90480-5
MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
Active
Term Description
This panel should be used for CMS MDS 3.0 v1.17.1 IPA assessments performed between October 1, 2019 and September 30, 2020 and CMS MDS 3.0 v1.17.2 IPA assessments performed after October 1, 2020.
Source: Regenstrief LOINC
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 90480-5 | MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] | |||
| Indent90503-4 | Identification Information | |||
| Indent Indent58198-3 | Type of Record | |||
| Indent Indent54581-4 | Facility Provider Numbers | |||
| Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
| Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
| Indent Indent Indent45398-5 | State Provider Number | |||
| Indent Indent85632-8 | Type of Provider | |||
| Indent Indent90521-6 | Optional State Assessment | |||
| Indent Indent Indent90522-4 | Is this assessment for state payment purposes only? | |||
| Indent Indent90571-1 | Type of Assessment | |||
| Indent Indent Indent54583-0 | Federal OBRA Reason for Assessment | |||
| Indent Indent Indent54584-8 | PPS Assessment | |||
| Indent Indent Indent54587-1 | Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry? | |||
| Indent Indent Indent58108-2 | Entry/discharge reporting | |||
| Indent Indent Indent71440-2 | Type of discharge | |||
| Indent Indent86526-1 | Unit Certification or Licensure Designation | |||
| Indent Indent54503-8 | Legal Name of Resident | |||
| Indent Indent Indent45392-8 | First name | |||
| Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent45394-4 | Last name | |||
| Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent45966-9 | Social Security and Medicare Numbers | |||
| Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent45397-7 | Medicare number | |||
| Indent Indent45400-9 | Medicaid Number | |||
| Indent Indent46098-0 | Gender | |||
| Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent59362-4 | Race/Ethnicity | 1..6 | ||
| Indent Indent54505-3 | Language | |||
| Indent Indent Indent54588-9 | Does the resident need or want an interpreter to communicate with a doctor or health care staff? | |||
| Indent Indent Indent54899-0 | Preferred language | |||
| Indent Indent45404-1 | Marital Status | |||
| Indent Indent54506-1 | Optional Resident Items | |||
| Indent Indent Indent46106-1 | Medical record number | |||
| Indent Indent Indent45403-3 | Room number | |||
| Indent Indent Indent52462-9 | Name by which resident prefers to be addressed | |||
| Indent Indent Indent21843-8 | Lifetime occupation(s) | |||
| Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent54507-9 | Medicare Stay | |||
| Indent Indent Indent54594-7 | Has the resident had a Medicare-covered stay since the most recent entry? | |||
| Indent Indent Indent54595-4 | Start date of most recent Medicare stay | {mm/dd/yyyy} | ||
| Indent Indent Indent54596-2 | End date of most recent Medicare stay | {mm/dd/yyyy} | ||
| Indent90505-9 | Hearing, Speech, and Vision | |||
| Indent Indent54597-0 | Comatose. Persistent vegetative state/no discernible consciousness | |||
| Indent Indent95737-3 | Makes Self Understood. Ability to express ideas and wants, consider both verbal and non-verbal expression | |||
| Indent93050-3 | Cognitive Patterns | |||
| Indent Indent54605-1 | Should Brief Interview for Mental Status (C0200-C0500) be Conducted? | |||
| Indent Indent103694-6 | Brief Interview for Mental Status (BIMS) | |||
| Indent Indent Indent103696-1 | Repetition of Three Words. Number of words repeated after first attempt | |||
| Indent Indent Indent103702-7 | Temporal Orientation (orientation to year, month, and day) | |||
| Indent Indent Indent Indent103697-9 | Able to report correct year | |||
| Indent Indent Indent Indent103698-7 | Able to report correct month | |||
| Indent Indent Indent Indent103703-5 | Able to report correct day of the week | |||
| Indent Indent Indent103695-3 | Recall | |||
| Indent Indent Indent Indent103699-5 | Able to recall "sock" | |||
| Indent Indent Indent Indent103700-1 | Able to recall "blue" | |||
| Indent Indent Indent Indent103701-9 | Able to recall "bed" | |||
| Indent Indent Indent103704-3 | BIMS Summary Score | {score} | ||
| Indent Indent54615-0 | Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted? | |||
| Indent Indent86814-1 | Staff Assessment for Mental Status | |||
| Indent Indent Indent54616-8 | Short-term Memory OK. Seems or appears to recall after 5 minutes | |||
| Indent Indent Indent54624-2 | Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life | |||
| Indent90482-1 | Mood | |||
| Indent Indent54634-1 | Should Resident Mood Interview be Conducted? | |||
| Indent Indent54635-8 | Resident Mood Interview (PHQ-9) | |||
| Indent Indent Indent86843-0 | Symptom Presence | |||
| Indent Indent Indent Indent54636-6 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54638-2 | Feeling down, depressed or hopeless | |||
| Indent Indent Indent Indent54640-8 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54642-4 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54644-0 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54646-5 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down | |||
| Indent Indent Indent Indent54648-1 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54650-7 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual | |||
| Indent Indent Indent Indent54652-3 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
| Indent Indent Indent86844-8 | Symptom Frequency | |||
| Indent Indent Indent Indent54637-4 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54639-0 | Feeling down, depressed or hopeless | |||
| Indent Indent Indent Indent54641-6 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54643-2 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54645-7 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54647-3 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down | |||
| Indent Indent Indent Indent54649-9 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54651-5 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual | |||
| Indent Indent Indent Indent54653-1 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
| Indent Indent103705-0 | Total Severity Score | {score} | ||
| Indent Indent103706-8 | Staff Assessment of Resident Mood (PHQ-9-OV) | |||
| Indent Indent Indent86833-1 | Symptom Presence | |||
| Indent Indent Indent Indent54658-0 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54660-6 | Feeling or appearing down, depressed, or hopeless | |||
| Indent Indent Indent Indent54662-2 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54664-8 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54666-3 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54668-9 | Indicating that s/he feels bad about self, is a failure, or has let self or family down | |||
| Indent Indent Indent Indent54670-5 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54672-1 | Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that s/he has been moving around a lot more than usual | |||
| Indent Indent Indent Indent54673-9 | States that life isn't worth living, wishes for death, or attempts to harm self | |||
| Indent Indent Indent Indent54675-4 | Being short-tempered, easily annoyed | |||
| Indent Indent Indent86891-9 | Symptom Frequency | |||
| Indent Indent Indent Indent54659-8 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54661-4 | Feeling or appearing down, depressed, or hopeless | |||
| Indent Indent Indent Indent54663-0 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54665-5 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54667-1 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54669-7 | Indicating that s/he feels bad about self, is a failure, or has let self or family down | |||
| Indent Indent Indent Indent54671-3 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54904-8 | Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that s/he has been moving around a lot more than usual | |||
| Indent Indent Indent Indent54674-7 | States that life isn't worth living, wishes for death, or attempts to harm self | |||
| Indent Indent Indent Indent54676-2 | Being short-tempered, easily annoyed | |||
| Indent Indent103707-6 | Total Severity Score | {score} | ||
| Indent86815-8 | Behavior | |||
| Indent Indent86597-2 | Potential Indicators of Psychosis | 1..2 | ||
| Indent Indent54514-5 | Behavioral Symptom - Presence & Frequency | |||
| Indent Indent Indent54682-0 | Physical behavioral symptoms directed toward others | d/(7.d) | ||
| Indent Indent Indent54683-8 | Verbal behavioral symptoms directed toward others | d/(7.d) | ||
| Indent Indent Indent54684-6 | Other behavioral symptoms not directed toward others | d/(7.d) | ||
| Indent Indent54692-9 | Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being? | d/(7.d) | ||
| Indent Indent54693-7 | Wandering - Presence & Frequency. Has the resident wandered? | d/(7.d) | ||
| Indent90526-5 | Functional Abilities and Goals - Interim Payment Assessment | |||
| Indent Indent90540-6 | Self-Care - Interim Performance | |||
| Indent Indent Indent95019-6 | Eating | |||
| Indent Indent Indent95018-8 | Oral hygiene | |||
| Indent Indent Indent95017-0 | Toileting hygiene | |||
| Indent Indent90541-4 | Mobility - Interim Performance | |||
| Indent Indent Indent95010-5 | Sit to lying | |||
| Indent Indent Indent95009-7 | Lying to sitting on side of bed | |||
| Indent Indent Indent95008-9 | Sit to stand | |||
| Indent Indent Indent95007-1 | Chair/bed-to-chair transfer | |||
| Indent Indent Indent95006-3 | Toilet transfer | |||
| Indent Indent Indent95004-8 | Walk 10 feet | |||
| Indent Indent Indent95003-0 | Walk 50 feet with two turns | |||
| Indent Indent Indent95002-2 | Walk 150 feet | |||
| Indent90507-5 | Bladder and Bowel | |||
| Indent Indent86624-4 | Appliances | 1..2 | ||
| Indent Indent54769-5 | Urinary Toileting Program. Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence? | |||
| Indent Indent88695-2 | Bowel Toileting Program. Is a toileting program currently being used to manage the resident's bowel continence? | |||
| Indent90485-4 | Active Diagnoses | |||
| Indent Indent96095-5 | Indicate the resident's primary medical condition category | 1..1 | ||
| Indent Indent52797-8 | ICD Code | |||
| Indent Indent86671-5 | Active Diagnoses in the last 7 days | 1..* | ||
| Indent Indent52797-8 | Additional active diagnoses | 0..10 | ||
| Indent90488-8 | Health Conditions | |||
| Indent Indent86889-3 | Other Health Conditions | |||
| Indent Indent Indent86675-6 | Shortness of Breath (dyspnea) | 1..1 | ||
| Indent Indent Indent86676-4 | Problem Conditions | 1..2 | ||
| Indent Indent90542-2 | Recent Surgery Requiring Active SNF Care-Did the resident have a major surgical procedure during the prior inpatient hospital stay that requires active care during the SNF stay? | |||
| Indent Indent90745-1 | Surgical Procedures | |||
| Indent90509-1 | Swallowing/Nutritional Status | |||
| Indent Indent86677-2 | Swallowing Disorder. Signs and symptoms of possible swallowing disorder | 1..4 | ||
| Indent Indent54863-6 | Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months | |||
| Indent Indent54568-1 | Nutritional Approaches | |||
| Indent Indent Indent71444-4 | Nutritional Approaches. While NOT a Resident | 0..2 | ||
| Indent Indent Indent71445-1 | Nutritional Approaches. While a Resident | 1..3 | ||
| Indent Indent90543-0 | Percent Intake by Artificial Route | |||
| Indent Indent Indent86681-4 | Proportion of total calories the resident received through parenteral or tube feeding. While a Resident | |||
| Indent Indent Indent86687-1 | Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days | |||
| Indent Indent Indent86683-0 | Average fluid intake per day by IV or tube feeding. While a Resident | mL/d;L/d | ||
| Indent Indent Indent86684-8 | Average fluid intake per day by IV or tube feeding. During Entire 7 Days | mL/d;L/d | ||
| Indent89051-7 | Skin Conditions | |||
| Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this resident have one or more unhealed pressure ulcers/injuries? | |||
| Indent Indent86892-7 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage | |||
| Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
| Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
| Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
| Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent54970-9 | Number of Venous and Arterial Ulcers | {#} | ||
| Indent Indent88696-0 | Other Ulcers, Wounds and Skin Problems | 1..6 | ||
| Indent Indent86748-1 | Skin and Ulcer/Injury Treatments | 1..9 | ||
| Indent90513-3 | Medications | |||
| Indent Indent58217-1 | Insulin | |||
| Indent Indent Indent58127-2 | Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days | d/(7.d) | ||
| Indent Indent Indent58128-0 | Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days | d/(7.d) | ||
| Indent90519-0 | Special Treatments, Procedures, and Programs | |||
| Indent Indent86761-4 | While a Resident | 1..10 | ||
| Indent Indent86849-7 | Respiratory therapy | |||
| Indent Indent Indent45766-3 | Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days | d/(7.d) | ||
| Indent Indent86773-9 | Restorative Nursing Programs | |||
| Indent Indent Indent86774-7 | Technique. Range of motion (passive) | d/(7.d) | ||
| Indent Indent Indent86775-4 | Technique. Range of motion (active) | d/(7.d) | ||
| Indent Indent Indent86776-2 | Technique. Splint or brace assistance | d/(7.d) | ||
| Indent Indent Indent86777-0 | Training and Skill Practice In: Bed mobility | d/(7.d) | ||
| Indent Indent Indent86778-8 | Training and Skill Practice In: Transfer | d/(7.d) | ||
| Indent Indent Indent86779-6 | Training and Skill Practice In: Walking | d/(7.d) | ||
| Indent Indent Indent86780-4 | Training and Skill Practice In: Dressing and/or grooming | d/(7.d) | ||
| Indent Indent Indent86781-2 | Training and Skill Practice In: Eating and/or swallowing | d/(7.d) | ||
| Indent Indent Indent86782-0 | Training and Skill Practice In: Amputation/prostheses care | d/(7.d) | ||
| Indent Indent Indent86783-8 | Training and Skill Practice In: Communication | d/(7.d) | ||
| Indent91579-3 | Correction Request | |||
| Indent Indent85632-8 | Type of Provider | |||
| Indent Indent87226-7 | Name of Resident | |||
| Indent Indent Indent45392-8 | Patient First (Given) name | |||
| Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent46098-0 | Gender | |||
| Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent45396-9 | Social Security Number | |||
| Indent Indent90522-4 | Optional State Assessment. Is this assessment for state payment purposes only? | |||
| Indent Indent91580-1 | Type of Assessment | |||
| Indent Indent Indent54583-0 | Federal OBRA Reason for Assessment | |||
| Indent Indent Indent54584-8 | PPS Assessment | |||
| Indent Indent Indent58108-2 | Entry/discharge reporting | |||
| Indent Indent54593-9 | Date on existing record to be modified/inactivated. Assessment Reference Date | {mm/dd/yyyy} | ||
| Indent Indent87209-3 | Correction Attestation Section | |||
| Indent Indent Indent58200-7 | Correction Number | {#} | ||
| Indent Indent Indent87217-6 | Reasons for Modification | 1..5 | ||
| Indent Indent Indent87225-9 | Reasons for Inactivation | 1..2 | ||
| Indent Indent Indent87218-4 | RN Assessment Coordinator Attestation of Completion | |||
| Indent Indent Indent Indent87219-2 | Attesting individual's first name | |||
| Indent Indent Indent Indent87220-0 | Attesting individual's last name | |||
| Indent Indent Indent Indent87221-8 | Attesting individual's title | |||
| Indent Indent Indent Indent87222-6 | Attestation date | {mm/dd/yyyy} | ||
| Indent90495-3 | Assessment Administration | |||
| Indent Indent90498-7 | Medicare Part A Billing | |||
| Indent Indent Indent55065-7 | Medicare Part A HIPPS code | |||
| Indent Indent Indent55081-4 | Version code |
Fully-Specified Name
- Component
- MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set
- Property
- -
- Time
- RptPeriod
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.66
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Release 2.68: DefinitionDescription: Added missing Term Description; COMPONENT: Version 1.17.2 was added to the Component because this panel now represents both versions.; Release 2.67: DefinitionDescription: Added missing Term Description
- Order vs. Observation
- Order
- Panel Type
- Panel
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