.ESRD/Survey
  Panel Type: Panel
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134066-2  Patient information - end stage renal disease form 2728 
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   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis Kidney Point in time
  Dz Pan Random
  End Stage Renal Disease (ESDR) pnl Panel Survey
  End-stage renal disease Panl  
  ESRD Patient information - ESRD 2728  
  ESRD survey Pnl  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: Patient information - end stage renal disease form 2728
  Fully Specified Name: Patient information - end stage renal disease form 2728: -: Pt: ^Patient: -:
     
  Component Word Count: 8
  ID: 63681
  Status (Raw): TRIAL


45394-4   Last nameLast nameLast name: Pn: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Last name  Pn  Pt  ^Patient  Nom 
  Long Common Name:  Last name
  Short Name:  Last name

OBSERVATION ID IN FORM
CMS-2728_A1

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-5.1

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  45963-6 MDS basic assessment tracking form - version 2.0
  45981-8 MDS full assessment form - version 2.0
  46102-0 MDS quarterly assessment form - version 2.0
  46103-8 MDS quarterly assessment form - version 2.0 - optional version for RUG-III
  46104-6 MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  46611-0 Mental residual functional capacity (RFC) assessment form
  46637-5 Residual physical functional capacity (RFC) assessment form [RFC]
  47245-6 HIV treatment form Document
  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
  54580-6 Minimum Data Set - version 3.0
  55140-8 Vaccine Adverse Event Reporting System (VAERS) panel
  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
  62812-3 PhenX domain - Physical activity and physical fitness
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  70297-7 ESRD patient information panel
  76464-7 American Physical Therapy Association registry panel
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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   LP75019-7  Last name 
Property   LP6844-7  Pn   [Person name] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP200101-6  Last 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  姓氏:人员姓名:时间点:^患者:名义型:姓氏:人员姓名: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)
 
  Cognome:Pn:Pt:^Paziente:Nom:Cognome:Pn:Pt:^Paziente:Nom:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Apellido:Pn:Punto temporal:^paciente:Nom:Apellido:Pn:Punto temporal:^paciente:Nom:
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Soyad:KişiAdı:Zmlı:^Hasta:Snf:Soyad:KişiAdı:Zmlı:^Hasta:Snf:

RELATED NAMES
  ADMIN Past Random
  ADMIN.PATIENT Person name  
  Nominal Point in time  

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   5A     1.4 
   CMS IRF-PAI   5A     1.5 
   CMS IRF-PAI   5A     2.0 
   CMS IRF-PAI   5A     3.0 
   CMS LCDS   A0500C     3.00 
   CMS LCDS   A0500C     4.00 
   CMS MDS   A0500C     1.15.1 
   CMS MDS   A0500C     1.17.1 
   CMS MDS   A0500C     1.14.1 
   CMS MDS   A0500C     1.16.1 
   CMS MDS   X0200C     1.16.1 
   CMS MDS   X0200C     1.15.1 
   CMS MDS   X0200C     1.17.1 
   CMS MDS   X0200C     1.14.1 
   CMS OASIS   M0040     C2 
   CMS OASIS   M0040     D 
   https://www.phenxtoolkit.org   PX150801010300   PX150801_Participant_Last_Name   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: Last name
  Shortname: Last name
  Fully Specified Name: Last name: Pn: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 38743
  Status (Raw): ACTIVE


45392-8   First nameFirst nameFirst name: Pn: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
First name  Pn  Pt  ^Patient  Nom 
  Long Common Name:  First name
  Short Name:  First name

OBSERVATION ID IN FORM
CMS-2728_A1

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-5.2

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  45963-6 MDS basic assessment tracking form - version 2.0
  45981-8 MDS full assessment form - version 2.0
  46102-0 MDS quarterly assessment form - version 2.0
  46103-8 MDS quarterly assessment form - version 2.0 - optional version for RUG-III
  46104-6 MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  46611-0 Mental residual functional capacity (RFC) assessment form
  46637-5 Residual physical functional capacity (RFC) assessment form [RFC]
  47245-6 HIV treatment form Document
  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
  54580-6 Minimum Data Set - version 3.0
  55140-8 Vaccine Adverse Event Reporting System (VAERS) panel
  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
  62812-3 PhenX domain - Physical activity and physical fitness
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  70297-7 ESRD patient information panel
  76464-7 American Physical Therapy Association registry panel
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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   LP74855-5  First name 
Property   LP6844-7  Pn   [Person name] 
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)
 
  名字:人员姓名:时间点:^患者:名义型:名字:人员姓名: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)
 
  Primo nome:Pn:Pt:^Paziente:Nom:Primo nome:Pn:Pt:^Paziente:Nom:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Nombre:Pn:Punto temporal:^paciente:Nom:Nombre:Pn:Punto temporal:^paciente:Nom:
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Ad:KişiAdı:Zmlı:^Hasta:Snf:Ad:KişiAdı:Zmlı:^Hasta:Snf:

RELATED NAMES
  ADMIN Nominal Random
  ADMIN.PATIENT Person name  
  Given name Point in time  

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   4     1.4 
   CMS IRF-PAI   4     1.5 
   CMS IRF-PAI   4     2.0 
   CMS IRF-PAI   4     3.0 
   CMS LCDS   A0500A     3.00 
   CMS LCDS   A0500A     4.00 
   CMS MDS   A0500A     1.15.1 
   CMS MDS   A0500A     1.17.1 
   CMS MDS   A0500A     1.14.1 
   CMS MDS   A0500A     1.16.1 
   CMS MDS   X0200A     1.16.1 
   CMS MDS   X0200A     1.15.1 
   CMS MDS   X0200A     1.17.1 
   CMS MDS   X0200A     1.14.1 
   CMS OASIS   M0040     C2 
   CMS OASIS   M0040     D 
   https://www.phenxtoolkit.org   PX150801010100   PX150801_Participant_First_Name   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: First name
  Shortname: First name
  Fully Specified Name: First name: Pn: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 38740
  Status (Raw): ACTIVE


45393-6   Middle initialMiddle initialMiddle initial: Pn: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Middle initial  Pn  Pt  ^Patient  Nom 
  Long Common Name:  Middle initial
  Short Name:  Middle initial

OBSERVATION ID IN FORM
CMS-2728_A1

OBSERVATION REQUIRED IN PANEL
Optional

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Change PROPERTY from ID to Pn to match convention for other name terms.

HL7 ATTRIBUTES
  HL7 Field ID: PID-5.3

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  45963-6 MDS basic assessment tracking form - version 2.0
  45981-8 MDS full assessment form - version 2.0
  46102-0 MDS quarterly assessment form - version 2.0
  46103-8 MDS quarterly assessment form - version 2.0 - optional version for RUG-III
  46104-6 MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  46611-0 Mental residual functional capacity (RFC) assessment form
  46637-5 Residual physical functional capacity (RFC) assessment form [RFC]
  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
  62812-3 PhenX domain - Physical activity and physical fitness
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  70297-7 ESRD patient information panel
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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   LP75126-0  Middle initial 
Property   LP6844-7  Pn   [Person name] 
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)
 
  中间名首字母:人员姓名:时间点:^患者:名义型:中间名首字母:人员姓名: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)
 
  Iniziale secondo nome:Pn:Pt:^Paziente:Nom:Iniziale secondo nome:Pn:Pt:^Paziente:Nom:

RELATED NAMES
  ADMIN Person name  
  ADMIN.PATIENT Point in time  
  Nominal Random  

RELATED CODES
Code System Code Code Text Code Version
   CMS LCDS   A0500B     3.00 
   CMS LCDS   A0500B     4.00 
   CMS MDS   A0500B     1.16.1 
   CMS MDS   A0500B     1.15.1 
   CMS MDS   A0500B     1.14.1 
   CMS MDS   A0500B     1.17.1 
   CMS OASIS   M0040     D 
   CMS OASIS   M0040     C2 
   https://www.phenxtoolkit.org   PX150801010200   PX150801_Participant_Middle_Initial   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: Middle initial
  Shortname: Middle initial
  Fully Specified Name: Middle initial: Pn: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 38742
  Status (Raw): ACTIVE


45397-7   Medicare or comparable numberMedicare or comparable numberMedicare or comparable number: ID: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Medicare or comparable number  ID  Pt  ^Patient  Nom 
  Long Common Name:  Medicare or comparable number
  Short Name:  Medicare or comparable #

OBSERVATION ID IN FORM
CMS-2728_A2

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT.ID/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Changed CLASS to ADMIN.

HL7 ATTRIBUTES
  HL7 Field ID: PID-3

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  45963-6 MDS basic assessment tracking form - version 2.0
  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
  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
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  70297-7 ESRD patient information panel
  76464-7 American Physical Therapy Association registry panel
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  84908-3 Cancer pathology panel - Prostate cancer
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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   LP75106-2  Medicare or comparable number 
Property   LP6818-1  ID   [Identifier] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP31795-5  ID 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  医疗保险或类似编号:标识符:时间点:^患者:名义型:医疗保险或类似编号:标识符: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)
 
  Medicare o numero equivalente:ID:Pt:^Paziente:Nom:Medicare o numero equivalente:ID:Pt:^Paziente:Nom:

RELATED NAMES
  ADMIN Intradermal Point in time
  ADMIN.PATIENT Medicare or comparable # Random
  ADMIN.PATIENT.ID No  
  Ident Nominal  
  Identifier Num  

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   2     2.0 
   CMS IRF-PAI   2     3.0 
   CMS IRF-PAI   2     1.5 
   CMS IRF-PAI   2     1.4 
   CMS LCDS   A0600B     3.00 
   CMS LCDS   A0600B     4.00 
   CMS MDS   A0600B     1.16.1 
   CMS MDS   A0600B     1.15.1 
   CMS MDS   A0600B     1.14.1 
   CMS MDS   A0600B     1.17.1 
   CMS OASIS   M0063     D 
   CMS OASIS   M0063     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:10 PM
  Attachment Units Required: N
  Long Common Name: Medicare or comparable number
  Shortname: Medicare or comparable #
  Fully Specified Name: Medicare or comparable number: ID: Pt: ^Patient: Nom:
     
  Component Word Count: 4
  ID: 38746
  Status (Raw): ACTIVE


45396-9   Social Security number [Identifier]Social Security number [Identifier]Social Security number: ID: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Social Security number  ID  Pt  ^Patient  Nom 
  Long Common Name:  Social Security number [Identifier]
  Short Name:  Social Security #

OBSERVATION ID IN FORM
CMS-2728_A3

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT.ID/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Updated Class from SURVEY.MDS to ADMIN; Capitalized Security in Component.

HL7 ATTRIBUTES
  HL7 Field ID: PID-19

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  45963-6 MDS basic assessment tracking form - version 2.0
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  46611-0 Mental residual functional capacity (RFC) assessment form
  46637-5 Residual physical functional capacity (RFC) assessment form [RFC]
  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
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
  54580-6 Minimum Data Set - version 3.0
  55168-9 Data Elements for Emergency Department Systems (DEEDS) Release 1.1
  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
  62812-3 PhenX domain - Physical activity and physical fitness
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  70297-7 ESRD patient information panel
  76464-7 American Physical Therapy Association registry panel
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  89070-7 ADAPTABLE patient reported item set [ADAPTABLE]
  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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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   LP75647-5  Social Security number 
Property   LP6818-1  ID   [Identifier] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP31795-5  ID 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  社会安全号码:标识符:时间点:^患者:名义型:社会安全号码:标识符:时间点:^患者:名义型:

RELATED NAMES
  ADMIN Intradermal Random
  ADMIN.PATIENT No Social Security #
  ADMIN.PATIENT.ID Nominal  
  Ident Num  
  Identifier Point in time  

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   7     1.4 
   CMS IRF-PAI   7     1.5 
   CMS IRF-PAI   7     2.0 
   CMS IRF-PAI   7     3.0 
   CMS LCDS   A0600A     3.00 
   CMS LCDS   A0600A     4.00 
   CMS MDS   A0600A     1.15.1 
   CMS MDS   A0600A     1.17.1 
   CMS MDS   A0600A     1.14.1 
   CMS MDS   A0600A     1.16.1 
   CMS MDS   X0500     1.16.1 
   CMS MDS   X0500     1.15.1 
   CMS MDS   X0500     1.17.1 
   CMS MDS   X0500     1.14.1 
   CMS OASIS   M0064     C2 
   CMS OASIS   M0064     D 
   https://www.phenxtoolkit.org   PX150701050000   PX150701_SSN   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Social Security number [Identifier]
  Shortname: Social Security #
  Fully Specified Name: Social Security number: ID: Pt: ^Patient: Nom:
     
  Component Word Count: 3
  ID: 38745
  Status (Raw): ACTIVE


21112-8   Birth dateBirth dateBirth date: TmStp: Pt: ^Patient: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Birth date  TmStp  Pt  ^Patient  Qn 
  Long Common Name:  Birth date
  Short Name:  Birth date
  Display Name:  Birth date [Date/time]

OBSERVATION ID IN FORM
CMS-2728_A3

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: MISC/Lab
  Common Lab Results Rank: #1736
  Common SI Lab Results Rank: #1736
  First Released in Version: 1.0m
  Last Updated in Version: 2.48
  Order vs. Obs.: Observation
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-7.1

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  35086-8 Second trimester triple maternal screen panel - Serum or Plasma
  45963-6 MDS basic assessment tracking form - version 2.0
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  47245-6 HIV treatment form Document
  48798-3 First trimester maternal screen panel - Serum or Plasma
  48799-1 Second trimester penta maternal screen panel - Serum or Plasma
  48800-7 Second trimester quad maternal screen panel - Serum or Plasma
  48802-3 Alpha-1-Fetoprotein panel - Serum or Plasma
  49085-4 First and Second trimester integrated maternal screen panel
  49086-2 First trimester maternal screen with nuchal translucency panel
  49087-0 Maternal screen clinical predictors panel
  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
  54127-6 US Surgeon General family health portrait [USSG-FHT]
  54580-6 Minimum Data Set - version 3.0
  55140-8 Vaccine Adverse Event Reporting System (VAERS) panel
  55168-9 Data Elements for Emergency Department Systems (DEEDS) Release 1.1
  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
  58735-2 Alpha-1-Fetoprotein panel - Amniotic fluid
  60687-1 Test of Infant Motor Performance Version 5.1
  61129-3 PhenX domain - Demographics
  62263-9 PhenX domain - Nutrition and dietary supplements
  62611-9 PhenX domain - Respiratory
  62812-3 PhenX domain - Physical activity and physical fitness
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  70182-1 NIH Stroke Scale
  70297-7 ESRD patient information panel
  74495-3 Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ]
  75199-0 Congenital syphilis case investigation and report panel [CDC.CS]
  75854-0 PCORnet common data model set - version 1.0 [PCORnet]
  76464-7 American Physical Therapy Association registry panel
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85057-8 PCORnet Common Data Model set - version 3.0 [PCORnet]
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86636-8 Family planning report - FPAR 2.0 set
  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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  89070-7 ADAPTABLE patient reported item set [ADAPTABLE]
  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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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   LP19498-2  Birth date 
Property   LP6882-7  TmStp   [Time Stamp (Date and Time)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  出生日期:时间戳:时间点:^患者:定量型:出生日期:时间戳:时间点:^患者:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  geboortedatum:tijdstempel:moment:^patiënt:kwantitatief:geboortedatum:tijdstempel:moment:^patiënt:kwantitatief:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Birth date:TmStp:Pt:^Patient:Qn:Birth date:TmStp:Pt:^Patient:Qn:Date de naissance [Horodatage] Patient ; Numérique
  German (GERMANY)  (From: Institute for Medical Documentation and Information (DIMDI))
 
  Geburtsdatum:ZtStpl:Pkt:^Patient:Qn:Geburtsdatum:ZtStpl:Pkt:^Patient:Qn:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Data di nascita:TmStp:Pt:^Paziente:Qn:Data di nascita:TmStp:Pt:^Paziente:Qn:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Data de nascimento:TmStp:Pt:^Paciente:Qn:Data de nascimento:TmStp:Pt:^Paciente:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Рождения дата:TmStp:ТчкВрм:^Пациент:Колич:Рождения дата:TmStp:ТчкВрм:^Пациент:Колич:
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  fecha de nacimiento:marca de tiempo:fecha y hora:punto en el tiempo:^paciente:cuantitativo:fecha de nacimiento:marca de tiempo:fecha y hora:punto en el tiempo:^paciente:cuantitativo:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Fecha de nacimiento:Certificado de tiempo (Dia y Hora):Punto temporal:^paciente:Qn:Fecha de nacimiento:Certificado de tiempo (Dia y Hora):Punto temporal:^paciente:Qn:
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Doğum tarihi:ZBel:Zmlı:^Hasta:Kant:Doğum tarihi:ZBel:Zmlı:^Hasta:Kant:

RELATED NAMES
  Birthdate Point in time Random
  Date and time QNT Time stamp
  Date of birth Quan Timestamp
  DOB Quant  
  MISC 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 IRF-PAI   6     2.0 
   CMS IRF-PAI   6     1.4 
   CMS IRF-PAI   6     1.5 
   CMS IRF-PAI   6     3.0 
   CMS LCDS   A0900     4.00 
   CMS LCDS   A0900     3.00 
   CMS MDS   A0900     1.15.1 
   CMS MDS   A0900     1.16.1 
   CMS MDS   A0900     1.17.1 
   CMS MDS   A0900     1.14.1 
   CMS MDS   X0400     1.16.1 
   CMS MDS   X0400     1.15.1 
   CMS MDS   X0400     1.17.1 
   CMS MDS   X0400     1.14.1 
   CMS OASIS   M0066     C2 
   CMS OASIS   M0066     D 
   https://www.phenxtoolkit.org   PX010101010100   PX010101_Birthdate_Month   
   https://www.phenxtoolkit.org   PX010101010200   PX010101_Birthdate_Day   
   https://www.phenxtoolkit.org   PX010101010300   PX010101_Birthdate_Year   
   https://www.phenxtoolkit.org   PX091502030000   PX091502_Child_Birth_Date   
   https://www.phenxtoolkit.org   PX091601410000   PX091601_Date_Of_Birth   
   https://www.phenxtoolkit.org   PX150701060000   PX150701_Birth_Date   
   https://www.phenxtoolkit.org   PX221001030000   PX221001_MFHP_BirthDate   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: Y
  Long Common Name: Birth date
  Shortname: Birth date
  Fully Specified Name: Birth date: TmStp: Pt: ^Patient: Qn:
     
  Component Word Count: 2
  ID: 12108
  Status (Raw): ACTIVE


67871-4   Patient demographics - end stage renal disease form 2728Patient demographics - end stage renal disease form 2728Patient demographics - end stage renal disease form 2728: -: Pt: ^Patient: -:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Patient demographics - end stage renal disease form 2728  Pt  ^Patient 
  Long Common Name:  Patient demographics - end stage renal disease form 2728

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.ESRD/Survey
  Panel Type: Panel
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134067-0  Patient demographics - end stage renal disease form 2728 
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   LP204151-7  Demographics 
Fragments for synonyms   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Demographic ESRD survey Pnl
  Dis Kidney Point in time
  Dz Pan Random
  End Stage Renal Disease (ESDR) pnl Panel Survey
  End-stage renal disease Panl  
  ESRD Patient demographics - ESRD 2728  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Patient demographics - end stage renal disease form 2728
  Fully Specified Name: Patient demographics - end stage renal disease form 2728: -: Pt: ^Patient: -:
     
  Component Word Count: 8
  ID: 63682
  Status (Raw): TRIAL


56799-0   AddressAddressAddress: Addr: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Address  Addr  Pt  ^Patient  Nom 
  Long Common Name:  Address
  Short Name:  Address

OBSERVATION ID IN FORM
CMS-2728_A5

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT/Clinical
  First Released in Version: 2.29
  Last Updated in Version: 2.66
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-11

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  61129-3 PhenX domain - Demographics
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  89070-7 ADAPTABLE patient reported item set [ADAPTABLE]
  89724-9 Minimum Data Set (MDS) for Public Health Emergency Operations Centers (EOC) [CDC Emergency Operations Centers]
  93025-5 Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP96251-1  Address 
Property   LP6775-3  Addr   [Address (HL7 data type)] 
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)
 
  地址:地址:时间点:^患者:名义型:地址:地址:时间点:^患者:名义型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  adres:adres (HL7-datatype):moment:^patiënt:nominaal:adres:adres (HL7-datatype):moment:^patiënt:nominaal:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Indirizzo:Addr:Pt:^Paziente:Nom:Indirizzo:Addr:Pt:^Paziente:Nom:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Endereço:#N/​A:Pt:^Paciente:Nom:Endereço:#N/​A:Pt:^Paciente:Nom:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Адрес:Адр:ТчкВрм:^Пациент:Ном:Адрес:Адр:ТчкВрм:^Пациент:Ном:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Dirección:Dirección:Punto temporal:^paciente:Nom:Dirección:Dirección:Punto temporal:^paciente:Nom:

RELATED NAMES
  Address Nominal  
  ADMIN Point in time  
  ADMIN.PATIENT Random  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Address
  Shortname: Address
  Fully Specified Name: Address: Addr: Pt: ^Patient: Nom:
     
  Component Word Count: 1
  ID: 51372
  Status (Raw): ACTIVE


68997-6   CityCityCity: Loc: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
City  Loc  Pt  ^Patient  Nom 
  Override Display Name for Form:  Patient City (Mailing)
  Long Common Name:  City

OBSERVATION ID IN FORM
CMS-2728_A5

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.54
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  

PARTS

Part Type    Part No.  Part Name   
Component   LP117862-5  City 
Property   LP6825-6  Loc   [Location] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

RELATED NAMES
  ESRD Nominal Survey
  ESRD survey Point in time  
  Location Random  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: City
  Fully Specified Name: City: Loc: Pt: ^Patient: Nom:
     
  Component Word Count: 1
  ID: 68308
  Status (Raw): ACTIVE


46499-0   State of residenceState of residenceState of residence: Loc: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
State of residence  Loc  Pt  ^Patient  Nom 
  Long Common Name:  State of residence
  Short Name:  State of residence

TERM DEFINITION/DESCRIPTION(S)
  The state in which the patient is currently residing while receiving care.
 
 

OBSERVATION ID IN FORM
CMS-2728_A5

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT.DEMOG/Clinical
  First Released in Version: 2.19
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-11.4

EXAMPLE ANSWER LIST    (LL3661-7)  
 
Externally Defined: Y
Source: Centers for Disease Control and Prevention
Link to external list: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.830

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
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start 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   LP75672-3  State of residence 
Property   LP6825-6  Loc   [Location] 
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)
 
  居住州:位置:时间点:^患者:名义型:居住州:位置:时间点:^患者:名义型:

RELATED NAMES
  ADMIN Location Random
  ADMIN.PATIENT Nominal  
  ADMIN.PT.DEMOG Point in time  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0050     D 
   CMS OASIS   M0050     C2 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: State of residence
  Shortname: State of residence
  Fully Specified Name: State of residence: Loc: Pt: ^Patient: Nom:
     
  Component Word Count: 3
  ID: 38413
  Status (Raw): ACTIVE


45401-7   Postal code [Location]Postal code [Location]Postal code: Loc: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Postal code  Loc  Pt  ^Patient  Nom 
  Long Common Name:  Postal code [Location]
  Short Name:  Postal code

OBSERVATION ID IN FORM
CMS-2728_A5

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT.DEMOG/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Updated Component name from "ZIP code" to "Postal code", the more universal nomenclature for this concept.

HL7 ATTRIBUTES
  HL7 Field ID: PID-11.5

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
  61129-3 PhenX domain - Demographics
  62611-9 PhenX domain - Respiratory
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  76464-7 American Physical Therapy Association registry panel
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start 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   LP75910-7  Postal code 
Property   LP6825-6  Loc   [Location] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP345099-8  Postal code 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  邮政编码:位置:时间点:^患者:名义型:邮政编码:位置: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)
 
  Codice di avviamento postale:Loc:Pt:^Paziente:Nom:Codice di avviamento postale:Loc:Pt:^Paziente:Nom:

RELATED NAMES
  ADMIN Location Random
  ADMIN.PATIENT Nominal ZIP code
  ADMIN.PT.DEMOG Point in time  

RELATED CODES
Code System Code Code Text Code Version
   CMS OASIS   M0060     D 
   CMS OASIS   M0060     C2 
   https://www.phenxtoolkit.org   PX010801060000   PX010801_ZIP_Code   

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Postal code [Location]
  Shortname: Postal code
  Fully Specified Name: Postal code: Loc: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 38751
  Status (Raw): ACTIVE


42077-8   Patient phone numberPatient phone numberPhone number: Tele: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Phone number  Tele  Pt  ^Patient  Nom 
  Long Common Name:  Patient phone number
  Short Name:  Phone #

TERM DEFINITION/DESCRIPTION(S)
  The patient's telephone number.
 
 

OBSERVATION ID IN FORM
CMS-2728_A6

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT/Clinical
  First Released in Version: 2.16
  Last Updated in Version: 2.66
  Order vs. Obs.: Observation
  Status: Active.
Change Reason: Revised description and removed NORMATIVE answer list, which only included results for unknown or no phone number available. The answer choices did not include entering the patient's phone number. This term was originally created for the NAACCR v11 tumor registry. The coding instructions in the term description and as part of the answer list are now available as Form Coding Instructions for the term in the instance of the NAACCR version 11 panel [LOINC: 49083-9].

HL7 ATTRIBUTES
  HL7 Field ID: PID-13

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  47245-6 HIV treatment form Document
  49083-9 North American Association of Central Cancer Registries, Inc (NAACCR, Inc) version 11 panel
  55140-8 Vaccine Adverse Event Reporting System (VAERS) panel
  55168-9 Data Elements for Emergency Department Systems (DEEDS) Release 1.1
  59852-4 North American Association of Central Cancer Registries, Inc (NAACCR, Inc) version 12 panel
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  79191-3 Patient demographics panel
  80399-9 Occupational exposure information panel
  89070-7 ADAPTABLE patient reported item set [ADAPTABLE]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP120627-7  Phone number 
Property   LP6871-0  Tele   [Telephone number (HL7 datatype)] 
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)
 
  电话号码:电话号码:时间点:^患者:名义型:电话号码:电话号码: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)
 
  Numero telefonico:Tele:Pt:^Paziente:Nom:Numero telefonico:Tele:Pt:^Paziente:Nom:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Telefone:Tele:Pt:^Paciente:Nom:Telefone:Tele:Pt:^Paciente:Nom:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Телефонный номер:Тел:ТчкВрм:^Пациент:Ном:Телефонный номер:Тел:ТчкВрм:^Пациент:Ном:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Número de teléfono:Teléfono:Punto temporal:^paciente:Nom:Número de teléfono:Teléfono:Punto temporal:^paciente:Nom:

RELATED NAMES
  ADMIN Num Telecommunication number
  ADMIN.PATIENT Phone # Telephone number
  No Point in time  
  Nominal Random  

RELATED CODES
Code System Code Code Text Code Version
   NAACCR_ID   2360     

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Patient phone number
  Shortname: Phone #
  Fully Specified Name: Phone number: Tele: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 35011
  Status (Raw): ACTIVE


46098-0   SexSexSex: Type: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Sex  Type  Pt  ^Patient  Nom 
  Long Common Name:  Sex
  Short Name:  Sex

PART DEFINITION/DESCRIPTION(S)
  Part: Sex
  In LOINC, sex refers to the biological sex of an organism, which is most commonly determined based on anatomy and physiology or genetic (chromosome) analysis. Our definition is based on the World Health Organization's definition of sex and gender: sex (male, female) refers to biological and physiological characteristics, and gender (masculine, feminine) refers to socially constructed roles, behaviors, activities, and attributes. (http://www.who.int/gender/whatisgender/en)
 
 

OBSERVATION ID IN FORM
CMS-2728_A7

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: ADMIN.PATIENT.DEMOG/Clinical
  First Released in Version: 2.17
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Changed Component from 'Gender' to 'Sex' to align with the World Health Organization (WHO) definition of this concept.

HL7 ATTRIBUTES
  HL7 Field ID: PID-8

EXAMPLE ANSWER LIST    (LL1-9)  
 
Source: Regenstrief LOINC
  SEQ#        Answer        Code         Answer ID    
  1       Male       1       LA2-8  
  2       Female       2       LA3-6  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code and, if applicable, override LOINC answer lists that are associated with this LOINC term in the context of that panel. Override lists are used when the panel requires a different answer list and/or answer list link type than the default answer list associated with this LOINC.
  LOINC   Long Common Name   Answer List Id Answer List Type   # of answers
  45963-6 MDS basic assessment tracking form - version 2.0
  46462-8 Outcome and assessment information set (OASIS) form - version B1
  47245-6 HIV treatment form Document
  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
  54580-6 Minimum Data Set - version 3.0
  55140-8 Vaccine Adverse Event Reporting System (VAERS) panel
  55168-9 Data Elements for Emergency Department Systems (DEEDS) Release 1.1
  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
  61129-3 PhenX domain - Demographics
  62263-9 PhenX domain - Nutrition and dietary supplements
  62611-9 PhenX domain - Respiratory
  62755-4 PhenX domain - Neurology
  62787-7 PhenX domain - Diabetes
  62812-3 PhenX domain - Physical activity and physical fitness
  62863-6 PhenX domain - Infectious diseases and immunity
  63009-5 PhenX domain - Social environments
  63067-3 PhenX domain - Speech and hearing
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  68359-9 End Stage Renal Disease (ESRD) Death Notification - OMB CMS form 2746
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
  69723-5 Patient Health Questionnaire (PHQ) [Reported]
  69919-9 Race, ethnicity, sex, primary language, disability - Health and Human Services (HHS) panel [HHS.ACA Section 4302]
  70297-7 ESRD patient information panel
  78698-8 Liver fibrosis score panel - Serum or Plasma Calculated by HepaScore
  78699-6 Liver fibrosis score panel - Serum or Plasma Calculated by FibroMeter
  82259-3 Metabolic equivalent of task and Resting metabolic rate panel
  82287-4 Physical activity panel
  83265-9 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
  85626-0 Kidney failure 2-year and 5-year risk panel by KFRE
  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]
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
  85907-4 Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
  86522-0 MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
  86636-8 Family planning report - FPAR 2.0 set
  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]
  86874-5 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
  86875-2 MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed tracking (NT/ST) 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]
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [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]
  88280-3 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88281-1 MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  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]
  88952-7 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
  88953-5 MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  89070-7 ADAPTABLE patient reported item set [ADAPTABLE]
  89724-9 Minimum Data Set (MDS) for Public Health Emergency Operations Centers (EOC) [CDC Emergency Operations Centers]
  89963-3 Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 [CMS Assessment] LL1-9 NORMATIVE 2
  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]
  90479-7 MDS v3.0 - RAI v1.17.1 - Nursing home and Swing bed tracking (NT and ST) 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]
  91393-9 Opioid risk tool panel
  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   LP101395-4  Sex 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP345158-2  Sex 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  性别:类型:时间点:^患者:名义型:性别:类型:时间点:^患者:名义型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  geslacht:type:moment:^patiënt:nominaal:geslacht:type:moment:^patiënt:nominaal:
  Estonian (ESTONIA)  (From: Regenstrief-generated full translation based on part translation provided by Estonian E-Health Foundation)
 
  Sugu:Tüüp:Pt:^patsient:Nom:Sugu:Tüüp:Pt:^patsient:Nom:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Sexe:Type:Temps ponctuel:^Patient:Nominal:Sexe:Type:Temps ponctuel:^Patient:Nominal:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Sexe:Type:Temps ponctuel:^Patient:Nominal:Sexe:Type:Temps ponctuel:^Patient:Nominal:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Sesso:Tipo:Pt:^Paziente:Nom:Sesso:Tipo:Pt:^Paziente:Nom:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Пол:Тип:ТчкВрм:^Пациент:Ном:Пол:Тип:ТчкВрм:^Пациент:Ном:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Sexo:Tipo:Punto temporal:^paciente:Nom:Sexo:Tipo:Punto temporal:^paciente:Nom:
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Cinsiyet:Tip:Zmlı:^Hasta:Snf:Cinsiyet:Tip:Zmlı:^Hasta:Snf:

RELATED NAMES
  ADMIN Gender Random
  ADMIN.PATIENT Nominal Typ
  ADMIN.PT.DEMOG Point in time  

RELATED CODES
Code System Code Code Text Code Version
   CMS IRF-PAI   8     3.0 
   CMS IRF-PAI   8     1.4 
   CMS IRF-PAI   8     1.5 
   CMS IRF-PAI   8     2.0 
   CMS LCDS   A0800     4.00 
   CMS LCDS   A0800     3.00 
   CMS MDS   A0800     1.16.1 
   CMS MDS   A0800     1.15.1 
   CMS MDS   A0800     1.17.1 
   CMS MDS   A0800     1.14.1 
   CMS MDS   X0300     1.17.1 
   CMS MDS   X0300     1.14.1 
   CMS MDS   X0300     1.16.1 
   CMS MDS   X0300     1.15.1 
   CMS OASIS   M0069     C2 
   CMS OASIS   M0069     D 
   https://www.phenxtoolkit.org   PX070601010100   PX070601_Self_Gender   
   https://www.phenxtoolkit.org   PX091501010400   PX091501_Sleep_Apnea_Gender   
   https://www.phenxtoolkit.org   PX091502040000   PX091502_Child_Gender   
   https://www.phenxtoolkit.org   PX091601390000   PX091601_Sex   
   https://www.phenxtoolkit.org   PX130501020200   PX130501_Gender   
   https://www.phenxtoolkit.org   PX140201010100   PX140201_Spouse_Sex   
   https://www.phenxtoolkit.org   PX150101020000   PX150101_Sex   
   https://www.phenxtoolkit.org   PX150102010000   PX150102_Sex   
   https://www.phenxtoolkit.org   PX150201020000   PX150201_Gender   
   https://www.phenxtoolkit.org   PX150202020000   PX150202_Gender   
   https://www.phenxtoolkit.org   PX150203010000   PX150203_Gender   
   https://www.phenxtoolkit.org   PX161201010000   PX161201_Gender   
   https://www.phenxtoolkit.org   PX201501170101   PX201501_Sibling1_Sex   
   https://www.phenxtoolkit.org   PX201501170104   PX201501_Sibling1_Cause_Of_Hearing_Difficulty   
   https://www.phenxtoolkit.org   PX201501170203   PX201501_Sibling2_Age_Onset_Hearing_Difficulty   
   https://www.phenxtoolkit.org   PX201501170302   PX201501_Sibling3_Birth_Year   
   https://www.phenxtoolkit.org   PX201501170401   PX201501_Sibling4_Sex   
   https://www.phenxtoolkit.org   PX211101010400   PX211101_Person1_Gender   
   https://www.phenxtoolkit.org   PX211101020400   PX211101_Person2_Gender   
   https://www.phenxtoolkit.org   PX211101030400   PX211101_Person3_Gender   
   https://www.phenxtoolkit.org   PX211101040400   PX211101_Person4_Gender   
   https://www.phenxtoolkit.org   PX211101050400   PX211101_Person5_Gender   
   https://www.phenxtoolkit.org   PX211101060400   PX211101_Person6_Gender   
   https://www.phenxtoolkit.org   PX211101070400   PX211101_Person7_Gender   
   https://www.phenxtoolkit.org   PX211101080400   PX211101_Person8_Gender   
   https://www.phenxtoolkit.org   PX211101090400   PX211101_Person9_Gender   
   https://www.phenxtoolkit.org   PX211101100400   PX211101_Person10_Gender   
   https://www.phenxtoolkit.org   PX211101110400   PX211101_Person11_Gender   
   https://www.phenxtoolkit.org   PX211101120400   PX211101_Person12_Gender   
   https://www.phenxtoolkit.org   PX211101130400   PX211101_Person13_Gender   
   https://www.phenxtoolkit.org   PX211101140400   PX211101_Person14_Gender   
   https://www.phenxtoolkit.org   PX211101150400   PX211101_Person15_Gender   
   https://www.phenxtoolkit.org   PX211101160400   PX211101_Person16_Gender   
   https://www.phenxtoolkit.org   PX211101170400   PX211101_Person17_Gender   
   https://www.phenxtoolkit.org   PX211101180400   PX211101_Person18_Gender   
   https://www.phenxtoolkit.org   PX211101190400   PX211101_Person19_Gender   
   https://www.phenxtoolkit.org   PX211101200400   PX211101_Person20_Gender   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Sex
  Shortname: Sex
  Fully Specified Name: Sex: Type: Pt: ^Patient: Nom:
     
  Component Word Count: 1
  ID: 39502
  Status (Raw): ACTIVE


54133-4   Ethnicity [USSG-FHT]Ethnicity [USSG-FHT]Ethnicity: Type: Pt: ^Patient: Nom: USSG-FHT  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Ethnicity  Type  Pt  ^Patient  Nom  USSG-FHT
  Long Common Name:  Ethnicity [USSG-FHT]

OBSERVATION ID IN FORM
CMS-2728_A8

OBSERVATION REQUIRED IN PANEL
Optional

BASIC ATTRIBUTES
  Class/Type: SURVEY.USSGFHT/Survey
  First Released in Version: 2.26
  Last Updated in Version: 2.44
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-22

NORMATIVE ANSWER LIST    (LL628-9)  
 
Source: US Surgeon General
  SEQ#        Answer        Code         Code 
System
   
    Answer ID    
  1       Hispanic or Latino       2135-2       PH_RaceAndEthnicity_CDC       LA6214-6  
  2       Central American       2155-0       PH_RaceAndEthnicity_CDC       LA10599-1  
  3       Cuban       2182-4       PH_RaceAndEthnicity_CDC       LA4190-0  
  4       Dominican(Republic)       2184-0       PH_RaceAndEthnicity_CDC       LA10601-5  
  5       Mexican       2148-5       PH_RaceAndEthnicity_CDC       LA4611-5  
  6       Puerto Rican       2180-8       PH_RaceAndEthnicity_CDC       LA4364-1  
  7       South American       2165-9       PH_RaceAndEthnicity_CDC       LA10606-4  
  8       Other Latin American                       LA14055-0  
  9       Other Hispanic/Latino/Spanish                       LA10603-1  
  10       Non-Hispanic or Latino       2186-5       PH_RaceAndEthnicity_CDC       LA10597-5  
  11       Ashkenazi Jewish                       LA10598-3  
  12       Unknown/No answer                       LA10607-2  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54127-6 US Surgeon General family health portrait [USSG-FHT]
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP72553-8  Ethnicity 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP76350-5  USSG-FHT   [US Surgeon General's Family History tool (USSG-FHT)] 

RELATED NAMES
  FHH Random Typ
  Nominal Survey US Surgeon General
  Point in time SURVEY.USSGFHT US Surgeon General family health portrait

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:11 PM
  Attachment Units Required: N
  Long Common Name: Ethnicity [USSG-FHT]
  Fully Specified Name: Ethnicity: Type: Pt: ^Patient: Nom: USSG-FHT
     
  Component Word Count: 1
  ID: 48425
  Status (Raw): ACTIVE


68329-2   Country of originCountry of originCountry of origin: Loc: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Country of origin  Loc  Pt  ^Patient  Nom 
  Long Common Name:  Country of origin

OBSERVATION ID IN FORM
CMS-2728_A9

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.52
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  78000-7 Case notification panel [CDC.PHIN]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP130862-8  Country of origin 
Property   LP6825-6  Loc   [Location] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

RELATED NAMES
  ESRD Nominal Survey
  ESRD survey Point in time  
  Location Random  

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Country of origin
  Fully Specified Name: Country of origin: Loc: Pt: ^Patient: Nom:
     
  Component Word Count: 3
  ID: 67638
  Status (Raw): ACTIVE


54134-2   Race [USSG-FHT]Race [USSG-FHT]Race: Type: Pt: ^Patient: Nom: USSG-FHT  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Race  Type  Pt  ^Patient  Nom  USSG-FHT
  Long Common Name:  Race [USSG-FHT]

OBSERVATION ID IN FORM
CMS-2728_A10

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.USSGFHT/Survey
  First Released in Version: 2.26
  Last Updated in Version: 2.44
  Status: Active

HL7 ATTRIBUTES
  HL7 Field ID: PID-10

NORMATIVE ANSWER LIST    (LL629-7)  
 
Source: US Surgeon General
  SEQ#        Answer        Code         Code 
System
   
    Answer ID    
  1       American Indian or Alaska Native       1002-5       PH_RaceAndEthnicity_CDC       LA10608-0  
  2       Asian       2028-5       PH_RaceAndEthnicity_CDC       LA6156-9  
  3       Asian Indian       2029-7       PH_RaceAndEthnicity_CDC       LA14048-5  
  4       Chinese       2034-7       PH_RaceAndEthnicity_CDC       LA4168-6  
  5       Filipino       2036-2       PH_RaceAndEthnicity_CDC       LA3969-8  
  6       Japanese       2039-6       PH_RaceAndEthnicity_CDC       LA4595-0  
  7       Korean       2040-4       PH_RaceAndEthnicity_CDC       LA4603-2  
  8       Vietnamese       2047-9       PH_RaceAndEthnicity_CDC       LA4443-3  
  9       Other Asian                       LA14049-3  
  10       Black or African American       2054-5       PH_RaceAndEthnicity_CDC       LA10610-6  
  11       Native Hawaiian or Other Pacific Islander       2076-8       PH_RaceAndEthnicity_CDC       LA10611-4  
  12       Native Hawaiian       2079-2       PH_RaceAndEthnicity_CDC       LA14045-1  
  13       Guamanian       2087-5       PH_RaceAndEthnicity_CDC       LA14046-9  
  14       Chamorro       2088-3       PH_RaceAndEthnicity_CDC       LA10621-3  
  15       Samoan       2080-0       PH_RaceAndEthnicity_CDC       LA4300-5  
  16       Other Pacific Islander       2500-7               LA14047-7  
  17       White       2106-3       PH_RaceAndEthnicity_CDC       LA4457-3  
  18       Other/Unknown/Refuse To Answer                       LA10613-0  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  54127-6 US Surgeon General family health portrait [USSG-FHT]
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP71009-2  Race 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP76350-5  USSG-FHT   [US Surgeon General's Family History tool (USSG-FHT)] 

RELATED NAMES
  Ethnicity Random US Surgeon General
  FHH Survey US Surgeon General family health portrait
  Nominal SURVEY.USSGFHT  
  Point in time Typ  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Race [USSG-FHT]
  Fully Specified Name: Race: Type: Pt: ^Patient: Nom: USSG-FHT
     
  Component Word Count: 1
  ID: 48426
  Status (Raw): ACTIVE


67884-7   Principal indian tribePrincipal indian tribePrincipal indian tribe: Type: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Principal indian tribe  Type  Pt  ^Patient  Nom 
  Long Common Name:  Principal indian tribe

CONDITION FOR INCLUSION
American Indian selected for Race

OBSERVATION ID IN FORM
CMS-2728_A10a

ANSWER CARDINALITY
0..*

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

SURVEY QUESTION
Text: Name of Enrolled/Principal Tribe
Source: ESRD.RQMT_210

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134081-1  Principal indian tribe 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

RELATED NAMES
  ESRD Point in time Typ
  ESRD survey Random  
  Nominal Survey  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Principal indian tribe
  Fully Specified Name: Principal indian tribe: Type: Pt: ^Patient: Nom:
     
  Component Word Count: 3
  ID: 63697
  Status (Raw): TRIAL


67872-2   Medicare end stage renal disease coverage requestedMedicare end stage renal disease coverage requestedMedicare end stage renal disease coverage requested: Find: Pt: ^Patient: Ord:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Medicare end stage renal disease coverage requested  Find  Pt  ^Patient  Ord 
  Long Common Name:  Medicare end stage renal disease coverage requested

OBSERVATION ID IN FORM
CMS-2728_A11

ANSWER CARDINALITY
1..*

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL361-7)  
 
Source: Regenstrief Institute
  SEQ#        Answer        Answer ID    
  1       Yes
http://snomed.info/sct ©: 373066001 Yes (qualifier value)    
  LA33-6  
  2       No
http://snomed.info/sct ©: 373067005 No (qualifier value)    
  LA32-8  

SURVEY QUESTION
Text: Is the patient applying for ESRD Medicare coverage?
Source: ESRD.RQMT_212

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134068-8  Medicare end stage renal disease coverage requested 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Fragments for synonyms   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis Findings Qual
  Dz Kidney Qualitative
  End-stage renal disease Medicare ESRD coverage requested Random
  ESRD Ordinal Screen
  ESRD survey Point in time Survey
  Finding QL  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Medicare end stage renal disease coverage requested
  Fully Specified Name: Medicare end stage renal disease coverage requested: Find: Pt: ^Patient: Ord:
     
  Component Word Count: 7
  ID: 63683
  Status (Raw): TRIAL


52556-8   Payment sourcesPayment sourcesPayment sources: Type: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Payment sources  Type  Pt  ^Patient  Nom 
  Long Common Name:  Payment sources

FORM CODING INSTRUCTIONS
Check all that apply

BASIC ATTRIBUTES
  Class/Type: SURVEY.CMS/Survey
  First Released in Version: 2.26
  Last Updated in Version: 2.63
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Changed METHOD to methodless - generic term that does not orginate from just one method; Removed "Current" from component because it is conveyed by TIMING = Pt;Updated PROPERTY from Find to Type.

EXAMPLE ANSWER LIST    (LL544-8)  
 
Source: Centers for Medicare & Medicaid Services
  SEQ#        Answer        Code         Answer ID    
  1       None (no charge for current services)       D1       LA10028-1  
  2       Medicare (traditional fee-for-service)       D2       LA6259-1  
  3       Medicare (HMO/managed care)       D3       LA6258-3  
  4       Medicaid (traditional fee-for-service)       D4       LA6257-5  
  5       Medicaid (HMO/managed care)       D5       LA6256-7  
  6       Workers’ compensation       D6       LA10123-0  
  7       Title programs (e.g., Title III, V, or XX)       D7       LA6398-7  
  8       Other government (e.g., TRICARE, VA, etc.)       D8       LA10049-7  
  9       Private insurance/Medigap       D9       LA10061-2  
  10       Private HMO/managed care       D10       LA6349-0  
  11       Self-pay       D11       LA6369-8  
  12       Other (specify)       D12       LA6310-2  
  13       Unknown
http://snomed.info/sct ©: 261665006 Unknown (qualifier value)    
  D13       LA4489-6  

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code and, if applicable, override LOINC answer lists that are associated with this LOINC term in the context of that panel. Override lists are used when the panel requires a different answer list and/or answer list link type than the default answer list associated with this LOINC.
  LOINC   Long Common Name   Answer List Id Answer List Type   # of answers
  52743-2 Continuity Assessment Record and Evaluation (CARE) tool - Acute Care LL544-8 NORMATIVE 13
  52744-0 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission LL544-8 NORMATIVE 13
  52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge LL544-8 NORMATIVE 13
  52746-5 Continuity Assessment Record and Evaluation (CARE) tool - Interim LL544-8 NORMATIVE 13
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission LL544-8 NORMATIVE 13
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  69412-5 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0 LL544-8 NORMATIVE 13
  85645-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  85662-5 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  85668-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  85671-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  86636-8 Family planning report - FPAR 2.0 set LL4688-9 NORMATIVE 1
  87506-2 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 4.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  87508-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 4.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  87509-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 [CMS Assessment] LL4470-2 NORMATIVE 13
  

MEMBER OF THESE EQUIVALENCE GROUPS
  LG41766-3  SDH.Healthcare

PARTS

Part Type    Part No.  Part Name   
Component   LP73082-7  Payment sources 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

RELATED NAMES
  Financing and insurance Point in time Typ
  Nominal Random  
  Payers Survey  

RELATED CODES
Code System Code Code Text Code Version
   CMS LCDS   A1400     3.00 
   CMS LCDS   A1400     4.00 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Payment sources
  Fully Specified Name: Payment sources: Type: Pt: ^Patient: Nom:
     
  Component Word Count: 2
  ID: 46677
  Status (Raw): ACTIVE


8302-2   Body heightBody heightBody height: Len: Pt: ^Patient: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Body height  Len  Pt  ^Patient  Qn 
  Long Common Name:  Body height
  Short Name:  Body height

OBSERVATION ID IN FORM
CMS-2728_A13

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: BDYHGT.ATOM/Clinical
  First Released in Version: 1.0h(2)
  Last Updated in Version: 2.66
  Status: Active

ASSOCIATED OBSERVATIONS

Definition/Description: This panel contains all of the "Special circumstances" LOINC codes that are used to report the specific context during which a particular measurement was taken, where that context may affect the measurement value. Circumstances that can affect measurement of certain variables include when the patient is asleep, in pain, crying, febrile, or during a period of apnea. This panel is attached to the generic LOINC code for each measurement so that the circumstance under which the measurement was taken can be reported along with the primary result.

  LOINC#   LOINC Name R/O/C  Cardinality  Ex. UCUM Units 
  89263-8   Special circumstances associated observations panelSpecial circumstances associated observations panelSpecial circumstances associated observations panel: -: Pt: ^Patient: -:    
       10224-4   Hemodynamic method special circumstancesHemodynamic method special circumstancesHemodynamic method special circumstances: Type: Pt: ^Patient: Nom:    
       55285-1   Glasgow coma score special circumstancesGlasgow coma score special circumstancesGlasgow coma score special circumstances: Type: Pt: ^Patient: Nom:    
       55416-2   Oxymetry special circumstancesOxymetry special circumstancesOxymetry special circumstances: Type: Pt: ^Patient: Nom:    
       8304-8   Body height special circumstancesBody height special circumstancesBody height special circumstances: Type: Pt: ^Patient: Nom:    
       8337-8   Body weight special circumstancesBody weight special circumstancesBody weight special circumstances: Type: Pt: ^Patient: Nom:    
       9278-3   Breath rate special circumstancesBreath rate special circumstancesBreath rate special circumstances: Type: Pt: ^Patient: Nom:    
       9848-3   Body temperature special circumstancesBody temperature special circumstancesBody temperature special circumstances: Type: Pt: ^Patient: Nom:    
       9855-8   Blood pressure special circumstancesBlood pressure special circumstancesBlood pressure special circumstances: Type: Pt: ^Patient: Nom:    
       89299-2   Heart rate special circumstancesHeart rate special circumstancesHeart rate special circumstances: Type: Pt: ^Patient: Nom:    
 

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  34565-2 Vital signs, weight and height panel
  34566-0 Vital signs with method details panel
  54127-6 US Surgeon General family health portrait [USSG-FHT]
  55168-9 Data Elements for Emergency Department Systems (DEEDS) Release 1.1
  55418-8 Weight and Height tracking panel
  58446-6 Creatinine 24H renal clearance adjusted for body surface area panel
  62812-3 PhenX domain - Physical activity and physical fitness
  67795-5 Vital signs, weight, height, head circumference and oximetry panel HITSP
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  70300-9 ESRD dialysis adequacy panel
  72513-5 Vital signs with smoking status and pain scale [VSP]
  74028-2 Virtual Medical Record for Clinical Decision Support panel HL7.VMR-CDS
  74293-2 Oncology plan of care and summary - recommended CDA set
  74728-7 Vital signs, weight, height, head circumference, oximetry, BMI, and BSA panel - HL7.CCDAr1.1
  75854-0 PCORnet common data model set - version 1.0 [PCORnet]
  75885-4 IEEE 11073 Rosetta panel
  85057-8 PCORnet Common Data Model set - version 3.0 [PCORnet]
  85353-1 Vital signs, weight, height, head circumference, oxygen saturation and BMI panel
  86636-8 Family planning report - FPAR 2.0 set
  87825-6 National Trauma Data Standard - version 2018 set
  89543-3 Laboratory ask at order entry panel
  

MEMBER OF THESE EQUIVALENCE GROUPS
  LG34373-7  Body height|Len|Pt|^Patient

PARTS

Part Type    Part No.  Part Name   
Component   LP64598-3  Body height 
Property   LP6822-3  Len   [Length] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Fragments for synonyms   LP28569-9  Body 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  身高:长度:时间点:^患者:定量型:身高:长度:时间点:^患者:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  lichaamslengte:lengte:moment:^patiënt:kwantitatief:lichaamslengte:lengte:moment:^patiënt:kwantitatief:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Taille corporelle:Longueur:Temps ponctuel:^Patient:Quantitatif:Taille corporelle:Longueur:Temps ponctuel:^Patient:Quantitatif:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Stature:Longueur:Temps ponctuel:^Patient:Quantitatif:Stature:Longueur:Temps ponctuel:^Patient:Quantitatif:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Body height:Len:Pt:^Patient:Qn:Body height:Len:Pt:^Patient:Qn:Taille du patient [Longueur] Patient ; Numérique
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Körpergröße
  German (GERMANY)  (From: Institute for Medical Documentation and Information (DIMDI))
 
  Körpergröße:Län:Pkt:^Patient:Qn:Körpergröße:Län:Pkt:^Patient:Qn:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Altezza corporea:Len:Pt:^Paziente:Qn:Altezza corporea:Len:Pt:^Paziente:Qn:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Estatura:Comprimento:Pt:^Paciente:Qn:Estatura:Comprimento:Pt:^Paciente:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Рост:Дл:ТчкВрм:^Пациент:Колич:Рост:Дл:ТчкВрм:^Пациент:Колич:
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  altura corporal:longitud:punto en el tiempo:^paciente:cuantitativo:altura corporal:longitud:punto en el tiempo:^paciente:cuantitativo:

RELATED NAMES
  Axial length Length Quantitative
  bod Point in time Random
  Bodies QNT  
  BODY HEIGHT(LENGTH).ATOM Quan  
  Body length Quant  

EXAMPLE UNITS
  Unit  Source Type
  INCH(S)  REGENSTRIEF 
  [in_i]  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  REGENSTRIEF 
  Unit:  INCH(S) 
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  [in_i] 

UNITS AND RANGE
  Range  Units Type
  [in_us]:  [ft_us]:;cm:;m:; 

RELATED CODES
Code System Code Code Text Code Version
   https://www.phenxtoolkit.org   PX020302140000   PX020302_BodyComposition_Dxa_WholeBody_Height   
   https://www.phenxtoolkit.org   PX090602210100   PX090602_Exercise_Capacity_Patient_Height_Feet   
   https://www.phenxtoolkit.org   PX090602210200   PX090602_Exercise_Capacity_Patient_Height_Inches   
   https://www.phenxtoolkit.org   PX090602220100   PX090602_Exercise_Capacity_Patient_Height_Meters   
   https://www.phenxtoolkit.org   PX150203040100   PX150203_Height_Feet   
   https://www.phenxtoolkit.org   PX150203040200   PX150203_Height_Inches   
   https://www.phenxtoolkit.org   PX220301280000   PX220301_Bone_Age_Patient_Height   
   https://www.phenxtoolkit.org   PX220704040000   PX220704_Mitochondrial_Disease_Adult_Height   
   https://www.phenxtoolkit.org   PX230101390200   PX230101_PsychopathologyEatingDisorders_Height   
   https://www.phenxtoolkit.org   PX230102440000   PX230102_PsychopathologyEatingDisordersInterview_Weight   
   https://www.phenxtoolkit.org   PX651201050100   PX651201_EatingWeightPatterns_Adult_Height_Feet   
   https://www.phenxtoolkit.org   PX651201050200   PX651201_EatingWeightPatterns_Adult_Height_Inches   
   https://www.phenxtoolkit.org   PX810301410000   PX810301_SingleBreath_CarbonMonoxide_DiffusingCapacity_Subject_Height   
   https://www.phenxtoolkit.org   PX810401070000   PX810401_Standardisation_LungVolumeMeasurement_Subject_Height   
   IEEE_CFCODE10_NUM   68060     
   IEEE_REFID_TXT   MDC_ATTR_PT_HEIGHT     

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Long Common Name: Body height
  Shortname: Body height
  Fully Specified Name: Body height: Len: Pt: ^Patient: Qn:
     
  Component Word Count: 2
  ID: 65820
  # of Panel Elements: 10
  Status (Raw): ACTIVE


8340-2   Dry body weight EstimatedDry body weight EstimatedDry body weight: Mass: Pt: ^Patient: Qn: Estimated  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Dry body weight  Mass  Pt  ^Patient  Qn  Estimated
  Long Common Name:  Dry body weight Estimated
  Short Name:  Dry weight Est

TERM DEFINITION/DESCRIPTION(S)
  Relating to hemodialysis: Dry weight is the lowest weight a patient can tolerate without the development of symptoms or hypotension.
 
 

PART DEFINITION/DESCRIPTION(S)
  Part: Dry body weight
  Dry body weight is the body weight of a hemodialysis patient post-dialysis, when the blood pressure is within normal limits without the use of antihypertensive medication. In patients with renal failure, decline in kidney function leads to increased total body sodium, which causes an increase in extracellular fluid volume (ECV) and hypertension. During dialysis, excess sodium and fluid is removed, with a consequent decrease in blood pressure. Recommended values for blood pressure are pre-dialysis pressure of <140/90 and post-dialysis pressure of <130/85, which indicate adequate volume control. Dry body weight can help monitor ECV but is difficult to determine since it is not a constant value and may vary between hemodialysis sessions. Other methods for measuring ECV include central venous pressure, examination of the external jugular vein, assessment of edema, and the cardiothoracic index. [PMID: 25028642]
 
 

OBSERVATION ID IN FORM
CMS-2728_A14

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: BDYWGT.MOLEC/Clinical
  First Released in Version: 1.0h(2)
  Last Updated in Version: 2.48
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP94912-0  Dry body weight 
Property   LP6826-4  Mass 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7753-9  Qn 
Method   LP6260-6  Estimated 
Fragments for synonyms   LP28569-9  Body 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  干体重:质量:时间点:^患者:定量型:估计法干体重:质量:时间点:^患者:定量型:估计法
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Dry body weight:Mass:Pt:^Patient:Qn:EstimatedDry body weight:Mass:Pt:^Patient:Qn:EstimatedPoids corporel sec [Masse] Patient ; Numérique ; Résultat estimé
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Peso corporeo secco:Massa:Pt:^Paziente:Qn:StimatoPeso corporeo secco:Massa:Pt:^Paziente:Qn:Stimato
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Peso corporal enxugado:Massa:Pt:^Paciente:Qn:EstimadoPeso corporal enxugado:Massa:Pt:^Paciente:Qn:Estimado
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  peso corporal^peso seco:masa:punto en el tiempo:^paciente:cuantitativo:estimativopeso corporal^peso seco:masa:punto en el tiempo:^paciente:cuantitativo:estimativo

RELATED NAMES
  Bdy weight Est Quant
  bod estimation Quantitative
  Bodies Point in time Random
  BODY WEIGHT.MOLEC QNT Wt
  Dry weight Quan  

EXAMPLE UNITS
  Unit  Source Type
  kg;[lb_av]  EXAMPLE UCUM UNITS 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  kg;[lb_av] 

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Long Common Name: Dry body weight Estimated
  Shortname: Dry weight Est
  Fully Specified Name: Dry body weight: Mass: Pt: ^Patient: Qn: Estimated
     
  Component Word Count: 3
  ID: 65853
  Status (Raw): ACTIVE


67873-0   Cause of renal failure.primary [Reported]Cause of renal failure.primary [Reported]Cause of renal failure.primary: Type: Pt: ^Patient: Nom: Reported  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Cause of renal failure.primary  Type  Pt  ^Patient  Nom  Reported
  Long Common Name:  Cause of renal failure.primary [Reported]

OBSERVATION ID IN FORM
CMS-2728_A15

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.48
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1892-0)  
 
Externally Defined: Y
Source: Centers for Disease Control and Prevention
Link to external list: http://www.cdc.gov/nchs/icd.htm

SURVEY QUESTION
Text: Primary Cause of Renal Failure Code
Source: ESRD.RQMT_216

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134069-6  Cause of renal failure.primary 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP6486-7  Reported 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Cause renal failure.primary Kidney Random
  ESRD Nominal Survey
  ESRD survey Point in time Typ

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Cause of renal failure.primary [Reported]
  Fully Specified Name: Cause of renal failure.primary: Type: Pt: ^Patient: Nom: Reported
     
  Component Word Count: 5
  ID: 63684
  Status (Raw): TRIAL


67874-8   Employment status - 6 months prior to renal failure [Reported]Employment status - 6 months prior to renal failure [Reported]Employment status - 6Mo prior to renal failure: Find: Pt: ^Patient: Nom: Reported  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Employment status - 6Mo prior to renal failure  Find  Pt  ^Patient  Nom  Reported
  Long Common Name:  Employment status - 6 months prior to renal failure [Reported]

OBSERVATION ID IN FORM
CMS-2728_A16a1

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.61
  Status: Trial – caution, may change.
Change Reason: Changed Mos to Mo in component based on current LOINC model.

NORMATIVE ANSWER LIST    (LL1901-9)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Unemployed       LA17956-6  
  2       Employed full time       LA17957-4  
  3       Employed part time       LA17958-2  
  4       Homemaker       LA17959-0  
  5       Retired due to age/preference       LA17960-8  
  6       Retired due to disability       LA17961-6  
  7       Medical leave of absence       LA17962-4  
  8       Student       LA15276-1  

SURVEY QUESTION
Text: Patient Prior Employment Status (6 Months Prior)
Source: ESRD.RQMT_217

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134070-4  Employment status - 6Mo prior to renal failure   [Employment status - 6 months prior to renal failure] 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Method   LP6486-7  Reported 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Employ 6Mo prior renal fail Findings Random
  ESRD Kidney Survey
  ESRD survey Nominal  
  Finding Point in time  

CHANGE HISTORY
  Change Type: NAM

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Employment status - 6 months prior to renal failure [Reported]
  Fully Specified Name: Employment status - 6Mo prior to renal failure: Find: Pt: ^Patient: Nom: Reported
     
  Component Word Count: 7
  ID: 63685
  Status (Raw): TRIAL


67875-5   Employment status - currentEmployment status - currentEmployment status - current: Type: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Employment status - current  Type  Pt  ^Patient  Nom 
  Override Display Name for Form:  Patient Current Employment Status (At Onset)
  Long Common Name:  Employment status - current

OBSERVATION ID IN FORM
CMS-2728_A16b1

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.66
  Status: Active.
Change Reason: Updated Property from "Find" to "Type" since this concept represents current employment status types. Remove Method of Reported. Move ESRD Survey question text to the Override Display Name within the context of the ESRD panel.

NORMATIVE ANSWER LIST    (LL1901-9)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Unemployed       LA17956-6  
  2       Employed full time       LA17957-4  
  3       Employed part time       LA17958-2  
  4       Homemaker       LA17959-0  
  5       Retired due to age/preference       LA17960-8  
  6       Retired due to disability       LA17961-6  
  7       Medical leave of absence       LA17962-4  
  8       Student       LA15276-1  

SURVEY QUESTION
Source: ESRD.RQMT_218

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code and, if applicable, override LOINC answer lists that are associated with this LOINC term in the context of that panel. Override lists are used when the panel requires a different answer list and/or answer list link type than the default answer list associated with this LOINC.
  LOINC   Long Common Name   Answer List Id Answer List Type   # of answers
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728 LL1901-9 NORMATIVE 8
  93025-5 Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE] LL5337-2 NORMATIVE 5
  

MEMBER OF THESE EQUIVALENCE GROUPS
  LG41763-0  SDH.Economics

PARTS

Part Type    Part No.  Part Name   
Component   LP134071-2  Employment status - current 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 

RELATED NAMES
  Employ status current Nominal Survey
  ESRD Point in time Typ
  ESRD survey Random  

RELATED CODES
Code System Code Code Text Code Version
   https://www.phenxtoolkit.org   PX730401140000   PX730401_Best_Describes_CurrentJob_Status   
   https://www.phenxtoolkit.org   PX751401010000   PX751401_Worksite_Policies_Employment_Status   

CHANGE HISTORY
  Change Type: MAJ

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:12 PM
  Attachment Units Required: N
  Long Common Name: Employment status - current
  Fully Specified Name: Employment status - current: Type: Pt: ^Patient: Nom:
     
  Component Word Count: 3
  ID: 63686
  Status (Raw): ACTIVE


67876-3   End stage renal disease (ESRD) co-morbidities ICD codeEnd stage renal disease (ESRD) co-morbidities ICD codeEnd stage renal disease co-morbidities ICD code: Find: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
End stage renal disease co-morbidities ICD code  Find  Pt  ^Patient  Nom 
  Long Common Name:  End stage renal disease (ESRD) co-morbidities ICD code

OBSERVATION ID IN FORM
CMS-2728_A17

FORM CODING INSTRUCTIONS
Check all that apply currently and/or during the last 10 years

OBSERVATION REQUIRED IN PANEL
Required

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.50
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1892-0)  
 
Externally Defined: Y
Source: Centers for Disease Control and Prevention
Link to external list: http://www.cdc.gov/nchs/icd.htm

SURVEY QUESTION
Text: Co-Morbid Conditions
Source: ESRD.RQMT_219

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134072-0  End stage renal disease co-morbidities ICD code   [End stage renal disease (ESRD) co-morbidities ICD code] 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 
Fragments for synonyms   LP57597-4  ICD 

RELATED NAMES
  Dis ESRD survey Nominal
  Dz Finding Point in time
  End-stage renal disease Findings Random
  ESRD International Classification of Diseases Survey
  ESRD co-morbidities ICD code Kidney  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: End stage renal disease (ESRD) co-morbidities ICD code
  Fully Specified Name: End stage renal disease co-morbidities ICD code: Find: Pt: ^Patient: Nom:
     
  Component Word Count: 8
  ID: 63688
  Status (Raw): TRIAL


67885-4   Received exogenous erythropoetin or equivalent prior to end stage renal disease therapyReceived exogenous erythropoetin or equivalent prior to end stage renal disease therapyReceived exogenous erythropoetin or equivalent prior to end stage renal disease therapy: Find: Pt: ^Patient: Ord:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy  Find  Pt  ^Patient  Ord 
  Long Common Name:  Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy

OBSERVATION ID IN FORM
CMS-2728_A18a

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1872-2)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Yes, <6mos       LA17807-1  
  2       Yes, 6-12 mos       LA17808-9  
  3       Yes, >12 mos       LA17809-7  
  4       No
http://snomed.info/sct ©: 373067005 No (qualifier value)    
  LA32-8  
  5       Unknown
http://snomed.info/sct ©: 261665006 Unknown (qualifier value)    
  LA4489-6  

SURVEY QUESTION
Text: Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy
Source: ESRD.RQMT_222

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134082-9  Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Fragments for synonyms   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis Finding Qual
  Dz Findings Qualitative
  End-stage renal disease Kidney Random
  Erythropoetin prior to ESRD Ordinal Screen
  ESRD Point in time Survey
  ESRD survey QL  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy
  Fully Specified Name: Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy: Find: Pt: ^Patient: Ord:
     
  Component Word Count: 12
  ID: 63698
  Status (Raw): TRIAL


67886-2   Care by nephrologist prior to end stage renal disease therapyCare by nephrologist prior to end stage renal disease therapyCare by nephrologist prior to end stage renal disease therapy: Find: Pt: ^Patient: Ord:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Care by nephrologist prior to end stage renal disease therapy  Find  Pt  ^Patient  Ord 
  Long Common Name:  Care by nephrologist prior to end stage renal disease therapy

OBSERVATION ID IN FORM
CMS-2728_A18b

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1872-2)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Yes, <6mos       LA17807-1  
  2       Yes, 6-12 mos       LA17808-9  
  3       Yes, >12 mos       LA17809-7  
  4       No
http://snomed.info/sct ©: 373067005 No (qualifier value)    
  LA32-8  
  5       Unknown
http://snomed.info/sct ©: 261665006 Unknown (qualifier value)    
  LA4489-6  

SURVEY QUESTION
Text: Care by nephrologist prior to end stage renal disease therapy
Source: ESRD.RQMT_222

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134083-7  Care by nephrologist prior to end stage renal disease therapy 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Fragments for synonyms   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis Findings Qual
  Dz Kidney Qualitative
  End-stage renal disease Nephrologist care prior to ESRD Random
  ESRD Ordinal Screen
  ESRD survey Point in time Survey
  Finding QL  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Care by nephrologist prior to end stage renal disease therapy
  Fully Specified Name: Care by nephrologist prior to end stage renal disease therapy: Find: Pt: ^Patient: Ord:
     
  Component Word Count: 10
  ID: 63699
  Status (Raw): TRIAL


67887-0   Care by kidney dietitian prior to end stage renal disease therapyCare by kidney dietitian prior to end stage renal disease therapyCare by kidney dietitian prior to end stage renal disease therapy: Find: Pt: ^Patient: Ord:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Care by kidney dietitian prior to end stage renal disease therapy  Find  Pt  ^Patient  Ord 
  Long Common Name:  Care by kidney dietitian prior to end stage renal disease therapy

OBSERVATION ID IN FORM
CMS-2728_A18c

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.40
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1872-2)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Yes, <6mos       LA17807-1  
  2       Yes, 6-12 mos       LA17808-9  
  3       Yes, >12 mos       LA17809-7  
  4       No
http://snomed.info/sct ©: 373067005 No (qualifier value)    
  LA32-8  
  5       Unknown
http://snomed.info/sct ©: 261665006 Unknown (qualifier value)    
  LA4489-6  

SURVEY QUESTION
Text: Care by kidney dietician prior to end stage renal disease therapy
Source: ESRD.RQMT_222

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134084-5  Care by kidney dietitian prior to end stage renal disease therapy 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 
Fragments for synonyms   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis Findings Qual
  Dz Kidney Qualitative
  End-stage renal disease Kidney dietitian care prior to ESRD Random
  ESRD Ordinal Screen
  ESRD survey Point in time Survey
  Finding QL  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Care by kidney dietitian prior to end stage renal disease therapy
  Fully Specified Name: Care by kidney dietitian prior to end stage renal disease therapy: Find: Pt: ^Patient: Ord:
     
  Component Word Count: 11
  ID: 63700
  Status (Raw): TRIAL


67888-8   Vascular access for first outpatient dialysisVascular access for first outpatient dialysisVascular access for first outpatient dialysis: Type: Pt: ^Patient: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Vascular access for first outpatient dialysis  Type  Pt  ^Patient  Nom 
  Long Common Name:  Vascular access for first outpatient dialysis

OBSERVATION ID IN FORM
CMS-2728_A18d

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.40
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1873-0)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Code         Answer ID    
  1       Arteriovenous fistula (AVF)       1       LA17810-5  
  2       Graft       2       LA17811-3  
  3       Catheter       3       LA17812-1  
  4       Other access type       4       LA17813-9  

SURVEY QUESTION
Text: Access Type for First Outpatient Dialysis
Source: ESRD.RQMT_227

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP134085-2  Vascular access for first outpatient dialysis 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7750-5  Nom 
Fragments for synonyms   LP100611-5  Outpatient 
Fragments for synonyms   LP20688-5  Dialysis 

RELATED NAMES
  Access type for OP dialysis Nominal Survey
  Dialy OP Typ
  ESRD Point in time  
  ESRD survey Random  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Vascular access for first outpatient dialysis
  Fully Specified Name: Vascular access for first outpatient dialysis: Type: Pt: ^Patient: Nom:
     
  Component Word Count: 6
  ID: 63701
  Status (Raw): TRIAL


68449-8   Arteriovenous fistula maturityArteriovenous fistula maturityArteriovenous fistula maturity: Find: Pt: ^Patient: Ord:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Arteriovenous fistula maturity  Find  Pt  ^Patient  Ord 
  Long Common Name:  Arteriovenous fistula maturity

OBSERVATION ID IN FORM
CMS-2728_A18e

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1885-4)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Yes, present but not mature       LA17835-2  
  2       No, access not present, or present and not maturing       LA17836-0  

SURVEY QUESTION
Text: Is maturing AVF present?
Source: ESRD.RQMT_228

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  72055-7 Vascular access panel [ESRD]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP135390-5  Arteriovenous fistula maturity 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 

RELATED NAMES
  ESRD Point in time Screen
  ESRD survey QL Survey
  Finding Qual  
  Findings Qualitative  
  Ordinal Random  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Arteriovenous fistula maturity
  Fully Specified Name: Arteriovenous fistula maturity: Find: Pt: ^Patient: Ord:
     
  Component Word Count: 3
  ID: 67758
  Status (Raw): TRIAL


68450-6   Graft maturityGraft maturityGraft maturity: Find: Pt: ^Patient: Ord:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Graft maturity  Find  Pt  ^Patient  Ord 
  Long Common Name:  Graft maturity

OBSERVATION ID IN FORM
CMS-2728_A18f

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.44
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1885-4)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       Yes, present but not mature       LA17835-2  
  2       No, access not present, or present and not maturing       LA17836-0  

SURVEY QUESTION
Text: Is maturing graft present?
Source: ESRD.RQMT_229

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  72055-7 Vascular access panel [ESRD]
  

PARTS

Part Type    Part No.  Part Name   
Component   LP135391-3  Graft maturity 
Property   LP6813-2  Find   [Finding] 
Time   LP6960-1  Pt   [Point in time (spot)] 
Super System   LP6985-8  Patient 
Scale   LP7751-3  Ord 

RELATED NAMES
  ESRD Point in time Screen
  ESRD survey QL Survey
  Finding Qual  
  Findings Qualitative  
  Ordinal Random  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Graft maturity
  Fully Specified Name: Graft maturity: Find: Pt: ^Patient: Ord:
     
  Component Word Count: 2
  ID: 67759
  Status (Raw): TRIAL


68996-8   Laboratory - end stage renal disease form 2728Laboratory - end stage renal disease form 2728Laboratory - end stage renal disease form 2728: -: Pt: ^Patient: -:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Laboratory - end stage renal disease form 2728  Pt  ^Patient 
  Long Common Name:  Laboratory - end stage renal disease form 2728

BASIC ATTRIBUTES
  Class/Type: PANEL.SURVEY.ESRD/Survey
  Panel Type: Panel
  First Released in Version: 2.38
  Last Updated in Version: 2.38
  Status: Trial – caution, may change

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP135707-0  Laboratory - end stage renal disease form 2728 
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   LP21006-9  Disease 
Fragments for synonyms   LP34712-7  Renal 

RELATED NAMES
  Dis Kidney Point in time
  Dz Laboratory - ESRD form 2728 Random
  End Stage Renal Disease (ESDR) pnl Pan Survey
  End-stage renal disease Panel  
  ESRD Panl  
  ESRD survey Pnl  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Laboratory - end stage renal disease form 2728
  Fully Specified Name: Laboratory - end stage renal disease form 2728: -: Pt: ^Patient: -:
     
  Component Word Count: 7
  ID: 68307
  Status (Raw): TRIAL


1751-7   Albumin [Mass/​volume] in Serum or PlasmaAlbumin [Mass/​volume] in Serum or PlasmaAlbumin: MCnc: Pt: Ser/​Plas: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Albumin  MCnc  Pt  Ser/Plas  Qn 
  Long Common Name:  Albumin [Mass/volume] in Serum or Plasma
  Short Name:  Albumin SerPl-mCnc
  Display Name:  Albumin [Mass/Vol]

PART DEFINITION/DESCRIPTION(S)
  Part: Albumin
  A non-glycosylated protein that is synthesized in the liver parenchymal cells, regulated by colloid osmotic pressure from interstitial fluid surrounding hepatocytes, and catabolized in nearly all organs. Albumin comprises >50% of plasma proteins in plasma, CSF and urine, and therefore is a key contributor to intravascular oncotic pressure and regulating fluid concentration in tissues. Albumin also binds and transports a variety of endogenous substances and medications. Serum albumin measurement is a reflection of hydration and nutritional status, blood oncotic pressure, liver and kidney function, and other chronic diseases, and the ratio of albumin in the CSF and serum can be used to evaluate blood brain barrier disorders. [Tietz] Urine albumin of less than 30 mg/day is considered normal. Microalbuminuria is defined as urine albumin of 30-300 mg/day and is an early sign of kidney damage from disorders such as diabetes or hypertension. Albuminuria is urine albumin >300 mg/day and is associated with overt kidney disease. [PMID: 25512779]
 
 

OBSERVATION ID IN FORM
CMS-2728_Aa1

OBSERVATION REQUIRED IN PANEL
Optional

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: CHEM/Lab
  CDISC Lab Test: Y
  Common Lab Results Rank: #20
  Common SI Lab Results Rank: #20
  Common Orders Rank: #210
  First Released in Version: 1.0
  Last Updated in Version: 2.66
  Mass or Substance Property: M
  Order vs. Obs.: Both
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  24322-0 Comprehensive metabolic 1998 panel - Serum or Plasma
  24323-8 Comprehensive metabolic 2000 panel - Serum or Plasma
  24324-6 Hepatic function 1996 panel - Serum or Plasma
  24325-3 Hepatic function 2000 panel - Serum or Plasma
  24362-6 Renal function 2000 panel - Serum or Plasma
  48811-4 Protein fractions 3 panel - Serum or Plasma
  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
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
  54232-4 Metabolic panel.large animal - Serum or Plasma
  54233-2 Metabolic panel.small animal - Serum or Plasma
  55121-8 Multiple sclerosis panel - Serum and CSF
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  70298-5 ESRD mineral metabolism panel
  88843-8 Metabolic panel.dialysis patient - Serum or Plasma
  89044-2 Basic metabolic and albumin panel - Serum or Plasma
  

MEMBER OF THESE EQUIVALENCE GROUPS
  LG5465-2  Albumin|MCnc|Pt|ANYBldSerPl
  LG49829-1  Albumin|Pt|Ser/Plas|2754.105 g/mole

PARTS

Part Type    Part No.  Part Name   
Component   LP6118-6  Albumin 
Property   LP6827-2  MCnc   [Mass Concentration] 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7576-4  Ser/Plas   [Serum or Plasma] 
Scale   LP7753-9  Qn 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  白蛋白:质量浓度:时间点:血清/​血浆:定量型:白蛋白:质量浓度:时间点:血清/​血浆:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  albumine:massa/​volume:moment:serum of plasma:kwantitatief:albumine:massa/​volume:moment:serum of plasma:kwantitatief:
  Estonian (ESTONIA)  (From: Regenstrief-generated full translation based on part translation provided by Estonian E-Health Foundation)
 
  Albumiin:MCnc:Pt:S/​P:Qn:Albumiin:MCnc:Pt:S/​P:Qn:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Albumine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:Albumine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Albumine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:Albumine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Albumin:MCnc:Pt:Ser/​Plas:Qn:Albumin:MCnc:Pt:Ser/​Plas:Qn:Albumine [Masse/​Volume] Sérum/​Plasma ; Numérique
  French (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  S--albumine
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Albumin
  German (GERMANY)  (From: Institute for Medical Documentation and Information (DIMDI))
 
  Albumin:MKnz:Pkt:Ser/​Plas:Qn:Albumin:MKnz:Pkt:Ser/​Plas:Qn:
  German (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  S--Albumin
  Greek (GREECE)  (From: Regenstrief-generated full translation based on part translation provided by Efstratia Kontaxi, MD, MSc, and Evripidis Stefanidis, MD, with technical support from Panagiotis Kontaxis, Diploma of Electrical and Computer Engineering.)
 
  Λευκωματίνη:Συγκέντρωση μάζας:Χρονική στιγμή:Ορός/​Πλάσμα:Ποσοτική:Λευκωματίνη:Συγκέντρωση μάζας:Χρονική στιγμή:Ορός/​Πλάσμα:Ποσοτική:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Albumina:MCnc:Pt:Siero/​Plasma:Qn:Albumina:MCnc:Pt:Siero/​Plasma:Qn:
  Italian (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  S--albumina
  Korean (KOREA, REPUBLIC OF)  (From: Korean Ministry for Health, Welfare, and Family Affairs)
 
  알부민:질량농도:검사시점:혈청/​혈장:정량:알부민:질량농도:검사시점:혈청/​혈장:정량:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Albumina:MCnc:Pt:Sor/​Plas:Qn:Albumina:MCnc:Pt:Sor/​Plas:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Альбумин:МассКонц:ТчкВрм:Сыв/​Плаз:Колич:Альбумин:МассКонц:ТчкВрм:Сыв/​Плаз:Колич:
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  albúmina:concentración de masa:punto en el tiempo:suero/​plasma:cuantitativo:albúmina:concentración de masa:punto en el tiempo:suero/​plasma:cuantitativo:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Albúmina:Concentración de masa:Punto temporal:Suero o Plasma:Qn:Albúmina:Concentración de masa:Punto temporal:Suero o Plasma:Qn:
  Spanish (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  S--albumina
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Albumin:KütlKons:Zmlı:Ser/​Plaz:Kant:Albumin:KütlKons:Zmlı:Ser/​Plaz:Kant:

RELATED NAMES
  Alb Point in time SerP
  Chemistry Protein.albumin SerPl
  Level QNT SerPlas
  Mass concentration Quan Serum
  Pl Quant Serum or plasma
  Plasma Quantitative SR
  Plsm Random  

EXAMPLE UNITS
  Unit  Source Type
  g/L  eCHN 
  g/dL  EXAMPLE UCUM UNITS 
  g/dL  REGENSTRIEF 
  mg/dL  REGENSTRIEF 

UNITS (INTERNAL DETAILS)
  Source Type:  eCHN 
  Unit:  g/L 
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  g/dL 
  Source Type:  REGENSTRIEF 
  Unit:  g/dL 
  Source Type:  REGENSTRIEF 
  Unit:  mg/dL 

UNITS AND RANGE
  Range  Units Type
  g/dL:[3.5,5.5]   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: Y
  Long Common Name: Albumin [Mass/volume] in Serum or Plasma
  Shortname: Albumin SerPl-mCnc
  Fully Specified Name: Albumin: MCnc: Pt: Ser/Plas: Qn:
     
  Component Word Count: 1
  ID: 8334
  Status (Raw): ACTIVE


49049-0   Collection time of Unspecified specimenCollection time of Unspecified specimenCollection time: TmStp: Pt: XXX: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Collection time  TmStp  Pt  XXX  Qn 
  Long Common Name:  Collection time of Unspecified specimen
  Short Name:  Collect Tme XXX
  Display Name:  Collection time (Unsp spec) [Date/time]

OBSERVATION REQUIRED IN PANEL
Conditional

BASIC ATTRIBUTES
  Class/Type: SPEC/Lab
  Common Lab Results Rank: #541
  Common SI Lab Results Rank: #541
  First Released in Version: 2.21
  Last Updated in Version: 2.38
  Order vs. Obs.: Observation
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  

PARTS

Part Type    Part No.  Part Name   
Component   LP29036-8  Collection time 
Property   LP6882-7  TmStp   [Time Stamp (Date and Time)] 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7735-6  XXX 
Scale   LP7753-9  Qn 
Fragments for synonyms   LP20988-9  Collection 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  采集时间:时间戳:时间点:XXX:定量型:采集时间:时间戳:时间点:XXX:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  verzameltijd:tijdstempel:moment:XXX:kwantitatief:verzameltijd:tijdstempel:moment:XXX:kwantitatief:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Heure de prélèvement:Estampille temporelle:Temps ponctuel:XXX:Quantitatif:Heure de prélèvement:Estampille temporelle:Temps ponctuel:XXX:Quantitatif:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Heure de prélèvement:Estampille temporelle:Temps ponctuel:XXX:Quantitatif:Heure de prélèvement:Estampille temporelle:Temps ponctuel:XXX:Quantitatif:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Collection time:TmStp:Pt:XXX:Qn:Collection time:TmStp:Pt:XXX:Qn:Heure du recueil [Horodatage] Milieux divers ; Numérique
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Mat.-gew. Zeitstp/​SM
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Raccolta, ora:TmStp:Pt:XXX:Qn:Raccolta, ora:TmStp:Pt:XXX:Qn:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Horário da coleta:TmStp:Pt:XXX:Qn:Horário da coleta:TmStp:Pt:XXX:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Изъятие время:TmStp:ТчкВрм:XXX:Колич:Изъятие время:TmStp:ТчкВрм:XXX:Колич:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  hora de obtención:Certificado de tiempo (Dia y Hora):Punto temporal:XXX:Qn:hora de obtención:Certificado de tiempo (Dia y Hora):Punto temporal:XXX:Qn:
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Toplama zamanı:ZBel:Zmlı:XXX:Kant:Toplama zamanı:ZBel:Zmlı:XXX:Kant:

RELATED NAMES
  Coll Other SPEC
  Collect Point in time Time stamp
  Collect Tme QNT Timestamp
  Collected Quan To be specified in another part of the message
  Date and time Quant Unspecified
  Misc Quantitative  
  Miscellaneous Random  

EXAMPLE UNITS
  Unit  Source Type
  {clock_time}  EXAMPLE UCUM UNITS 

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

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:13 PM
  Attachment Units Required: N
  Long Common Name: Collection time of Unspecified specimen
  Shortname: Collect Tme XXX
  Fully Specified Name: Collection time: TmStp: Pt: XXX: Qn:
     
  Component Word Count: 2
  ID: 42785
  Status (Raw): ACTIVE


68900-0   Albumin lab methodAlbumin lab methodAlbumin lab method: Type: Pt: Ser/​Plas: Nom:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Albumin lab method  Type  Pt  Ser/Plas  Nom 
  Long Common Name:  Albumin lab method

OBSERVATION ID IN FORM
CMS-2728_Aa3

OBSERVATION REQUIRED IN PANEL
Optional

BASIC ATTRIBUTES
  Class/Type: SURVEY.ESRD/Survey
  First Released in Version: 2.38
  Last Updated in Version: 2.42
  Status: Trial – caution, may change

NORMATIVE ANSWER LIST    (LL1902-7)  
 
Source: 3M Health Information Systems
  SEQ#        Answer        Answer ID    
  1       BCG - bromocresol green       LA17963-2  
  2       BCP - bromocresol purple       LA17964-0  

SURVEY QUESTION
Text: Albumin Lab Method
Source: ESRD.RQMT_233

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  70298-5 ESRD mineral metabolism panel
  

PARTS

Part Type    Part No.  Part Name   
Component   LP135593-4  Albumin lab method 
Property   LP6886-8  Type 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7576-4  Ser/Plas   [Serum or Plasma] 
Scale   LP7750-5  Nom 

RELATED NAMES
  Alb Plasma SerPlas
  ESRD Plsm Serum
  ESRD survey Point in time Serum or plasma
  Meth Protein.albumin SR
  Method of Random Survey
  Nominal SerP Typ
  Pl SerPl  

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:14 PM
  Attachment Units Required: N
  Long Common Name: Albumin lab method
  Fully Specified Name: Albumin lab method: Type: Pt: Ser/Plas: Nom:
     
  Component Word Count: 3
  ID: 68209
  Status (Raw): TRIAL


2160-0   Creatinine [Mass/​volume] in Serum or PlasmaCreatinine [Mass/​volume] in Serum or PlasmaCreatinine: MCnc: Pt: Ser/​Plas: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Creatinine  MCnc  Pt  Ser/Plas  Qn 
  Long Common Name:  Creatinine [Mass/volume] in Serum or Plasma
  Short Name:  Creat SerPl-mCnc
  Display Name:  Creatinine [Mass/Vol]

PART DEFINITION/DESCRIPTION(S)
  Part: Creatinine
  Creatinine or creatine anhydride, is a breakdown product of creatine phosphate in muscle. The loss of water molecule from creatine results in the formation of creatinine. It is transferred to the kidneys by blood plasma, whereupon it is eliminated by glomular filtration and partial tubular excretion. Creatinine is usually produced at a fairly constant rate and measuring its serum level is a simple test. A rise in blood creatinine levels is observed only with marked damage to functioning nephrons; therefore this test is not suitable for detecting early kidney disease. Creatine and creatinine are metabolized in the kidneys, muscle, liver and pancreas.
  Copyright: Copyright ©2005-2009 Genome Alberta (Reference to original publication: Wishart DS, Knox C, Guo AC, et al. HMDB: a knowledgebase for the human metabolome. Nucleic Acids Res. 2009 37(Database issue):D603-610.)
 
 

OBSERVATION ID IN FORM
CMS-2728_Ab

OBSERVATION REQUIRED IN PANEL
Required

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: CHEM/Lab
  CDISC Lab Test: Y
  Common Lab Results Rank: #1
  Common Orders Rank: #55
  First Released in Version: 1.0
  Last Updated in Version: 2.66
  Mass or Substance Property: M
  Order vs. Obs.: Both
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  24320-4 Basic metabolic 1998 panel - Serum or Plasma
  24321-2 Basic metabolic 2000 panel - Serum or Plasma
  24322-0 Comprehensive metabolic 1998 panel - Serum or Plasma
  24323-8 Comprehensive metabolic 2000 panel - Serum or Plasma
  24362-6 Renal function 2000 panel - Serum or Plasma
  34555-3 Creatinine 24H renal clearance panel
  44789-6 Amylase and Creatinine clearance panel - Urine and Serum or Plasma
  45066-8 Creatinine and Glomerular filtration rate.predicted panel - Serum, Plasma or Blood
  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
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
  54037-7 HEDIS 2009 panel
  54232-4 Metabolic panel.large animal - Serum or Plasma
  54233-2 Metabolic panel.small animal - Serum or Plasma
  57820-3 HEDIS 2010 panel
  58446-6 Creatinine 24H renal clearance adjusted for body surface area panel
  60442-1 HEDIS 2011 panel
  67767-4 HEDIS 2012 panel
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  70219-1 Basic metabolic 2008 panel with ionized calcium - Serum or Plasma
  70300-9 ESRD dialysis adequacy panel
  72199-3 HEDIS 2013 panel
  74234-6 HEDIS 2014 Value Sets
  75868-0 HEDIS 2015 Value Sets
  79544-3 HEDIS 2016 Value Sets
  82955-6 HEDIS 2017 Value Sets
  87625-0 HEDIS 2018 Value Sets
  88843-8 Metabolic panel.dialysis patient - Serum or Plasma
  89044-2 Basic metabolic and albumin panel - Serum or Plasma
  90766-7 HEDIS 2019 Value Sets
  

MEMBER OF THESE EQUIVALENCE GROUPS
  LG6657-3  Creatinine|MCnc|Pt|ANYBldSerPl
  LG50024-5  Creatinine|Pt|Ser/Plas|113.12 g/mole

PARTS

Part Type    Part No.  Part Name   
Component   LP14355-9  Creatinine 
Property   LP6827-2  MCnc   [Mass Concentration] 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7576-4  Ser/Plas   [Serum or Plasma] 
Scale   LP7753-9  Qn 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  肌酐:质量浓度:时间点:血清/​血浆:定量型:肌酐:质量浓度:时间点:血清/​血浆:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  creatinine:massa/​volume:moment:serum of plasma:kwantitatief:creatinine:massa/​volume:moment:serum of plasma:kwantitatief:
  Estonian (ESTONIA)  (From: Regenstrief-generated full translation based on part translation provided by Estonian E-Health Foundation)
 
  Kreatiniin:MCnc:Pt:S/​P:Qn:Kreatiniin:MCnc:Pt:S/​P:Qn:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Créatinine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:Créatinine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Créatinine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:Créatinine:Concentration de masse:Temps ponctuel:Sérum/​Plasma:Quantitatif:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Creatinine:MCnc:Pt:Ser/​Plas:Qn:Creatinine:MCnc:Pt:Ser/​Plas:Qn:Créatinine [Masse/​Volume] Sérum/​Plasma ; Numérique
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Kreatinin
  German (GERMANY)  (From: Institute for Medical Documentation and Information (DIMDI))
 
  Kreatinin:MKnz:Pkt:Ser/​Plas:Qn:Kreatinin:MKnz:Pkt:Ser/​Plas:Qn:
  Greek (GREECE)  (From: Regenstrief-generated full translation based on part translation provided by Efstratia Kontaxi, MD, MSc, and Evripidis Stefanidis, MD, with technical support from Panagiotis Kontaxis, Diploma of Electrical and Computer Engineering.)
 
  Κρεατινίνη:Συγκέντρωση μάζας:Χρονική στιγμή:Ορός/​Πλάσμα:Ποσοτική:Κρεατινίνη:Συγκέντρωση μάζας:Χρονική στιγμή:Ορός/​Πλάσμα:Ποσοτική:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Creatinina:MCnc:Pt:Siero/​Plasma:Qn:Creatinina:MCnc:Pt:Siero/​Plasma:Qn:
  Korean (KOREA, REPUBLIC OF)  (From: Korean Ministry for Health, Welfare, and Family Affairs)
 
  크레아티닌:질량농도:검사시점:혈청/​혈장:정량:크레아티닌:질량농도:검사시점:혈청/​혈장:정량:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Creatinina:MCnc:Pt:Sor/​Plas:Qn:Creatinina:MCnc:Pt:Sor/​Plas:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Креатинин:МассКонц:ТчкВрм:Сыв/​Плаз:Колич:Креатинин:МассКонц:ТчкВрм:Сыв/​Плаз:Колич:
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  creatinina:concentración de masa:punto en el tiempo:suero/​plasma:cuantitativo:creatinina:concentración de masa:punto en el tiempo:suero/​plasma:cuantitativo:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Creatinina:Concentración de masa:Punto temporal:Suero o Plasma:Qn:Creatinina:Concentración de masa:Punto temporal:Suero o Plasma:Qn:
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Kreatinin:KütlKons:Zmlı:Ser/​Plaz:Kant:Kreatinin:KütlKons:Zmlı:Ser/​Plaz:Kant:

RELATED NAMES
  Chemistry Plsm SerPl
  CR Point in time SerPlas
  Crea QNT Serum
  Creat Quan Serum or plasma
  Level Quant SR
  Mass concentration Quantitative  
  Pl Random  
  Plasma SerP  

EXAMPLE UNITS
  Unit  Source Type
  mg/dL  EXAMPLE UCUM UNITS 
  mg/dL  REGENSTRIEF 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  mg/dL 
  Source Type:  REGENSTRIEF 
  Unit:  mg/dL 

UNITS AND RANGE
  Range  Units Type
  mg/dL:[0,1.5)   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:14 PM
  Attachment Units Required: Y
  Long Common Name: Creatinine [Mass/volume] in Serum or Plasma
  Shortname: Creat SerPl-mCnc
  Fully Specified Name: Creatinine: MCnc: Pt: Ser/Plas: Qn:
     
  Component Word Count: 1
  ID: 12679
  Status (Raw): ACTIVE


718-7   Hemoglobin [Mass/​volume] in BloodHemoglobin [Mass/​volume] in BloodHemoglobin: MCnc: Pt: Bld: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Hemoglobin  MCnc  Pt  Bld  Qn 
  Long Common Name:  Hemoglobin [Mass/volume] in Blood
  Short Name:  Hgb Bld-mCnc
  Display Name:  Hemoglobin (Bld) [Mass/Vol]

MAPPING GUIDANCE
  Description: This is the the code included in the CBC auto. It is NOT obtained via the automated counting but uses a chemistry method just like most other hemoglobins.
 
 

OBSERVATION ID IN FORM
CMS-2728_Ac

OBSERVATION REQUIRED IN PANEL
Optional

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: HEM/BC/Lab
  CDISC Lab Test: Y
  Common Lab Results Rank: #2
  Common SI Lab Results Rank: #2
  Common Orders Rank: #66
  First Released in Version: 1.0
  Last Updated in Version: 2.66
  Mass or Substance Property: M
  Order vs. Obs.: Both
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  24317-0 Hemogram and platelets WO differential panel - Blood
  24338-6 Gas panel - Blood
  24343-6 Gas and Carbon monoxide panel - Blood
  24358-4 Hemogram without Platelets panel - Blood
  24359-2 Hemogram without Platelets and with Manual Differential panel - Blood
  24360-0 Hemoglobin and Hematocrit panel - Blood
  24361-8 Deprecated Hemogram, platelets & Differential panel in Blood
  24364-2 Obstetric 1996 panel - Serum and Blood
  34527-2 Deprecated Hemogram, Platelets, Differential & Reticulocyte panel in Blood
  39294-4 Children's preventive health services attachment Set
  48809-8 Erythrogram panel - Blood
  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
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
  55429-5 Short blood count panel - Blood
  57021-8 CBC W Auto Differential panel - Blood
  57022-6 CBC W Reflex Manual Differential panel - Blood
  57782-5 CBC with Ordered Manual Differential panel - Blood
  58410-2 Complete blood count (hemogram) panel - Blood by Automated count
  62611-9 PhenX domain - Respiratory
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  69742-5 CBC W Differential panel, method unspecified - Blood
  70299-3 ESRD anemia management panel
  

MEMBER OF THESE EQUIVALENCE GROUPS
  LG44868-4  Hemoglobin|Pt|Bld

PARTS

Part Type    Part No.  Part Name   
Component   LP14449-0  Hemoglobin 
Property   LP6827-2  MCnc   [Mass Concentration] 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7057-5  Bld   [Blood] 
Scale   LP7753-9  Qn 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  血红蛋白:质量浓度:时间点:全血:定量型:血红蛋白:质量浓度:时间点:全血:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  hemoglobine:massa/​volume:moment:bloed:kwantitatief:hemoglobine:massa/​volume:moment:bloed:kwantitatief:
  Estonian (ESTONIA)  (From: Regenstrief-generated full translation based on part translation provided by Estonian E-Health Foundation)
 
  Hemoglobiin:MCnc:Pt:B:Qn:Hemoglobiin:MCnc:Pt:B:Qn:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Hémoglobine:Concentration de masse:Temps ponctuel:Sang:Quantitatif:Hémoglobine:Concentration de masse:Temps ponctuel:Sang:Quantitatif:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Hémoglobine:Concentration de masse:Temps ponctuel:Sang:Quantitatif:Hémoglobine:Concentration de masse:Temps ponctuel:Sang:Quantitatif:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Hemoglobin:MCnc:Pt:Bld:Qn:Hemoglobin:MCnc:Pt:Bld:Qn:Hémoglobine [Masse/​Volume] Sang ; Numérique
  French (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  Sg--hémoglobine
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Hämoglobin
  German (GERMANY)  (From: Institute for Medical Documentation and Information (DIMDI))
 
  Hämoglobin:MKnz:Pkt:Blut:Qn:Hämoglobin:MKnz:Pkt:Blut:Qn:
  German (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  B--Hämoglobin
  Greek (GREECE)  (From: Regenstrief-generated full translation based on part translation provided by Efstratia Kontaxi, MD, MSc, and Evripidis Stefanidis, MD, with technical support from Panagiotis Kontaxis, Diploma of Electrical and Computer Engineering.)
 
  Αιμοσφαιρίνη:Συγκέντρωση μάζας:Χρονική στιγμή:Αίμα:Ποσοτική:Αιμοσφαιρίνη:Συγκέντρωση μάζας:Χρονική στιγμή:Αίμα:Ποσοτική:
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Emoglobina:MCnc:Pt:Sangue:Qn:Emoglobina:MCnc:Pt:Sangue:Qn:
  Italian (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  Sg--emoglobina
  Korean (KOREA, REPUBLIC OF)  (From: Korean Ministry for Health, Welfare, and Family Affairs)
 
  혈색소:질량농도:검사시점:전혈:정량:혈색소:질량농도:검사시점:전혈:정량:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Hemoglobina:MCnc:Pt:SgTotal:Qn:Hemoglobina:MCnc:Pt:SgTotal:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Гемоглобин:МассКонц:ТчкВрм:Кр:Колич:Гемоглобин:МассКонц:ТчкВрм:Кр:Колич:
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  hemoglobina:concentración de masa:punto en el tiempo:sangre:cuantitativo:hemoglobina:concentración de masa:punto en el tiempo:sangre:cuantitativo:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Hemoglobina:Concentración de masa:Punto temporal:Sangre:Qn:Hemoglobina:Concentración de masa:Punto temporal:Sangre:Qn:
  Spanish (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  Sg--hemoglobina
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Hemoglobin:KütlKons:Zmlı:Kan:Kant:Hemoglobin:KütlKons:Zmlı:Kan:Kant:

RELATED NAMES
  Blood Mass concentration Random
  Haemoglobin Point in time WB
  Hb QNT Whole blood
  HEMATOLOGY/CELL COUNTS Quan  
  Hgb Quant  
  Level Quantitative  

EXAMPLE UNITS
  Unit  Source Type
  g/L  REGENSTRIEF 
  g/L  eCHN 
  g/dL  EXAMPLE UCUM UNITS 
  g/dL  REGENSTRIEF 

UNITS (INTERNAL DETAILS)
  Source Type:  REGENSTRIEF 
  Unit:  g/L 
  Source Type:  eCHN 
  Unit:  g/L 
  Source Type:  EXAMPLE UCUM UNITS 
  Unit:  g/dL 
  Source Type:  REGENSTRIEF 
  Unit:  g/dL 

UNITS AND RANGE
  Range  Units Type
  g/dL:[12.0,16.0]   

RELATED CODES
Code System Code Code Text Code Version
   https://www.phenxtoolkit.org   PX090201140000   PX090201_Total_Hemoglobin   

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:14 PM
  Attachment Units Required: Y
  Long Common Name: Hemoglobin [Mass/volume] in Blood
  Shortname: Hgb Bld-mCnc
  Fully Specified Name: Hemoglobin: MCnc: Pt: Bld: Qn:
     
  Component Word Count: 1
  ID: 64560
  Status (Raw): ACTIVE


4548-4   Hemoglobin A1c/​Hemoglobin.total in BloodHemoglobin A1c/​Hemoglobin.total in BloodHemoglobin A1c/​Hemoglobin.total: MFr: Pt: Bld: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Hemoglobin A1c/Hemoglobin.total  MFr  Pt  Bld  Qn 
  Long Common Name:  Hemoglobin A1c/Hemoglobin.total in Blood
  Short Name:  Hgb A1c MFr Bld
  Display Name:  HbA1c (Bld) [Mass fraction]

PART DEFINITION/DESCRIPTION(S)
  Part: Hemoglobin A1c
  Currently (2010), four standardization protocols exist for measuring Hgb A1c:

1. IFCC - designated as a Reference Method or RM (http://www.ifcchba1c.net/)
2. NGSP - the long standing protocol used in the US and most other countries since the DCCT study (http://www.ngsp.org/factors.asp)
3.JDS/JSCC - a protocol used in Japan, Spain and possibly other countries
4. Swedish - used in Sweden at least

Protocols 2-4 are known as Designated Comparison Methods (DCM) and have been connected to the Reference Method and each other through various regression equations.

Because of the high degrees of standardization within protocol it should no longer be necessary to specify a LOINC code with a method such as “HPLC”, “electrophoresis” or anything else. Analytical instruments will be designed so that an Hgb A1c result can be traced back to a specific standardization protocol, so the important distinction will be the standardization protocol as described above and which will be carried in the method field.

A meeting of instrument manufacturers (presumably including Japanese) in Milan, Italy, December 12, 2007, agreed (among other items) that:

-All manufacturers should implement worldwide the traceability to the IFCC reference system for Hgb -A1c.
-All new instruments sold after January 1st, 2011 will report (as a result of an Hgb A1c test) both SI (mmol/mol – no decimals) and NGSP derived units (percentage – one decimal), in agreement with the Consensus Statement.
-Note they only committed to supporting protocol (1) and (2)

Different countries are adopting the international harmonization recommendations in different ways. We have information from the NGSP that the US will continue to report only Hgb A1c/NGSP, with the unit percent – i.e., no change. In Great Britain, labs have already started to report all results both as Hgb A1c (NGSP) in % and Hgb A1c (IFCC) in mmol/mol. In Canada, they are awaiting a recommendation from an expert panel. Any of these measures could be reported in the same units, but the convention for the reporting Hgb A1c under the new IFCC protocol will be to use units of mmol/mol to avoid confusion between the DCCT/NGSP and the IFFCC protocol.

LOINC has defined 59261-8 (Hemoglobin A1c/Hemoglobin.total in Blood) by IFCC protocol.

These protocols produce different results when expressed in the same units. For example, the equivalent of Hgb A1c (NGSP) of 6.5% is Hgb A1c (IFCC) is 4.8%.

The NGSP web site (http://www.ngsp.org/factors.asp) suggests the use of alternate measures, such as glycated albumen, for patients with severe iron deficiency, dialysis patients, and those with SS SC CC because of over or under reading that can occur with these interferences. It also describes the effect of abnormal hemoglobins on results of HbA1c by instrument.
 
 

MAPPING GUIDANCE
  Description: Today, all US HbA1c measurements reported in the US and many other countries are standardized to the NGSP protocol and that has been true for years. This code [LOINC: 4548-4] should be used for reporting the HbA1c in the US. Other countries may report HbA1c measured by the IFCC protocol [LOINC: 59261-8] , a protocol with results reported in units of mmol/mol. In Japan and parts of Spain it may be measured using the Japanese protocol. All three protocols produce different numeric values.
 
 

OBSERVATION ID IN FORM
CMS-2728_Ad

OBSERVATION REQUIRED IN PANEL
Optional

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: HEM/BC/Lab
  CDISC Lab Test: Y
  Common Lab Results Rank: #81
  Common SI Lab Results Rank: #81
  Common Orders Rank: #48
  First Released in Version: 1.0
  Last Updated in Version: 2.66
  Order vs. Obs.: Both
  Status: Active.
Change Reason: Changing from the property from Mass fraction to substance fraction has not effect on the meaning when the molecular weight of the numerator and the denominator are the same (for practical purposes). These terms had had a property of MFR in the past and we changed to SFR because we thought the LOINC community preferred SFR for HbA1c. But we mis understood the preference is to use the MFR variant- so we have changed back.

SUBMITTER'S INFORMATION
  Submitted Units: %

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.
  LOINC   Long Common Name  
  43150-2 Hemoglobin A1c measurement device panel
  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
  52748-1 Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
  54037-7 HEDIS 2009 panel
  55399-0 Diabetes tracking panel
  57820-3 HEDIS 2010 panel
  60442-1 HEDIS 2011 panel
  67767-4 HEDIS 2012 panel
  67868-0 End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728
  72199-3 HEDIS 2013 panel
  74234-6 HEDIS 2014 Value Sets
  75868-0 HEDIS 2015 Value Sets
  79544-3 HEDIS 2016 Value Sets
  82955-6 HEDIS 2017 Value Sets
  87625-0 HEDIS 2018 Value Sets
  90766-7 HEDIS 2019 Value Sets
  

PARTS

Part Type    Part No.  Part Name   
Component   LP16413-4  Hemoglobin A1c 
     Divisors   LP32069-4  Hemoglobin.total 
Property   LP6831-4  MFr   [Mass fraction] 
Time   LP6960-1  Pt   [Point in time (spot)] 
System   LP7057-5  Bld   [Blood] 
Scale   LP7753-9  Qn 
Fragments for synonyms   LP21089-5  Total 

LANGUAGE VARIANTS
  Chinese (CHINA)  (From: Regenstrief-generated full translation based on part translation provided by Lin Zhang, A LOINC volunteer from China)
 
  血红蛋白 A1c/​血红蛋白.总计:质量分数:时间点:全血:定量型:血红蛋白 A1c/​血红蛋白.总计:质量分数:时间点:全血:定量型:
  Dutch (NETHERLANDS)  (From: Regenstrief-generated full translation based on part translation provided by NVKC, Dutch Society for Clinical Chemistry and Laboratory Medicine, The Netherlands)
 
  hemoglobine A1c/​hemoglobine.totaal:massafractie:moment:bloed:kwantitatief:hemoglobine A1c/​hemoglobine.totaal:massafractie:moment:bloed:kwantitatief:
  Estonian (ESTONIA)  (From: Regenstrief-generated full translation based on part translation provided by Estonian E-Health Foundation)
 
  Hemoglobiin A1c/​hemoglobiin.üld:MFr:Pt:B:Qn:Hemoglobiin A1c/​hemoglobiin.üld:MFr:Pt:B:Qn:
  French (BELGIUM)  (From: Regenstrief-generated full translation based on part translation provided by Jean M. Prevost, MD, Biopathology)
 
  Hémoglobine A1c/​Hémoglobine.totale:Fraction de masse:Temps ponctuel:Sang:Quantitatif:Hémoglobine A1c/​Hémoglobine.totale:Fraction de masse:Temps ponctuel:Sang:Quantitatif:
  French (CANADA)  (From: Regenstrief-generated full translation based on part translation provided by Canada Health Infoway Inc.)
 
  Hémoglobine A1c/​Hémoglobine.totale:Fraction de masse:Temps ponctuel:Sang:Quantitatif:Hémoglobine A1c/​Hémoglobine.totale:Fraction de masse:Temps ponctuel:Sang:Quantitatif:
  French (FRANCE)  (From: ASIP Santé (Agence des systèmes d'information partagés de santé))
 
  Hemoglobin A1c/​Hemoglobin.total:MFr:Pt:Bld:Qn:Hemoglobin A1c/​Hemoglobin.total:MFr:Pt:Bld:Qn:Hémoglobine A1c/​hémoglobine totale [Fraction massique] Sang ; Numérique
  French (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  Sg--hémoglobine A1c; fraction de l'hémoglobine
  German (AUSTRIA)  (From: ELGA, Austria)
 
  Hämoglobin A1c
  German (GERMANY)  (From: Institute for Medical Documentation and Information (DIMDI))
 
  Hämoglobin A1c/​Hämoglobin.total:SFr:Pkt:Blut:Qn:Hämoglobin A1c/​Hämoglobin.total:SFr:Pkt:Blut:Qn:
  German (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  B--Hämoglobin A1c; Hämoglobinfraktion
  Italian (ITALY)  (From: Regenstrief-generated full translation based on part translation provided by Consiglio Nazionale delle Ricerche)
 
  Emoglobina A1c/​Emoglobina.totale:MFr:Pt:Sangue:Qn:Emoglobina A1c/​Emoglobina.totale:MFr:Pt:Sangue:Qn:
  Italian (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  Sg--emoglobina A1c; frazione dell'emoglobina
  Korean (KOREA, REPUBLIC OF)  (From: Korean Ministry for Health, Welfare, and Family Affairs)
 
  혈색소 A1C/​총혈색소:질량분획:검사시점:전혈:정량:혈색소 A1C/​총혈색소:질량분획:검사시점:전혈:정량:
  Portuguese (BRAZIL)  (From: HL7 Brazil Institute)
 
  Hemoglobina A1c/​Hemoglobina.total:SFr:Pt:SgTotal:Qn:Hemoglobina A1c/​Hemoglobina.total:SFr:Pt:SgTotal:Qn:
  Russian (RUSSIAN FEDERATION)  (From: Regenstrief-generated full translation based on part translation provided by Yaroslavl State Medical Academy)
 
  Гемоглобин А1с/​Гемоглобин.общий:МассДол:ТчкВрм:Кр:Колич:Гемоглобин А1с/​Гемоглобин.общий:МассДол:ТчкВрм:Кр:Колич:
  Spanish (ARGENTINA)  (From: Conceptum Medical Terminology Center)
 
  hemoglobina A1c/​hemoglobina.total:fracción de masa:punto en el tiempo:sangre:cuantitativo:hemoglobina A1c/​hemoglobina.total:fracción de masa:punto en el tiempo:sangre:cuantitativo:
  Spanish (SPAIN)  (From: Regenstrief-generated full translation based on part translation provided by the Clinical Laboratory Committee of SERVICIO EXTREMEÑO DE SALUD, with the support of BITAC MAP.)
 
  Hemoglobina A1c (Hemoglobina glicosilada)/​Hemoglobina.total:Fracción de masa:Punto temporal:Sangre:Qn:Hemoglobina A1c (Hemoglobina glicosilada)/​Hemoglobina.total:Fracción de masa:Punto temporal:Sangre:Qn:
  Spanish (SWITZERLAND)  (From: CUMUL, Switzerland)
 
  Sg--hemoglobina A1c; fracción de la hemoglobina
  Turkish (TURKEY)  (From: Regenstrief-generated full translation based on part translation provided by LOINC Turkish Translation Group and the Turkish Ministry of Health)
 
  Hemoglobin A1c/​Hemoglobin.total:KütlFr:Zmlı:Kan:Kant:Hemoglobin A1c/​Hemoglobin.total:KütlFr:Zmlı:Kan:Kant:

RELATED NAMES
  Blood HbA1c Quant
  GHb HEMATOLOGY/CELL COUNTS Quantitative
  Glycated hemoglobin Hgb Random
  Glycohaemogolobin Hgb A1c Tot
  Glycohemogolobin Mass Fraction Totl
  Glycosylated hemoglobin Percent WB
  HA1c Point in time Whole blood
  Haemoglobin QNT  
  Hb Quan  

EXAMPLE UNITS
  Unit  Source Type
  EXAMPLE UCUM UNITS 
  ORIGINAL SUBMISSION 
  REGENSTRIEF 
  eCHN 
  % Hgb  REGENSTRIEF 

UNITS (INTERNAL DETAILS)
  Source Type:  EXAMPLE UCUM UNITS 
  Unit: 
  Source Type:  ORIGINAL SUBMISSION 
  Unit: 
  Source Type:  REGENSTRIEF 
  Unit: 
  Source Type:  eCHN 
  Unit: 
  Source Type:  REGENSTRIEF 
  Unit:  % Hgb 

UNITS AND RANGE
  Range  Units Type
  %:[3.8,6.4]   

RELATED CODES
Code System Code Code Text Code Version
   IEEE_CFCODE10_NUM   160220     
   IEEE_REFID_TXT   MDC_CONC_HBA1C     

CHANGE HISTORY
  Change Type: MIN

INTERNAL FIELDS
  Detail Page Created On: 6/26/2019 3:38:14 PM
  Attachment Units Required: Y
  Long Common Name: Hemoglobin A1c/Hemoglobin.total in Blood
  Shortname: Hgb A1c MFr Bld
  Fully Specified Name: Hemoglobin A1c/Hemoglobin.total: MFr: Pt: Bld: Qn:
     
  Component Word Count: 4
  ID: 38833
  Status (Raw): ACTIVE


2093-3   Cholesterol [Mass/​volume] in Serum or PlasmaCholesterol [Mass/​volume] in Serum or PlasmaCholesterol: MCnc: Pt: Ser/​Plas: Qn:  

NAME
  Fully Specified Name: 
Component   Property   Time   System   Scale   Method
Cholesterol  MCnc  Pt  Ser/Plas  Qn 
  Long Common Name:  Cholesterol [Mass/volume] in Serum or Plasma
  Short Name:  Cholest SerPl-mCnc
  Display Name:  Cholesterol [Mass/Vol]

PART DEFINITION/DESCRIPTION(S)
  Part: Cholesterol
  Cholesterol is a lipidic, waxy alcohol found in the cell membranes and transported in the blood plasma of all animals. It is an essential component of mammalian cell membranes where it establishes proper membrane permeability and fluidity. Cholesterol is the principal sterol synthesized by animals, but small quantities are synthesized in other eukaryotes, such as plants and fungi. It is almost completely absent among prokaryotes, which include bacteria. Cholesterol is classified as a sterol.
  Copyright: Text is available under the Creative Commons Attribution/Share-Alike License. See http://creativecommons.org/licenses/by-sa/3.0/ for details.
 
 

OBSERVATION ID IN FORM
CMS-2728_Ae

OBSERVATION REQUIRED IN PANEL
Optional

TYPE OF ENTRY
Question

BASIC ATTRIBUTES
  Class/Type: CHEM/Lab
  CDISC Lab Test: Y
  Common Lab Results Rank: #32
  Common Orders Rank: #124
  First Released in Version: 1.0
  Last Updated in Version: 2.34
  Mass or Substance Property: M
  Order vs. Obs.: Both
  Status: Active

MEMBER OF THESE PANELS     
  This section provides information about panels that contain this LOINC code.