*** Effective Date: 9/19/2025   The following required for Bulk Import: ||||||||||||||||||||
HOSPICE|3.00|900|SFTWR_VNDR_NAME|Software vendor company name|63|30|Y|x| | | | | | |x|x||0||Homecare Accounting Solutions LLC|
HOSPICE|3.00|1000|SFTWR_VNDR_EMAIL_ADR|Software vendor email address|93|50|Y|x| | | | | | |x|x||0||support@has-software.com|
HOSPICE|3.00|1100|SFTWR_PROD_NAME|Software product name|143|50|Y|x| | | | | | |x|x||0||HomeCare Billing Solutions|
HOSPICE|3.00|1200|SFTWR_PROD_VRSN_CD|Software product version code|193|20|Y|x| | | | | | |x|x||0||1.2.7.30|
HOSPICE|3.00|1500|A0050|Type of record|413|1|N|x| | | | | | |x|x||0||1|
HOSPICE|3.00|1600|A0100A|Facility National Provider Identifier (NPI)|414|10|Y|x| | | | | | |x| ||0|||
HOSPICE|3.00|1700|A0100B|Facility CMS Certification Number (CCN)|424|12|Y|x| | | | | | |x| ||0|||
HOSPICE|3.00|1800|A0205|Site of service at admission|436|2|N|x| | | | | | | | ||0|||
HOSPICE|3.00|1900|A0220|Admission date|438|8|N|x| | | | | | |x|x||0|||
HOSPICE|3.00|2000|A0245|Date initial nursing assessment initiated|446|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|2100|A0250|Reason for record|454|2|N|x| | | | | | |x|x||0|||
HOSPICE|3.00|2200|A0270|Discharge date|456|8|N| | | | | | | |x|x||0|||
HOSPICE|3.00|2300|A0500A|Patient first name|464|12|Y|x| | | | | | |x|x|Pat_Master|1|Name_First||
HOSPICE|3.00|2400|A0500B|Patient middle initial|476|1|Y|x| | | | | | |x| |Pat_Master|1|Name_Middle|^|
HOSPICE|3.00|2500|A0500C|Patient last name|477|18|Y|x| | | | | | |x|x|Pat_Master|1|Name_Last||
HOSPICE|3.00|2600|A0500D|Patient name suffix|495|3|Y|x| | | | | | |x| |Pat_Master|1|Name_Suffix|^|
HOSPICE|3.00|2700|A0600A|Social Security Number|498|9|Y|x| | | | | | |x|x|Pat_Master|1|Soc_Sec_No|^|
HOSPICE|3.00|2800|A0600B|Patient Medicare/railroad insurance number|507|12|Y|x| | | | | | |x| ||0||^|
HOSPICE|3.00|2900|A0700|Patient Medicaid number|519|14|Y|x| | | | | | |x| ||0|||
HOSPICE|3.00|3000|A0800|Gender|533|1|Y|x| | | | | | |x|x||0|||
HOSPICE|3.00|3100|A0900|Birthdate|534|8|Y|x| | | | | | |x|x||0|||
HOSPICE|3.00|3200|A1000A|Ethnicity: American Indian or Alaska Native|542|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3300|A1000B|Ethnicity: Asian|543|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3400|A1000C|Ethnicity: Black or African American|544|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3500|A1000D|Ethnicity: Hispanic or Latino|545|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3600|A1000E|Ethnicity: Native Hawaiian/Pacific Islander|546|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3700|A1000F|Ethnicity: White|547|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3800|A1802|Admitted from|548|2|N|x| | | | | | | | ||0|||
HOSPICE|3.00|3900|A2115|Reason for discharge|550|2|N| | | | | | | |x| ||0|||
HOSPICE|3.00|4000|F2000A|Was patient asked about CPR|552|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4100|F2000B|Date asked about CPR|553|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4200|F2100A|Was patient asked about treatments other than CPR|561|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4300|F2100B|Date asked about treatment other than CPR|562|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4400|F2200A|Was patient asked about hospitalization|570|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4500|F2200B|Date asked about hospitalization|571|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4600|F3000A|Was patient asked spiritual/existential concerns|579|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4700|F3000B|Date asked about spiritual/existential concerns|580|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|4800|I0010|Principal diagnosis|588|2|Y|x| | | | | | | | ||0|||
HOSPICE|3.00|4900|J0900A|Was patient screened for pain|590|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5000|J0900B|Date of first screening for pain|591|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5100|J0900C|Patient's pain severity was|599|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5200|J0900D|Type of standardized pain tool used|600|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5300|J0910A|Was comprehensive pain assessment done|601|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5400|J0910B|Date of comprehensive pain assessment|602|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5500|J0910C1|Pain asmt included: location|610|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5600|J0910C2|Pain asmt included: severity|611|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5700|J0910C3|Pain asmt included: character|612|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5800|J0910C4|Pain asmt included: duration|613|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|5900|J0910C5|Pain asmt included: frequency|614|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6000|J0910C6|Pain asmt included: what relieves/worsens|615|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6100|J0910C7|Pain asmt included: effect function/quality life|616|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6200|J0910C9|Pain asmt included: none of the above|617|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6300|J2030A|Was patient screened for shortness of breath|618|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6400|J2030B|Date of first screening for shortness of breath|619|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6500|J2030C|Did screening indicate pt had shortness of breath|627|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6600|J2040A|Was treatment for shortness of breath initiated|628|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6700|J2040B|Date treatment for shortness of breath initiated|629|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6800|J2040C1|Type(s) treat for shortness of breath: opioids|637|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|6900|J2040C2|Type(s) treat for shortness of breath: other med|638|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7000|J2040C3|Type(s) treat for shortness of breath: oxygen|639|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7100|J2040C4|Type(s) treat for shortness of breath: non-med|640|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7200|N0500A|Was scheduled opioid initiated or continued|641|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7300|N0500B|Date scheduled opioid initiated or continued|642|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7400|N0510A|Was PRN opioid initiated or continued|650|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7500|N0510B|Date PRN opioid initiated or continued|651|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7600|N0520A|Was bowel regimen initiated or continued|659|1|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7700|N0520B|Date bowel regimen initiated or continued|660|8|N|x| | | | | | | | ||0|||
HOSPICE|3.00|7800|Z0500B|Date of signature verifying record completion|668|8|N|x| | | | | | |x|x||0|||
HOSPICE|3.00|2650|A0550|Patient Zip|676|11|N|x||||||||||0|||
HOSPICE|3.00|3715|A1400B|Payor: Medicare (managed care/Part C/Mcr Advant.)|688|1|N|x||||||||||0|||
HOSPICE|3.00|3720|A1400C|Payor: Medicaid (FFS)|689|1|N|x||||||||||0|||
HOSPICE|3.00|3725|A1400D|Payor: Medicaid (managed care)|690|1|N|x||||||||||0|||
HOSPICE|3.00|3730|A1400G|Payor: Other Government|691|1|N|x||||||||||0|||
HOSPICE|3.00|3735|A1400H|Payor: Private insurance/Medigap|692|1|N|x||||||||||0|||
HOSPICE|3.00|3740|A1400I|Payor: Private managed care|693|1|N|x||||||||||0|||
HOSPICE|3.00|3745|A1400J|Payor: Self-pay|694|1|N|x||||||||||0|||
HOSPICE|3.00|3750|A1400K|Payor: No payor source|695|1|N|x||||||||||0|||
HOSPICE|3.00|3755|A1400X|Payor: Unknown|696|1|N|x||||||||||0|||
HOSPICE|3.00|3760|A1400Y|Payor: Other|697|1|N|x||||||||||0|||
HOSPICE|3.00|3710|A1400A|Payor: Medicare (FFS)|687|1|N|x||||||||||0|||
HOSPICE|3.00|5250|J0905|Is pain an active problem for the patient?|698|1|N|x|||||||||||||
HOSPICE|1.00|100|ITM_SET_SYS_CD|Item set system code|1|10|Y|x| | | | | | |x|x||0||HOSPICE|
HOSPICE|1.00|200|ITM_SBST_CD|Item subset code|11|3|N|x| | | | | | |x|x||0||HA|
HOSPICE|1.00|300|ITM_SET_VRSN_CD|Item set version code|14|10|Y|x| | | | | | |x|x||0||1.00|
HOSPICE|1.00|400|SPEC_VRSN_CD|Specifications version code|24|10|Y|x| | | | | | |x|x||0||1.00|
HOSPICE|1.00|550|CRCTN_NUM|Correction number|34|2|Y|x| | | | | | |x|x||0||00|
HOSPICE|1.00|600|STATE_CD|Provider's state postal code|36|2|Y|x| | | | | | |x|x|Adm_Entity|0|State||
HOSPICE|1.00|700|FAC_ID|Assigned provider submission ID|38|16|Y|x| | | | | | |x|x|Adm_Entity|0|Taxonomy_Code||
HOSPICE|1.00|800|SFTWR_VNDR_ID|Software vendor federal employer tax ID|54|9|Y|x| | | | | | |x|x||0||270020344|
HOSPICE|1.00|900|SFTWR_VNDR_NAME|Software vendor company name|63|30|Y|x| | | | | | |x|x||0||Homecare Accounting Solutions LLC|
HOSPICE|1.00|1000|SFTWR_VNDR_EMAIL_ADR|Software vendor email address|93|50|Y|x| | | | | | |x|x||0||support@has-software.com|
HOSPICE|1.00|1100|SFTWR_PROD_NAME|Software product name|143|50|Y|x| | | | | | |x|x||0||HomeCare Billing Solutions|
HOSPICE|1.00|1200|SFTWR_PROD_VRSN_CD|Software product version code|193|20|Y|x| | | | | | |x|x||0||1.2.7.30|
HOSPICE|1.00|1500|A0050|Type of record|413|1|N|x| | | | | | |x|x||0||1|
HOSPICE|1.00|1600|A0100A|Facility National Provider Identifier (NPI)|414|10|Y|x| | | | | | |x| ||0|||
HOSPICE|1.00|1700|A0100B|Facility CMS Certification Number (CCN)|424|12|Y|x| | | | | | |x| ||0|||
HOSPICE|1.00|1800|A0205|Site of service at admission|436|2|N|x| | | | | | | | ||0|||
HOSPICE|1.00|1900|A0220|Admission date|438|8|N|x| | | | | | |x|x||0|||
HOSPICE|1.00|2000|A0245|Date initial nursing assessment initiated|446|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|2100|A0250|Reason for record|454|2|N|x| | | | | | |x|x||0|||
HOSPICE|1.00|2200|A0270|Discharge date|456|8|N| | | | | | | |x|x||0|||
HOSPICE|1.00|2300|A0500A|Patient first name|464|12|Y|x| | | | | | |x|x|Pat_Master|1|Name_First||
HOSPICE|1.00|2400|A0500B|Patient middle initial|476|1|Y|x| | | | | | |x| |Pat_Master|1|Name_Middle|^|
HOSPICE|1.00|2500|A0500C|Patient last name|477|18|Y|x| | | | | | |x|x|Pat_Master|1|Name_Last||
HOSPICE|1.00|2600|A0500D|Patient name suffix|495|3|Y|x| | | | | | |x| |Pat_Master|1|Name_Suffix|^|
HOSPICE|1.00|2700|A0600A|Social Security Number|498|9|Y|x| | | | | | |x|x|Pat_Master|1|Soc_Sec_No|^|
HOSPICE|1.00|2800|A0600B|Patient Medicare/railroad insurance number|507|12|Y|x| | | | | | |x| ||0||^|
HOSPICE|1.00|2900|A0700|Patient Medicaid number|519|14|Y|x| | | | | | |x| ||0|||
HOSPICE|1.00|3000|A0800|Gender|533|1|Y|x| | | | | | |x|x||0|||
HOSPICE|1.00|3100|A0900|Birthdate|534|8|Y|x| | | | | | |x|x||0|||
HOSPICE|1.00|3200|A1000A|Ethnicity: American Indian or Alaska Native|542|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3300|A1000B|Ethnicity: Asian|543|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3400|A1000C|Ethnicity: Black or African American|544|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3500|A1000D|Ethnicity: Hispanic or Latino|545|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3600|A1000E|Ethnicity: Native Hawaiian/Pacific Islander|546|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3700|A1000F|Ethnicity: White|547|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3800|A1802|Admitted from|548|2|N|x| | | | | | | | ||0|||
HOSPICE|1.00|3900|A2115|Reason for discharge|550|2|N| | | | | | | |x| ||0|||
HOSPICE|1.00|4000|F2000A|Was patient asked about CPR|552|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4100|F2000B|Date asked about CPR|553|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4200|F2100A|Was patient asked about treatments other than CPR|561|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4300|F2100B|Date asked about treatment other than CPR|562|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4400|F2200A|Was patient asked about hospitalization|570|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4500|F2200B|Date asked about hospitalization|571|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4600|F3000A|Was patient asked spiritual/existential concerns|579|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4700|F3000B|Date asked about spiritual/existential concerns|580|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|4800|I0010|Principal diagnosis|588|2|Y|x| | | | | | | | ||0|||
HOSPICE|1.00|4900|J0900A|Was patient screened for pain|590|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5000|J0900B|Date of first screening for pain|591|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5100|J0900C|Patient's pain severity was|599|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5200|J0900D|Type of standardized pain tool used|600|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5300|J0910A|Was comprehensive pain assessment done|601|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5400|J0910B|Date of comprehensive pain assessment|602|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5500|J0910C1|Pain asmt included: location|610|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5600|J0910C2|Pain asmt included: severity|611|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5700|J0910C3|Pain asmt included: character|612|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5800|J0910C4|Pain asmt included: duration|613|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|5900|J0910C5|Pain asmt included: frequency|614|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6000|J0910C6|Pain asmt included: what relieves/worsens|615|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6100|J0910C7|Pain asmt included: effect function/quality life|616|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6200|J0910C9|Pain asmt included: none of the above|617|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6300|J2030A|Was patient screened for shortness of breath|618|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6400|J2030B|Date of first screening for shortness of breath|619|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6500|J2030C|Did screening indicate pt had shortness of breath|627|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6600|J2040A|Was treatment for shortness of breath initiated|628|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6700|J2040B|Date treatment for shortness of breath initiated|629|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6800|J2040C1|Type(s) treat for shortness of breath: opioids|637|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|6900|J2040C2|Type(s) treat for shortness of breath: other med|638|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7000|J2040C3|Type(s) treat for shortness of breath: oxygen|639|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7100|J2040C4|Type(s) treat for shortness of breath: non-med|640|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7200|N0500A|Was scheduled opioid initiated or continued|641|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7300|N0500B|Date scheduled opioid initiated or continued|642|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7400|N0510A|Was PRN opioid initiated or continued|650|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7500|N0510B|Date PRN opioid initiated or continued|651|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7600|N0520A|Was bowel regimen initiated or continued|659|1|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7700|N0520B|Date bowel regimen initiated or continued|660|8|N|x| | | | | | | | ||0|||
HOSPICE|1.00|7800|Z0500B|Date of signature verifying record completion|668|8|N|x| | | | | | |x|x||0|||
OASIS|2.10|50|ASMT_SYS_CD|Assessment system code|1|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|100|TRANS_TYPE_CD|Transaction type code|11|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|150|ITM_SBST_CD|Item subset code|12|3||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|200|ITM_SET_VRSN_CD|Item set version code|15|10||x|x|x|x|x|x|x|x|x||23|||
OASIS|2.10|250|SPEC_VRSN_CD|Specifications version code|25|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|300|CORRECTION_NUM|Correction number|35|2||x|x|x|x|x|x|x|x|x||13|2||
OASIS|2.10|350|STATE_CD|Agency's state postal code|37|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|400|HHA_AGENCY_ID|Assigned agency submission ID|39|16||x|x|x|x|x|x|x|x|x||54|16||
OASIS|2.10|450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|500|SFW_ID|Software vendor federal employer tax ID|65|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|550|SFW_NAME|Software vendor company name|74|30||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|600|SFW_EMAIL_ADR|Software vendor email address|104|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|650|SFW_PROD_NAME|Software product name|154|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|700|SFW_PROD_VRSN_CD|Software product version code|204|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|750|ACY_DOC_CD|Document ID code (agency use)|224|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.10|800|SUBM_HIPPS_CODE|HIPPS group code: submitted|244|5||x|x|x|x| | | | | ||1081|||
OASIS|2.10|850|SUBM_HIPPS_VERSION|HIPPS version code: submitted|249|5||x|x|x|x| | | | | ||1091|||
OASIS|2.10|1500|M0010_CCN|Facility CMS certification number (CCN)|254|6||x|x|x|x|x|x|x|x| ||124|6||
OASIS|2.10|1600|M0014_BRANCH_STATE|Branch state|260|2||x|x|x|x|x|x|x|x| ||145|2||
OASIS|2.10|1700|M0016_BRANCH_ID|Branch ID|262|10||x|x|x|x|x|x|x|x| ||147|10||
OASIS|2.10|1800|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10||x|x|x|x|x|x|x|x| ||289|10||
OASIS|2.10|1900|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1||x|x|x|x|x|x|x|x| ||299|1||
OASIS|2.10|2000|M0020_PAT_ID|Patient ID number|283|20||x|x|x|x|x|x|x|x| ||157|||
OASIS|2.10|2100|M0030_START_CARE_DT|Start of care date|303|8||x|x|x|x|x|x|x|x|x||177|||
OASIS|2.10|2200|M0032_ROC_DT|Resumption of care date|311|8||x|x|x|x|x|x|x|x|x||185|||
OASIS|2.10|2300|M0032_ROC_DT_NA|No resumption of care date|319|1||x|x|x|x|x|x|x|x|x||193|||
OASIS|2.10|2400|M0040_PAT_FNAME|Patient's first name|320|12||x|x|x|x|x|x|x|x|x||194|||
OASIS|2.10|2500|M0040_PAT_MI|Patient's middle initial|332|1||x|x|x|x|x|x|x|x| ||206|||
OASIS|2.10|2600|M0040_PAT_LNAME|Patient's last name|333|18||x|x|x|x|x|x|x|x|x||207|||
OASIS|2.10|2700|M0040_PAT_SUFFIX|Patient's suffix|351|3||x|x|x|x|x|x|x|x| ||225|||
OASIS|2.10|2800|M0050_PAT_ST|Patient state of residence|354|2||x|x|x|x|x|x|x|x| ||228|||
OASIS|2.10|2900|M0060_PAT_ZIP|Patient zip code|356|11||x|x|x|x|x|x|x|x| ||230|||
OASIS|2.10|3000|M0063_MEDICARE_NUM|Medicare number including suffix|367|12||x|x|x|x|x|x|x|x| ||241|||
OASIS|2.10|3100|M0063_MEDICARE_NA|No Medicare number|379|1||x|x|x|x|x|x|x|x| ||253|||
OASIS|2.10|3200|M0064_SSN|Patient's Social Security number|380|9||x|x|x|x|x|x|x|x|x||254|||
OASIS|2.10|3300|M0064_SSN_UK|No Social Security number|389|1||x|x|x|x|x|x|x|x|x||263|||
OASIS|2.10|3400|M0065_MEDICAID_NUM|Medicaid number|390|14||x|x|x|x|x|x|x|x| ||264|||
OASIS|2.10|3500|M0065_MEDICAID_NA|No Medicaid number|404|1||x|x|x|x|x|x|x|x| ||278|||
OASIS|2.10|3600|M0066_PAT_BIRTH_DT|Date of birth|405|8||x|x|x|x|x|x|x|x|x||279|||
OASIS|2.10|3700|M0069_PAT_GENDER|Gender|413|1||x|x|x|x|x|x|x|x|x||288|||
OASIS|2.10|3800|M0140_ETHNIC_AI_AN|Ethnicity: American Indian or Alaska Native|414|1||x|x| | | | | | | ||312|||
OASIS|2.10|3900|M0140_ETHNIC_ASIAN|Ethnicity: Asian|415|1||x|x| | | | | | | ||313|||
OASIS|2.10|4000|M0140_ETHNIC_BLACK|Ethnicity: Black or African American|416|1||x|x| | | | | | | ||314|||
OASIS|2.10|4100|M0140_ETHNIC_HISP|Ethnicity: Hispanic or Latino|417|1||x|x| | | | | | | ||315|||
OASIS|2.10|4200|M0140_ETHNIC_NH_PI|Ethnicity: Native Hawaiian/Pacific Islander|418|1||x|x| | | | | | | ||316|||
OASIS|2.10|4300|M0140_ETHNIC_WHITE|Ethnicity: White|419|1||x|x| | | | | | | ||317|||
OASIS|2.10|4400|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1||x|x|x|x|x|x|x|x| ||319|||
OASIS|2.10|4500|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1||x|x|x|x|x|x|x|x| ||320|||
OASIS|2.10|4600|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1||x|x|x|x|x|x|x|x| ||321|||
OASIS|2.10|4700|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1||x|x|x|x|x|x|x|x| ||322|||
OASIS|2.10|4800|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1||x|x|x|x|x|x|x|x| ||323|||
OASIS|2.10|4900|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1||x|x|x|x|x|x|x|x| ||324|||
OASIS|2.10|5000|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1||x|x|x|x|x|x|x|x| ||325|||
OASIS|2.10|5100|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1||x|x|x|x|x|x|x|x| ||326|||
OASIS|2.10|5200|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1||x|x|x|x|x|x|x|x| ||327|||
OASIS|2.10|5300|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1||x|x|x|x|x|x|x|x| ||328|||
OASIS|2.10|5400|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1||x|x|x|x|x|x|x|x| ||329|||
OASIS|2.10|5500|M0150_CPAY_OTHER|Payment sources: other|431|1||x|x|x|x|x|x|x|x| ||330|||
OASIS|2.10|5600|M0150_CPAY_UK|Payment sources: unknown|432|1||x|x| | | | | | | ||331|||
OASIS|2.10|5700|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2||x|x|x|x|x|x|x|x| ||300|||
OASIS|2.10|5800|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8||x|x|x|x|x|x|x|x|x||302|||
OASIS|2.10|5900|M0100_ASSMT_REASON|Reason for assessment|443|2||x|x|x|x|x|x|x|x|x||310|||
OASIS|2.10|6000|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8||x|x| | | | | | | ||870|||
OASIS|2.10|6100|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1||x|x| | | | | | | ||878|||
OASIS|2.10|6200|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8||x|x| | | | | | | ||879|||
OASIS|2.10|6300|M0110_EPISODE_TIMING|Episode timing|462|2||x|x|x|x| | | | | ||779|||
OASIS|2.10|6400|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1||x|x| | | | | | | ||887|||
OASIS|2.10|6500|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1||x|x| | | | | | | ||751|||
OASIS|2.10|6600|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1||x|x| | | | | | | ||888|||
OASIS|2.10|6700|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1||x|x| | | | | | | ||889|||
OASIS|2.10|6800|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1||x|x| | | | | | | ||890|||
OASIS|2.10|6900|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1||x|x| | | | | | | ||891|||
OASIS|2.10|7000|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1||x|x| | | | | | | ||892|||
OASIS|2.10|7100|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1||x|x| | | | | | | ||754|||
OASIS|2.10|7200|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8||x|x| | | | | | | ||343|||
OASIS|2.10|7300|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1||x|x| | | | | | | ||351|||
OASIS|2.10|7400|M1010_14_DAY_INP1_ICD|Inpatient stay within last 14 days: ICD code 1|481|7||x|x| | | | | | | ||352|||
OASIS|2.10|7500|M1010_14_DAY_INP2_ICD|Inpatient stay within last 14 days: ICD code 2|488|7||x|x| | | | | | | ||359|||
OASIS|2.10|7600|M1010_14_DAY_INP3_ICD|Inpatient stay within last 14 days: ICD code 3|495|7||x|x| | | | | | | ||893|||
OASIS|2.10|7700|M1010_14_DAY_INP4_ICD|Inpatient stay within last 14 days: ICD code 4|502|7||x|x| | | | | | | ||900|||
OASIS|2.10|7800|M1010_14_DAY_INP5_ICD|Inpatient stay within last 14 days: ICD code 5|509|7||x|x| | | | | | | ||907|||
OASIS|2.10|7900|M1010_14_DAY_INP6_ICD|Inpatient stay within last 14 days: ICD code 6|516|7||x|x| | | | | | | ||914|||
OASIS|2.10|8000|M1012_INP_PRCDR1_ICD|Inpatient ICD procedure1 code|523|7||x|x| | | | | | | ||921|||
OASIS|2.10|8100|M1012_INP_PRCDR2_ICD|Inpatient ICD procedure2 code|530|7||x|x| | | | | | | ||928|||
OASIS|2.10|8200|M1012_INP_PRCDR3_ICD|Inpatient ICD procedure3 code|537|7||x|x| | | | | | | ||935|||
OASIS|2.10|8300|M1012_INP_PRCDR4_ICD|Inpatient ICD procedure4 code|544|7||x|x| | | | | | | ||942|||
OASIS|2.10|8400|M1012_INP_NA_ICD|Inpatient ICD procedure code - NA|551|1||x|x| | | | | | | ||949|||
OASIS|2.10|8600|M1012_INP_UK_ICD|Inpatient ICD procedure code - UK|552|1||x|x| | | | | | | ||950|||
OASIS|2.10|8700|M1016_CHGREG_ICD1|Regimen change in past 14 days: ICD code 1|553|7||x|x| | | | | | | ||367|||
OASIS|2.10|8800|M1016_CHGREG_ICD2|Regimen change in past 14 days: ICD code 2|560|7||x|x| | | | | | | ||374|||
OASIS|2.10|8900|M1016_CHGREG_ICD3|Regimen change in past 14 days: ICD code 3|567|7||x|x| | | | | | | ||381|||
OASIS|2.10|9000|M1016_CHGREG_ICD4|Regimen change in past 14 days: ICD code 4|574|7||x|x| | | | | | | ||388|||
OASIS|2.10|9100|M1016_CHGREG_ICD5|Regimen change in past 14 days: ICD code 5|581|7||x|x| | | | | | | ||951|||
OASIS|2.10|9200|M1016_CHGREG_ICD6|Regimen change in past 14 days: ICD code 6|588|7||x|x| | | | | | | ||958|||
OASIS|2.10|9300|M1016_CHGREG_ICD_NA|Regimen change in past 14 days: not applicable|595|1||x|x| | | | | | | ||965|||
OASIS|2.10|9400|M1018_PRIOR_UR_INCON|Prior condition: urinary incontinence|596|1||x|x| | | | | | | ||395|||
OASIS|2.10|9500|M1018_PRIOR_CATH|Prior condition: indwelling/suprapubic catheter|597|1||x|x| | | | | | | ||396|||
OASIS|2.10|9600|M1018_PRIOR_INTRACT_PAIN|Prior condition: intractable pain|598|1||x|x| | | | | | | ||397|||
OASIS|2.10|9700|M1018_PRIOR_IMPR_DECSN|Prior condition: impaired decision-making|599|1||x|x| | | | | | | ||398|||
OASIS|2.10|9800|M1018_PRIOR_DISRUPTIVE|Prior condition: disruptive/inappropriate behav|600|1||x|x| | | | | | | ||399|||
OASIS|2.10|9900|M1018_PRIOR_MEM_LOSS|Prior condition: memory loss  supervision required|601|1||x|x| | | | | | | ||400|||
OASIS|2.10|10000|M1018_PRIOR_NONE|Prior condition: none of the above|602|1||x|x| | | | | | | ||401|||
OASIS|2.10|10100|M1018_PRIOR_NOCHG_14D|Prior condition: no inpt disch/no change regimen|603|1||x|x| | | | | | | ||402|||
OASIS|2.10|10200|M1018_PRIOR_UNKNOWN|Prior condition: unknown|604|1||x|x| | | | | | | ||403|||
OASIS|2.10|10300|M1020_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|605|7||x|x|x|x| | | | | ||404|||
OASIS|2.10|10400|M1020_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|612|2||x|x|x|x| | | | | ||411|||
OASIS|2.10|10500|M1022_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|614|7||x|x|x|x| | | | | ||413|||
OASIS|2.10|10600|M1022_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|621|2||x|x|x|x| | | | | ||420|||
OASIS|2.10|10700|M1022_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|623|7||x|x|x|x| | | | | ||422|||
OASIS|2.10|10800|M1022_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|630|2||x|x|x|x| | | | | ||429|||
OASIS|2.10|10900|M1022_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|632|7||x|x|x|x| | | | | ||431|||
OASIS|2.10|11000|M1022_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|639|2||x|x|x|x| | | | | ||438|||
OASIS|2.10|11100|M1022_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|641|7||x|x|x|x| | | | | ||440|||
OASIS|2.10|11200|M1022_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|648|2||x|x|x|x| | | | | ||447|||
OASIS|2.10|11300|M1022_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|650|7||x|x|x|x| | | | | ||449|||
OASIS|2.10|11400|M1022_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|657|2||x|x|x|x| | | | | ||456|||
OASIS|2.10|11500|M1024_PMT_DIAG_ICD_A3|Case mix diagnosis: primary  column 3|659|7||x|x|x|x| | | | | ||781|||
OASIS|2.10|11600|M1024_PMT_DIAG_ICD_B3|Case mix diagnosis: first secondary  column 3|666|7||x|x|x|x| | | | | ||788|||
OASIS|2.10|11700|M1024_PMT_DIAG_ICD_C3|Case mix diagnosis: second secondary  column 3|673|7||x|x|x|x| | | | | ||795|||
OASIS|2.10|11800|M1024_PMT_DIAG_ICD_D3|Case mix diagnosis: third secondary  column 3|680|7||x|x|x|x| | | | | ||802|||
OASIS|2.10|11900|M1024_PMT_DIAG_ICD_E3|Case mix diagnosis: fourth secondary  column 3|687|7||x|x|x|x| | | | | ||809|||
OASIS|2.10|12000|M1024_PMT_DIAG_ICD_F3|Case mix diagnosis: fifth secondary  column 3|694|7||x|x|x|x| | | | | ||816|||
OASIS|2.10|12100|M1024_PMT_DIAG_ICD_A4|Case mix diagnosis: primary  column 4|701|7||x|x|x|x| | | | | ||823|||
OASIS|2.10|12200|M1024_PMT_DIAG_ICD_B4|Case mix diagnosis: first secondary  column 4|708|7||x|x|x|x| | | | | ||830|||
OASIS|2.10|12300|M1024_PMT_DIAG_ICD_C4|Case mix diagnosis: second secondary  column 4|715|7||x|x|x|x| | | | | ||837|||
OASIS|2.10|12400|M1024_PMT_DIAG_ICD_D4|Case mix diagnosis: third secondary  column 4|722|7||x|x|x|x| | | | | ||844|||
OASIS|2.10|12500|M1024_PMT_DIAG_ICD_E4|Case mix diagnosis: fourth secondary  column 4|729|7||x|x|x|x| | | | | ||851|||
OASIS|2.10|12600|M1024_PMT_DIAG_ICD_F4|Case mix diagnosis: fifth secondary  column 4|736|7||x|x|x|x| | | | | ||858|||
OASIS|2.10|12700|M1030_THH_IV_INFUSION|Therapies received at home: intravenous  infusion|743|1||x|x|x|x| | | | | ||458|||
OASIS|2.10|12800|M1030_THH_PAR_NUTRITION|Therapies received at home: parenteral nutrition|744|1||x|x|x|x| | | | | ||459|||
OASIS|2.10|12900|M1030_THH_ENT_NUTRITION|Therapies received at home: enteral nutrition|745|1||x|x|x|x| | | | | ||460|||
OASIS|2.10|13000|M1030_THH_NONE_ABOVE|Therapies received at home: none of the above|746|1||x|x|x|x| | | | | ||461|||
OASIS|2.10|13100|M1032_HOSP_RISK_RCNT_DCLN|Hosp risk: decline mental/emotional/behav status|747|1||x|x| | | | | | | ||966|||
OASIS|2.10|13200|M1032_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 12 months|748|1||x|x| | | | | | | ||967|||
OASIS|2.10|13300|M1032_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|749|1||x|x| | | | | | | ||968|||
OASIS|2.10|13400|M1032_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|750|1||x|x| | | | | | | ||969|||
OASIS|2.10|13500|M1032_HOSP_RISK_FRAILTY|Hosp risk: frailty indicators|751|1||x|x| | | | | | | ||970|||
OASIS|2.10|13600|M1032_HOSP_RISK_OTHR|Hosp risk: other|752|1||x|x| | | | | | | ||971|||
OASIS|2.10|13700|M1032_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|753|1||x|x| | | | | | | ||972|||
OASIS|2.10|13800|M1034_PTNT_OVRAL_STUS|Patient's overall status|754|2||x|x| | | | | | | ||973|||
OASIS|2.10|13900|M1036_RSK_SMOKING|High risk factor: smoking|756|1||x|x| | | | | | | ||468|||
OASIS|2.10|14000|M1036_RSK_OBESITY|High risk factor: obesity|757|1||x|x| | | | | | | ||469|||
OASIS|2.10|14100|M1036_RSK_ALCOHOLISM|High risk factor: alcoholism|758|1||x|x| | | | | | | ||470|||
OASIS|2.10|14200|M1036_RSK_DRUGS|High risk factor: drugs|759|1||x|x| | | | | | | ||471|||
OASIS|2.10|14300|M1036_RSK_NONE|High risk factor: none of the above|760|1||x|x| | | | | | | ||472|||
OASIS|2.10|14400|M1036_RSK_UNKNOWN|High risk factor: unknown|761|1||x|x| | | | | | | ||473|||
OASIS|2.10|14500|M1040_INFLNZ_RCVD_AGNCY|Was influenza vaccine received|762|2|| | | | |x|x| |x| ||975|||
OASIS|2.10|14600|M1045_INFLNZ_RSN_NOT_RCVD|If influenza vaccine not received  state reason|764|2|| | | | |x|x| |x| ||977|||
OASIS|2.10|14700|M1050_PPV_RCVD_AGNCY|Was pneumococcal vaccine received|766|1|| | | | |x|x| |x| ||979|||
OASIS|2.10|14800|M1055_PPV_RSN_NOT_RCVD_AGNCY|If pneumococcal vacc not received  state reason|767|2|| | | | |x|x| |x| ||980|||
OASIS|2.10|14900|M1100_PTNT_LVG_STUTN|Patient living situation|769|2||x|x| | | | | | | ||982|||
OASIS|2.10|15000|M1200_VISION|Sensory status: vision|771|2||x|x|x|x| | | | | ||529|||
OASIS|2.10|15100|M1210_HEARG_ABLTY|Ability to hear|773|2||x|x| | | | | | | ||984|||
OASIS|2.10|15200|M1220_UNDRSTG_VERBAL_CNTNT|Understanding verbal content in patient's language|775|2||x|x| | | | | | | ||986|||
OASIS|2.10|15300|M1230_SPEECH|Sensory status: speech|777|2||x|x| | | | | |x| ||533|||
OASIS|2.10|15400|M1240_FRML_PAIN_ASMT|Has patient had a formal pain assessment|779|2||x|x| | | | | | | ||988|||
OASIS|2.10|15500|M1242_PAIN_FREQ_ACTVTY_MVMT|Freq of pain interfering with pt activity/movement|781|2||x|x|x|x| | | |x| ||990|||
OASIS|2.10|15600|M1300_PRSR_ULCR_RISK_ASMT|Was patient assessed for risk of developing PUs|783|2||x|x| | | | | | | ||992|||
OASIS|2.10|15700|M1302_RISK_OF_PRSR_ULCR|Does this patient have a risk of developing PUs|785|1||x|x| | | | | | | ||994|||
OASIS|2.10|15800|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU at stage 2 or higher|786|1||x|x|x|x| | | |x| ||995|||
OASIS|2.10|16000|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2|| | | | | | | |x| ||1004|||
OASIS|2.10|16010|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8|| | | | | | | |x| ||996|||
OASIS|2.10|16100|M1308_NBR_PRSULC_STG2|Number of stage 2 pressure ulcers|797|2||x|x|x|x| | | |x| ||1006|||
OASIS|2.10|16200|M1308_NBR_STG2_AT_SOC_ROC|Number of stage 2 pressure ulcers at SOC/ROC|799|2|| | |x|x| | | |x| ||1008|||
OASIS|2.10|16300|M1308_NBR_PRSULC_STG3|Number of stage 3 pressure ulcers|801|2||x|x|x|x| | | |x| ||1010|||
OASIS|2.10|16400|M1308_NBR_STG3_AT_SOC_ROC|Number of stage 3 pressure ulcers at SOC/ROC|803|2|| | |x|x| | | |x| ||1012|||
OASIS|2.10|16500|M1308_NBR_PRSULC_STG4|Number of stage 4 pressure ulcers|805|2||x|x|x|x| | | |x| ||1014|||
OASIS|2.10|16600|M1308_NBR_STG4_AT_SOC_ROC|Number of stage 4 pressure ulcers at SOC/ROC|807|2|| | |x|x| | | |x| ||1016|||
OASIS|2.10|16700|M1308_NSTG_DRSG|Unstageable: non-removable dressing/device|809|2||x|x|x|x| | | |x| ||1018|||
OASIS|2.10|16800|M1308_NSTG_DRSG_SOC_ROC|Unstageable: non-removable dressing/device-SOC/ROC|811|2|| | |x|x| | | |x| ||1020|||
OASIS|2.10|16900|M1308_NSTG_CVRG|Unstageable: coverage by slough or eschar|813|2||x|x|x|x| | | |x| ||1022|||
OASIS|2.10|17000|M1308_NSTG_CVRG_SOC_ROC|Unstageable: coverage by slough or eschar-SOC/ROC|815|2|| | |x|x| | | |x| ||1024|||
OASIS|2.10|17100|M1308_NSTG_DEEP_TISUE|Unstageable: suspect deep tissue injury|817|2||x|x|x|x| | | |x| ||1026|||
OASIS|2.10|17200|M1308_NSTG_DEEP_TISUE_SOC_ROC|Unstageable: suspect deep tissue injury-SOC/ROC|819|2|| | |x|x| | | |x| ||1028|||
OASIS|2.10|17300|M1310_PRSR_ULCR_LNGTH|Length (cm) of stage 3 or 4 PU with largest area|821|4||x|x| | | | | |x| ||1030|||
OASIS|2.10|17400|M1312_PRSR_ULCR_WDTH|Width (cm) of stage 3 or 4 PU with largest area|825|4||x|x| | | | | |x| ||1034|||
OASIS|2.10|17500|M1314_PRSR_ULCR_DEPTH|Depth (cm) of stage 3 or 4 PU with largest area|829|4||x|x| | | | | |x| ||1038|||
OASIS|2.10|17600|M1320_STUS_PRBLM_PRSR_ULCR|Status of most problematic pressure ulcer|833|2||x|x| | | | | |x| ||1042|||
OASIS|2.10|17700|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure ulcers|835|2||x|x|x|x| | | |x| ||540|||
OASIS|2.10|17800|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer|837|2||x|x|x|x| | | |x| ||549|||
OASIS|2.10|17900|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2||x|x|x|x| | | |x| ||1044|||
OASIS|2.10|18000|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2||x|x|x|x| | | |x| ||1046|||
OASIS|2.10|18100|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2||x|x|x|x| | | |x| ||1048|||
OASIS|2.10|18200|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2||x|x|x|x| | | |x| ||1050|||
OASIS|2.10|18300|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2||x|x|x|x| | | |x| ||1052|||
OASIS|2.10|18400|M1350_LESION_OPEN_WND|Has skin lesion or open wound|849|1||x|x|x|x| | | |x| ||1054|||
OASIS|2.10|18500|M1400_WHEN_DYSPNEIC|When dyspneic|850|2||x|x|x|x| | | |x| ||565|||
OASIS|2.10|18600|M1410_RESPTX_OXYGEN|Respiratory treatments: oxygen|852|1||x|x| | | | | |x| ||567|||
OASIS|2.10|18700|M1410_RESPTX_VENTILATOR|Respiratory treatments: ventilator|853|1||x|x| | | | | |x| ||568|||
OASIS|2.10|18800|M1410_RESPTX_AIRPRESS|Respiratory treatments: airway pressure|854|1||x|x| | | | | |x| ||569|||
OASIS|2.10|18900|M1410_RESPTX_NONE|Respiratory treatments: none of the above|855|1||x|x| | | | | |x| ||570|||
OASIS|2.10|19000|M1500_SYMTM_HRT_FAILR_PTNTS|Symptoms in heart failure patients|856|2|| | | | |x|x| |x| ||1055|||
OASIS|2.10|19100|M1510_HRT_FAILR_NO_ACTN|Heart failure follow up:  no action|858|1|| | | | |x|x| |x| ||1057|||
OASIS|2.10|19200|M1510_HRT_FAILR_PHYSN_CNTCT|Heart failure follow up:  physician contacted|859|1|| | | | |x|x| |x| ||1058|||
OASIS|2.10|19300|M1510_HRT_FAILR_ER_TRTMT|Heart failure follow up:  ER treatment advised|860|1|| | | | |x|x| |x| ||1059|||
OASIS|2.10|19400|M1510_HRT_FAILR_PHYSN_TRTMT|Heart failure follow up:  phys-ordered treatmnt|861|1|| | | | |x|x| |x| ||1060|||
OASIS|2.10|19500|M1510_HRT_FAILR_CLNCL_INTRVTN|Heart failure follow up: pt educ/other clinical|862|1|| | | | |x|x| |x| ||1061|||
OASIS|2.10|19600|M1510_HRT_FAILR_CARE_PLAN_CHG|Heart failure follow up: change in care plan|863|1|| | | | |x|x| |x| ||1062|||
OASIS|2.10|19700|M1600_UTI|Treated for urinary tract infection past 14 days|864|2||x|x| | | | | |x| ||571|||
OASIS|2.10|19800|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2||x|x|x|x| | | |x| ||573|||
OASIS|2.10|19900|M1615_INCNTNT_TIMING|When urinary incontinence occurs|868|2||x|x| | | | | |x| ||1063|||
OASIS|2.10|20000|M1620_BWL_INCONT|Bowel incontinence frequency|870|2||x|x|x|x| | | |x| ||577|||
OASIS|2.10|20100|M1630_OSTOMY|Ostomy for bowel elimination|872|2||x|x|x|x| | | | | ||579|||
OASIS|2.10|20200|M1700_COG_FUNCTION|Cognitive functioning|874|2||x|x| | | | | |x| ||581|||
OASIS|2.10|20300|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2||x|x| | | | | |x| ||583|||
OASIS|2.10|20400|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2||x|x| | | | | |x| ||585|||
OASIS|2.10|20500|M1730_STDZ_DPRSN_SCRNG|Has the patient been screened for depression|880|2||x|x| | | | | | | ||1065|||
OASIS|2.10|20600|M1730_PHQ2_LACK_INTRST|PHQ2: little interest or pleasure in doing things|882|2||x|x| | | | | | | ||1067|||
OASIS|2.10|20700|M1730_PHQ2_DPRSN|PHQ2: feeling down  depressed or hopeless|884|2||x|x| | | | | | | ||1069|||
OASIS|2.10|20800|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1||x|x| | | | | |x| ||600|||
OASIS|2.10|20900|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1||x|x| | | | | |x| ||601|||
OASIS|2.10|21000|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1||x|x| | | | | |x| ||602|||
OASIS|2.10|21100|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1||x|x| | | | | |x| ||603|||
OASIS|2.10|21200|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1||x|x| | | | | |x| ||604|||
OASIS|2.10|21300|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1||x|x| | | | | |x| ||605|||
OASIS|2.10|21400|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1||x|x| | | | | |x| ||606|||
OASIS|2.10|21500|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2||x|x| | | | | |x| ||607|||
OASIS|2.10|21600|M1750_REC_PSYCH_NURS|Receives psychiatric nursing|895|1||x|x| | | | | | | ||609|||
OASIS|2.10|21700|M1800_CRNT_GROOMING|Current: grooming|896|2||x|x| | | | | |x| ||612|||
OASIS|2.10|21800|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2||x|x|x|x| | | |x| ||616|||
OASIS|2.10|21900|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2||x|x|x|x| | | |x| ||620|||
OASIS|2.10|22000|M1830_CRNT_BATHG|Current: bathing|902|2||x|x|x|x| | | |x| ||1071|||
OASIS|2.10|22100|M1840_CRNT_TOILTG|Current: toileting|904|2||x|x|x|x| | | |x| ||1073|||
OASIS|2.10|22200|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2||x|x| | | | | |x| ||1075|||
OASIS|2.10|22300|M1850_CRNT_TRNSFRNG|Current: transferring|908|2||x|x|x|x| | | |x| ||1077|||
OASIS|2.10|22400|M1860_CRNT_AMBLTN|Current: ambulation|910|2||x|x|x|x| | | |x| ||1079|||
OASIS|2.10|22500|M1870_CRNT_FEEDING|Current: feeding|912|2||x|x| | | | | |x| ||640|||
OASIS|2.10|22600|M1880_CRNT_PREP_LT_MEALS|Current: prepare light meals|914|2||x|x| | | | | |x| ||644|||
OASIS|2.10|22700|M1890_CRNT_PHONE_USE|Current: telephone use|916|2||x|x| | | | | |x| ||664|||
OASIS|2.10|22800|M1900_PRIOR_ADLIADL_SELF|Prior functioning ADL/IADL: self-care|918|2||x|x| | | | | | | ||1096|||
OASIS|2.10|22900|M1900_PRIOR_ADLIADL_AMBLTN|Prior functioning ADL/IADL: ambulation|920|2||x|x| | | | | | | ||1098|||
OASIS|2.10|23000|M1900_PRIOR_ADLIADL_TRNSFR|Prior functioning ADL/IADL: transfer|922|2||x|x| | | | | | | ||1100|||
OASIS|2.10|23100|M1900_PRIOR_ADLIADL_HSEHOLD|Prior functioning ADL/IADL: household tasks|924|2||x|x| | | | | | | ||1102|||
OASIS|2.10|23200|M1910_MLT_FCTR_FALL_RISK_ASMT|Has patient had a multi-factor fall risk asmt|926|2||x|x| | | | | | | ||1104|||
OASIS|2.10|23300|M2000_DRUG_RGMN_RVW|Drug regimen review|928|2||x|x| | | | | | | ||1106|||
OASIS|2.10|23400|M2002_MDCTN_FLWP|Medication follow-up|930|1||x|x| | | | | | | ||1108|||
OASIS|2.10|23500|M2004_MDCTN_INTRVTN|Medication intervention|931|2|| | | | |x|x| |x| ||1109|||
OASIS|2.10|23600|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2||x|x| | | | | | | ||1111|||
OASIS|2.10|23700|M2015_DRUG_EDCTN_INTRVTN|Patient/caregiver drug education intervention|935|2|| | | | |x|x| |x| ||1113|||
OASIS|2.10|23800|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2||x|x| | | | | |x| ||1115|||
OASIS|2.10|23900|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2||x|x|x|x| | | |x| ||1117|||
OASIS|2.10|24000|M2040_PRIOR_MGMT_ORAL_MDCTN|Prior med mgmt: oral medications|941|2||x|x| | | | | | | ||1119|||
OASIS|2.10|24100|M2040_PRIOR_MGMT_INJCTN_MDCTN|Prior med mgmt: injectable medications|943|2||x|x| | | | | | | ||1121|||
OASIS|2.10|24200|M2100_CARE_TYPE_SRC_ADL|Care mgmt  types/sources: ADL|945|2||x|x| | | | | |x| ||1123|||
OASIS|2.10|24300|M2100_CARE_TYPE_SRC_IADL|Care mgmt  types/sources: IADL|947|2||x|x| | | | | |x| ||1125|||
OASIS|2.10|24400|M2100_CARE_TYPE_SRC_MDCTN|Care mgmt  types/sources: med admin|949|2||x|x| | | | | |x| ||1127|||
OASIS|2.10|24500|M2100_CARE_TYPE_SRC_PRCDR|Care mgmt  types/sources: med procs tx|951|2||x|x| | | | | |x| ||1129|||
OASIS|2.10|24600|M2100_CARE_TYPE_SRC_EQUIP|Care mgmt  types/sources: equipment|953|2||x|x| | | | | |x| ||1131|||
OASIS|2.10|24700|M2100_CARE_TYPE_SRC_SPRVSN|Care mgmt  types/sources: supervision and safety|955|2||x|x| | | | | |x| ||1133|||
OASIS|2.10|24800|M2100_CARE_TYPE_SRC_ADVCY|Care mgmt  types/sources: advocacy or facilitation|957|2||x|x| | | | | |x| ||1135|||
OASIS|2.10|24900|M2110_ADL_IADL_ASTNC_FREQ|How often recv non-HHA caregiver ADL/IADL assist|959|2||x|x| | | | | |x| ||1137|||
OASIS|2.10|25000|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3||x|x|x|x| | | | | ||865|||
OASIS|2.10|25100|M2200_THER_NEED_NA|Therapy need: not applicable|964|1||x|x|x|x| | | | | ||868|||
OASIS|2.10|25200|M2250_PLAN_SMRY_PTNT_SPECF|Plan of care synopsis: patient specific parameters|965|2||x|x| | | | | | | ||1139|||
OASIS|2.10|25300|M2250_PLAN_SMRY_DBTS_FT_CARE|Plan of care synopsis: diabetic foot care|967|2||x|x| | | | | | | ||1141|||
OASIS|2.10|25400|M2250_PLAN_SMRY_FALL_PRVNT|Plan of care synopsis: falls prevention|969|2||x|x| | | | | | | ||1143|||
OASIS|2.10|25500|M2250_PLAN_SMRY_DPRSN_INTRVTN|Plan of care synopsis: depression interventions|971|2||x|x| | | | | | | ||1145|||
OASIS|2.10|25600|M2250_PLAN_SMRY_PAIN_INTRVTN|Plan of care synopsis: pain interventions|973|2||x|x| | | | | | | ||1147|||
OASIS|2.10|25700|M2250_PLAN_SMRY_PRSULC_PRVNT|Plan of care synopsis: PU prevention|975|2||x|x| | | | | | | ||1149|||
OASIS|2.10|25800|M2250_PLAN_SMRY_PRSULC_TRTMT|Plan of care synopsis: PU moist treatment|977|2||x|x| | | | | | | ||1151|||
OASIS|2.10|25900|M2300_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since last OASIS|979|2|| | | | |x|x| |x| ||1153|||
OASIS|2.10|26000|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1|| | | | |x|x| |x| ||687|||
OASIS|2.10|26100|M2310_ECR_INJRY_BY_FALL|Emergent care reason: injury caused by fall|982|1|| | | | |x|x| |x| ||1155|||
OASIS|2.10|26200|M2310_ECR_RSPRTRY_INFCTN|Emergent care reason: respiratory infection|983|1|| | | | |x|x| |x| ||1156|||
OASIS|2.10|26300|M2310_ECR_RSPRTRY_OTHR|Emergent care reason: respiratory other|984|1|| | | | |x|x| |x| ||1157|||
OASIS|2.10|26400|M2310_ECR_HRT_FAILR|Emergent care reason: heart failure|985|1|| | | | |x|x| |x| ||1158|||
OASIS|2.10|26500|M2310_ECR_CRDC_DSRTHM|Emergent care reason: cardiac dysrhythmia|986|1|| | | | |x|x| |x| ||1159|||
OASIS|2.10|26600|M2310_ECR_MI_CHST_PAIN|Emergent care reason: myocard infarct/chest pain|987|1|| | | | |x|x| |x| ||1160|||
OASIS|2.10|26700|M2310_ECR_OTHR_HRT_DEASE|Emergent care reason: other heart disease|988|1|| | | | |x|x| |x| ||1161|||
OASIS|2.10|26800|M2310_ECR_STROKE_TIA|Emergent care reason: stroke (CVA) or TIA|989|1|| | | | |x|x| |x| ||1162|||
OASIS|2.10|26900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1|| | | | |x|x| |x| ||693|||
OASIS|2.10|27000|M2310_ECR_GI_PRBLM|Emergent care: GI bleed/obstruct/constip/impact|991|1|| | | | |x|x| |x| ||1163|||
OASIS|2.10|27100|M2310_ECR_DHYDRTN_MALNTR|Emergent care reason: dehydration  malnutrition|992|1|| | | | |x|x| |x| ||1164|||
OASIS|2.10|27200|M2310_ECR_UTI|Emergent care reason: urinary tract infection|993|1|| | | | |x|x| |x| ||1165|||
OASIS|2.10|27300|M2310_ECR_CTHTR_CMPLCTN|Emergent care reason: IV catheter infect/complic|994|1|| | | | |x|x| |x| ||1166|||
OASIS|2.10|27400|M2310_ECR_WND_INFCTN_DTRORTN|Emergent care reason: wound infect/deterioration|995|1|| | | | |x|x| |x| ||1167|||
OASIS|2.10|27500|M2310_ECR_UNCNTLD_PAIN|Emergent care reason: uncontrolled pain|996|1|| | | | |x|x| |x| ||1168|||
OASIS|2.10|27600|M2310_ECR_MENTL_BHVRL_PRBLM|Emergent care reason: acute mental/behav problem|997|1|| | | | |x|x| |x| ||1169|||
OASIS|2.10|27700|M2310_ECR_DVT_PULMNRY|Emergent care reason: deep vein thromb/pulm embol|998|1|| | | | |x|x| |x| ||1170|||
OASIS|2.10|27800|M2310_ECR_OTHER|Emergent care reason: other than above|999|1|| | | | |x|x| |x| ||1171|||
OASIS|2.10|27900|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1|| | | | |x|x| |x| ||696|||
OASIS|2.10|28000|M2400_INTRVTN_SMRY_DBTS_FT|Intervention synopsis: diabetic foot care|1001|2|| | | | |x|x| |x| ||1172|||
OASIS|2.10|28100|M2400_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1003|2|| | | | |x|x| |x| ||1174|||
OASIS|2.10|28200|M2400_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1005|2|| | | | |x|x| |x| ||1176|||
OASIS|2.10|28300|M2400_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1007|2|| | | | |x|x| |x| ||1178|||
OASIS|2.10|28400|M2400_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1009|2|| | | | |x|x| |x| ||1180|||
OASIS|2.10|28500|M2400_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1011|2|| | | | |x|x| |x| ||1182|||
OASIS|2.10|28600|M2410_INPAT_FACILITY|Inpatient facility|1013|2|| | | | |x|x| |x| ||697|||
OASIS|2.10|28700|M2420_DSCHRG_DISP|Discharge disposition|1015|2|| | | | | | | |x| ||1184|||
OASIS|2.10|28800|M2430_HOSP_MED|Hospitalized: medication|1017|1|| | | | |x|x| | | ||706|||
OASIS|2.10|28900|M2430_HOSP_INJRY_BY_FALL|Hospitalized: injury caused by fall|1018|1|| | | | |x|x| | | ||1186|||
OASIS|2.10|29000|M2430_HOSP_RSPRTRY_INFCTN|Hospitalized: respiratory infection|1019|1|| | | | |x|x| | | ||1187|||
OASIS|2.10|29100|M2430_HOSP_RSPRTRY_OTHR|Hospitalized: other respiratory|1020|1|| | | | |x|x| | | ||1188|||
OASIS|2.10|29200|M2430_HOSP_HRT_FAILR|Hospitalized: heart failure|1021|1|| | | | |x|x| | | ||1189|||
OASIS|2.10|29300|M2430_HOSP_CRDC_DSRTHM|Hospitalized: cardiac dysrhythmia|1022|1|| | | | |x|x| | | ||1190|||
OASIS|2.10|29400|M2430_HOSP_MI_CHST_PAIN|Hospitalized: myocardial infarction or chest pain|1023|1|| | | | |x|x| | | ||1191|||
OASIS|2.10|29500|M2430_HOSP_OTHR_HRT_DEASE|Hospitalized: other heart disease|1024|1|| | | | |x|x| | | ||1192|||
OASIS|2.10|29600|M2430_HOSP_STROKE_TIA|Hospitalized: stroke (CVA) or TIA|1025|1|| | | | |x|x| | | ||1193|||
OASIS|2.10|29700|M2430_HOSP_HYPOGLYC|Hospitalized: hypoglycemia/hyperglycemia|1026|1|| | | | |x|x| | | ||710|||
OASIS|2.10|29800|M2430_HOSP_GI_PRBLM|Hospitalized: GI bleed/obstruct/constip/impact|1027|1|| | | | |x|x| | | ||1194|||
OASIS|2.10|29900|M2430_HOSP_DHYDRTN_MALNTR|Hospitalized: dehydration  malnutrition|1028|1|| | | | |x|x| | | ||1195|||
OASIS|2.10|30000|M2430_HOSP_UR_TRACT|Hospitalized: urinary tract infection|1029|1|| | | | |x|x| | | ||716|||
OASIS|2.10|30100|M2430_HOSP_CTHTR_CMPLCTN|Hospitalized: IV catheter infect/complic|1030|1|| | | | |x|x| | | ||1196|||
OASIS|2.10|30200|M2430_HOSP_WND_INFCTN|Hospitalized: wound infect/deterioration|1031|1|| | | | |x|x| | | ||1197|||
OASIS|2.10|30300|M2430_HOSP_PAIN|Hospitalized: uncontrolled pain|1032|1|| | | | |x|x| | | ||719|||
OASIS|2.10|30400|M2430_HOSP_MENTL_BHVRL_PRBLM|Hospitalized: acute mental/behav problem|1033|1|| | | | |x|x| | | ||1198|||
OASIS|2.10|30500|M2430_HOSP_DVT_PULMNRY|Hospitalized: deep vein thromb/pulm embol|1034|1|| | | | |x|x| | | ||718|||
OASIS|2.10|30600|M2430_HOSP_SCHLD_TRTMT|Hospitalized: scheduled treatment or procedure|1035|1|| | | | |x|x| | | ||1199|||
OASIS|2.10|30700|M2430_HOSP_OTHER|Hospitalized: other|1036|1|| | | | |x|x| | | ||1200|||
OASIS|2.10|30800|M2430_HOSP_UK|Hospitalized: UK|1037|1|| | | | |x|x| | | ||1201|||
OASIS|2.10|30900|M2440_NH_THERAPY|Admitted to nursing home: therapy|1038|1|| | | | |x|x| | | ||722|||
OASIS|2.10|31000|M2440_NH_RESPITE|Admitted to nursing home: respite|1039|1|| | | | |x|x| | | ||723|||
OASIS|2.10|31100|M2440_NH_HOSPICE|Admitted to nursing home: hospice|1040|1|| | | | |x|x| | | ||724|||
OASIS|2.10|31200|M2440_NH_PERMANENT|Admitted to nursing home: permanent placement|1041|1|| | | | |x|x| | | ||725|||
OASIS|2.10|31300|M2440_NH_UNSAFE_HOME|Admitted to nursing home: unsafe at home|1042|1|| | | | |x|x| | | ||726|||
OASIS|2.10|31400|M2440_NH_OTHER|Admitted to nursing home: other|1043|1|| | | | |x|x| | | ||727|||
OASIS|2.10|31500|M2440_NH_UNKNOWN|Admitted to nursing home: unknown|1044|1|| | | | |x|x| | | ||728|||
OASIS|2.10|31600|M0903_LAST_HOME_VISIT|Date of last home visit|1045|8|| | | | |x|x|x|x| ||729|||
OASIS|2.10|31700|M0906_DC_TRAN_DTH_DT|Discharge  transfer  death date|1053|8|| | | | |x|x|x|x|x||737|||
OASIS|2.11|50|ASMT_SYS_CD|Assessment system code|1|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|100|TRANS_TYPE_CD|Transaction type code|11|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|150|ITM_SBST_CD|Item subset code|12|3||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|200|ITM_SET_VRSN_CD|Item set version code|15|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|250|SPEC_VRSN_CD|Specifications version code|25|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|300|CORRECTION_NUM|Correction number|35|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|350|STATE_CD|Agency's state postal code|37|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|400|HHA_AGENCY_ID|Assigned agency submission ID|39|16||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|500|SFW_ID|Software vendor federal employer tax ID|65|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|550|SFW_NAME|Software vendor company name|74|30||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|600|SFW_EMAIL_ADR|Software vendor email address|104|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|650|SFW_PROD_NAME|Software product name|154|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|700|SFW_PROD_VRSN_CD|Software product version code|204|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|750|ACY_DOC_CD|Document ID code (agency use)|224|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|800|SUBM_HIPPS_CODE|HIPPS group code: submitted|244|5||x|x|x|x||||||||||
OASIS|2.11|850|SUBM_HIPPS_VERSION|HIPPS version code: submitted|249|5||x|x|x|x||||||||||
OASIS|2.11|1500|M0010_CCN|Facility CMS certification number (CCN)|254|6||x|x|x|x|x|x|x|x||||||
OASIS|2.11|1600|M0014_BRANCH_STATE|Branch state|260|2||x|x|x|x|x|x|x|x||||||
OASIS|2.11|1700|M0016_BRANCH_ID|Branch ID|262|10||x|x|x|x|x|x|x|x||||||
OASIS|2.11|1800|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10||x|x|x|x|x|x|x|x||||||
OASIS|2.11|1900|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|2000|M0020_PAT_ID|Patient ID number|283|20||x|x|x|x|x|x|x|x||||||
OASIS|2.11|2100|M0030_START_CARE_DT|Start of care date|303|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|2200|M0032_ROC_DT|Resumption of care date|311|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|2300|M0032_ROC_DT_NA|No resumption of care date|319|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|2400|M0040_PAT_FNAME|Patient's first name|320|12||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|2500|M0040_PAT_MI|Patient's middle initial|332|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|2600|M0040_PAT_LNAME|Patient's last name|333|18||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|2700|M0040_PAT_SUFFIX|Patient's suffix|351|3||x|x|x|x|x|x|x|x||||||
OASIS|2.11|2800|M0050_PAT_ST|Patient state of residence|354|2||x|x|x|x|x|x|x|x||||||
OASIS|2.11|2900|M0060_PAT_ZIP|Patient zip code|356|11||x|x|x|x|x|x|x|x||||||
OASIS|2.11|3000|M0063_MEDICARE_NUM|Medicare number including suffix|367|12||x|x|x|x|x|x|x|x||||||
OASIS|2.11|3100|M0063_MEDICARE_NA|No Medicare number|379|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|3200|M0064_SSN|Patient's Social Security number|380|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|3300|M0064_SSN_UK|No Social Security number|389|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|3400|M0065_MEDICAID_NUM|Medicaid number|390|14||x|x|x|x|x|x|x|x||||||
OASIS|2.11|3500|M0065_MEDICAID_NA|No Medicaid number|404|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|3600|M0066_PAT_BIRTH_DT|Date of birth|405|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|3700|M0069_PAT_GENDER|Gender|413|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|3800|M0140_ETHNIC_AI_AN|Ethnicity: American Indian or Alaska Native|414|1||x|x| |||||||||||
OASIS|2.11|3900|M0140_ETHNIC_ASIAN|Ethnicity: Asian|415|1||x|x| |||||||||||
OASIS|2.11|4000|M0140_ETHNIC_BLACK|Ethnicity: Black or African American|416|1||x|x| |||||||||||
OASIS|2.11|4100|M0140_ETHNIC_HISP|Ethnicity: Hispanic or Latino|417|1||x|x| |||||||||||
OASIS|2.11|4200|M0140_ETHNIC_NH_PI|Ethnicity: Native Hawaiian/Pacific Islander|418|1||x|x| |||||||||||
OASIS|2.11|4300|M0140_ETHNIC_WHITE|Ethnicity: White|419|1||x|x| |||||||||||
OASIS|2.11|4400|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|4500|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|4600|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|4700|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|4800|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|4900|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5000|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5100|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5200|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5300|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5400|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5500|M0150_CPAY_OTHER|Payment sources: other|431|1||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5600|M0150_CPAY_UK|Payment sources: unknown|432|1||x|x| |||||||||||
OASIS|2.11|5700|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2||x|x|x|x|x|x|x|x||||||
OASIS|2.11|5800|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|5900|M0100_ASSMT_REASON|Reason for assessment|443|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.11|6000|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8||x|x| |||||||||||
OASIS|2.11|6100|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1||x|x| |||||||||||
OASIS|2.11|6200|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8||x|x| |||||||||||
OASIS|2.11|6300|M0110_EPISODE_TIMING|Episode timing|462|2||x|x|x|x||||||||||
OASIS|2.11|6400|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1||x|x| |||||||||||
OASIS|2.11|6500|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1||x|x| |||||||||||
OASIS|2.11|6600|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1||x|x| |||||||||||
OASIS|2.11|6700|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1||x|x| |||||||||||
OASIS|2.11|6800|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1||x|x| |||||||||||
OASIS|2.11|6900|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1||x|x| |||||||||||
OASIS|2.11|7000|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1||x|x| |||||||||||
OASIS|2.11|7100|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1||x|x| |||||||||||
OASIS|2.11|7200|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8||x|x| |||||||||||
OASIS|2.11|7300|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1||x|x| |||||||||||
OASIS|2.11|7400|M1010_14_DAY_INP1_ICD|Inpatient stay within last 14 days: ICD code 1|481|7||x|x| |||||||||||
OASIS|2.11|7500|M1010_14_DAY_INP2_ICD|Inpatient stay within last 14 days: ICD code 2|488|7||x|x| |||||||||||
OASIS|2.11|7600|M1010_14_DAY_INP3_ICD|Inpatient stay within last 14 days: ICD code 3|495|7||x|x| |||||||||||
OASIS|2.11|7700|M1010_14_DAY_INP4_ICD|Inpatient stay within last 14 days: ICD code 4|502|7||x|x| |||||||||||
OASIS|2.11|7800|M1010_14_DAY_INP5_ICD|Inpatient stay within last 14 days: ICD code 5|509|7||x|x| |||||||||||
OASIS|2.11|7900|M1010_14_DAY_INP6_ICD|Inpatient stay within last 14 days: ICD code 6|516|7||x|x| |||||||||||
OASIS|2.11|8700|M1016_CHGREG_ICD1|Regimen change in past 14 days: ICD code 1|553|7||x|x| |||||||||||
OASIS|2.11|8800|M1016_CHGREG_ICD2|Regimen change in past 14 days: ICD code 2|560|7||x|x| |||||||||||
OASIS|2.11|8900|M1016_CHGREG_ICD3|Regimen change in past 14 days: ICD code 3|567|7||x|x| |||||||||||
OASIS|2.11|9000|M1016_CHGREG_ICD4|Regimen change in past 14 days: ICD code 4|574|7||x|x| |||||||||||
OASIS|2.11|9100|M1016_CHGREG_ICD5|Regimen change in past 14 days: ICD code 5|581|7||x|x| |||||||||||
OASIS|2.11|9200|M1016_CHGREG_ICD6|Regimen change in past 14 days: ICD code 6|588|7||x|x| |||||||||||
OASIS|2.11|9300|M1016_CHGREG_ICD_NA|Regimen change in past 14 days: not applicable|595|1||x|x| |||||||||||
OASIS|2.11|9400|M1018_PRIOR_UR_INCON|Prior condition: urinary incontinence|596|1||x|x| |||||||||||
OASIS|2.11|9500|M1018_PRIOR_CATH|Prior condition: indwelling/suprapubic catheter|597|1||x|x| |||||||||||
OASIS|2.11|9600|M1018_PRIOR_INTRACT_PAIN|Prior condition: intractable pain|598|1||x|x| |||||||||||
OASIS|2.11|9700|M1018_PRIOR_IMPR_DECSN|Prior condition: impaired decision-making|599|1||x|x| |||||||||||
OASIS|2.11|9800|M1018_PRIOR_DISRUPTIVE|Prior condition: disruptive/inappropriate behav|600|1||x|x| |||||||||||
OASIS|2.11|9900|M1018_PRIOR_MEM_LOSS|Prior condition: memory loss supervision required|601|1||x|x| |||||||||||
OASIS|2.11|10000|M1018_PRIOR_NONE|Prior condition: none of the above|602|1||x|x| |||||||||||
OASIS|2.11|10100|M1018_PRIOR_NOCHG_14D|Prior condition: no inpt disch/no change regimen|603|1||x|x| |||||||||||
OASIS|2.11|10200|M1018_PRIOR_UNKNOWN|Prior condition: unknown|604|1||x|x| |||||||||||
OASIS|2.11|10300|M1020_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|605|7||x|x|x|x||||||||||
OASIS|2.11|10400|M1020_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|612|2||x|x|x|x||||||||||
OASIS|2.11|10500|M1022_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|614|7||x|x|x|x||||||||||
OASIS|2.11|10600|M1022_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|621|2||x|x|x|x||||||||||
OASIS|2.11|10700|M1022_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|623|7||x|x|x|x||||||||||
OASIS|2.11|10800|M1022_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|630|2||x|x|x|x||||||||||
OASIS|2.11|10900|M1022_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|632|7||x|x|x|x||||||||||
OASIS|2.11|11000|M1022_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|639|2||x|x|x|x||||||||||
OASIS|2.11|11100|M1022_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|641|7||x|x|x|x||||||||||
OASIS|2.11|11200|M1022_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|648|2||x|x|x|x||||||||||
OASIS|2.11|11300|M1022_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|650|7||x|x|x|x||||||||||
OASIS|2.11|11400|M1022_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|657|2||x|x|x|x||||||||||
OASIS|2.11|11500|M1024_PMT_DIAG_ICD_A3|Case mix diagnosis: primary column 3|659|7||x|x|x|x||||||||||
OASIS|2.11|11600|M1024_PMT_DIAG_ICD_B3|Case mix diagnosis: first secondary column 3|666|7||x|x|x|x||||||||||
OASIS|2.11|11700|M1024_PMT_DIAG_ICD_C3|Case mix diagnosis: second secondary column 3|673|7||x|x|x|x||||||||||
OASIS|2.11|11800|M1024_PMT_DIAG_ICD_D3|Case mix diagnosis: third secondary column 3|680|7||x|x|x|x||||||||||
OASIS|2.11|11900|M1024_PMT_DIAG_ICD_E3|Case mix diagnosis: fourth secondary column 3|687|7||x|x|x|x||||||||||
OASIS|2.11|12000|M1024_PMT_DIAG_ICD_F3|Case mix diagnosis: fifth secondary column 3|694|7||x|x|x|x||||||||||
OASIS|2.11|12100|M1024_PMT_DIAG_ICD_A4|Case mix diagnosis: primary column 4|701|7||x|x|x|x||||||||||
OASIS|2.11|12200|M1024_PMT_DIAG_ICD_B4|Case mix diagnosis: first secondary column 4|708|7||x|x|x|x||||||||||
OASIS|2.11|12300|M1024_PMT_DIAG_ICD_C4|Case mix diagnosis: second secondary column 4|715|7||x|x|x|x||||||||||
OASIS|2.11|12400|M1024_PMT_DIAG_ICD_D4|Case mix diagnosis: third secondary column 4|722|7||x|x|x|x||||||||||
OASIS|2.11|12500|M1024_PMT_DIAG_ICD_E4|Case mix diagnosis: fourth secondary column 4|729|7||x|x|x|x||||||||||
OASIS|2.11|12600|M1024_PMT_DIAG_ICD_F4|Case mix diagnosis: fifth secondary column 4|736|7||x|x|x|x||||||||||
OASIS|2.11|12700|M1030_THH_IV_INFUSION|Therapies received at home: intravenous infusion|743|1||x|x|x|x||||||||||
OASIS|2.11|12800|M1030_THH_PAR_NUTRITION|Therapies received at home: parenteral nutrition|744|1||x|x|x|x||||||||||
OASIS|2.11|12900|M1030_THH_ENT_NUTRITION|Therapies received at home: enteral nutrition|745|1||x|x|x|x||||||||||
OASIS|2.11|13000|M1030_THH_NONE_ABOVE|Therapies received at home: none of the above|746|1||x|x|x|x||||||||||
OASIS|2.11|13110|M1033_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|1515|1||x|x||||||||||||
OASIS|2.11|13210|M1033_HOSP_RISK_WEIGHT_LOSS|Hosp risk: unintentional weight loss|1516|1||x|x||||||||||||
OASIS|2.11|13310|M1033_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 12 months|1517|1||x|x||||||||||||
OASIS|2.11|13410|M1033_HOSP_RISK_MLTPL_ED_VISIT|Hosp risk: 2+ emergcy dept visits in past 6 months|1518|1||x|x||||||||||||
OASIS|2.11|13510|M1033_HOSP_RISK_MNTL_BHV_DCLN|Hosp risk: decline mental/emotional/behav status|1519|1||x|x||||||||||||
OASIS|2.11|13610|M1033_HOSP_RISK_COMPLIANCE|Hosp risk: difficulty with medical instructions|1520|1||x|x||||||||||||
OASIS|2.11|13710|M1033_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|1521|1||x|x||||||||||||
OASIS|2.11|13720|M1033_HOSP_RISK_CRNT_EXHSTN|Hosp risk: current exhaustion|1522|1||x|x||||||||||||
OASIS|2.11|13730|M1033_HOSP_RISK_OTHR_RISK|Hosp risk: other risk(s) not listed|1523|1||x|x||||||||||||
OASIS|2.11|13740|M1033_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|1524|1||x|x||||||||||||
OASIS|2.11|13800|M1034_PTNT_OVRAL_STUS|Patient's overall status|754|2||x|x| |||||||||||
OASIS|2.11|13900|M1036_RSK_SMOKING|High risk factor: smoking|756|1||x|x| |||||||||||
OASIS|2.11|14000|M1036_RSK_OBESITY|High risk factor: obesity|757|1||x|x| |||||||||||
OASIS|2.11|14100|M1036_RSK_ALCOHOLISM|High risk factor: alcoholism|758|1||x|x| |||||||||||
OASIS|2.11|14200|M1036_RSK_DRUGS|High risk factor: drugs|759|1||x|x| |||||||||||
OASIS|2.11|14300|M1036_RSK_NONE|High risk factor: none of the above|760|1||x|x| |||||||||||
OASIS|2.11|14400|M1036_RSK_UNKNOWN|High risk factor: unknown|761|1||x|x| |||||||||||
OASIS|2.11|14510|M1041_IN_INFLNZ_SEASON|Does episode include Oct 1 thru Mar 31|1525|1||||||x|x||x||||||
OASIS|2.11|14610|M1046_INFLNZ_RECD_CRNT_SEASON|Did patient receive influenza vaccine|1526|2||||||x|x||x||||||
OASIS|2.11|14710|M1051_PVX_RCVD_AGNCY|Was pneumococcal vaccine received|1528|1||||||x|x||x||||||
OASIS|2.11|14810|M1056_PVX_RSN_NOT_RCVD_AGNCY|If pneumococcal vacc not received state reason|1529|2||||||x|x||x||||||
OASIS|2.11|14900|M1100_PTNT_LVG_STUTN|Patient living situation|769|2||x|x| |||||||||||
OASIS|2.11|15000|M1200_VISION|Sensory status: vision|771|2||x|x|x|x||||||||||
OASIS|2.11|15100|M1210_HEARG_ABLTY|Ability to hear|773|2||x|x| |||||||||||
OASIS|2.11|15200|M1220_UNDRSTG_VERBAL_CNTNT|Understanding verbal content in patient's language|775|2||x|x| |||||||||||
OASIS|2.11|15300|M1230_SPEECH|Sensory status: speech|777|2||x|x| |||||x||||||
OASIS|2.11|15400|M1240_FRML_PAIN_ASMT|Has patient had a formal validated pain assessment|779|2||x|x| |||||||||||
OASIS|2.11|15500|M1242_PAIN_FREQ_ACTVTY_MVMT|Freq of pain interfering with pt activity/movement|781|2||x|x|x|x||||x||||||
OASIS|2.11|15600|M1300_PRSR_ULCR_RISK_ASMT|Was patient assessed for risk of developing PUs|783|2||x|x| |||||||||||
OASIS|2.11|15700|M1302_RISK_OF_PRSR_ULCR|Does this patient have a risk of developing PUs|785|1||x|x| |||||||||||
OASIS|2.11|15800|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU at stage 2 or higher|786|1||x|x|x|x||||x||||||
OASIS|2.11|16000|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2|| | | |||||x||||||
OASIS|2.11|16010|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8|| | | |||||x||||||
OASIS|2.11|16100|M1308_NBR_PRSULC_STG2|Number of stage 2 pressure ulcers|797|2||x|x|x|x||||x||||||
OASIS|2.11|16300|M1308_NBR_PRSULC_STG3|Number of stage 3 pressure ulcers|801|2||x|x|x|x||||x||||||
OASIS|2.11|16500|M1308_NBR_PRSULC_STG4|Number of stage 4 pressure ulcers|805|2||x|x|x|x||||x||||||
OASIS|2.11|16700|M1308_NSTG_DRSG|Unstageable: non-removable dressing/device|809|2||x|x|x|x||||x||||||
OASIS|2.11|16900|M1308_NSTG_CVRG|Unstageable: coverage by slough or eschar|813|2||x|x|x|x||||x||||||
OASIS|2.11|17100|M1308_NSTG_DEEP_TISUE|Unstageable: suspect deep tissue injury|817|2||x|x|x|x||||x||||||
OASIS|2.11|17210|M1309_NBR_NEW_WRS_PRSULC_STG2|Number of new or worsening stage 2|1531|2|||||||||x||||||
OASIS|2.11|17220|M1309_NBR_NEW_WRS_PRSULC_STG3|Number of new or worsening stage 3|1533|2|||||||||x||||||
OASIS|2.11|17230|M1309_NBR_NEW_WRS_PRSULC_STG4|Number of new or worsening stage 4|1535|2|||||||||x||||||
OASIS|2.11|17240|M1309_NBR_NEW_WRS_PRSULC_NSTG|Number of new or worsening unstageable|1551|2|||||||||x||||||
OASIS|2.11|17600|M1320_STUS_PRBLM_PRSR_ULCR|Status of most problematic pressure ulcer|833|2||x|x| |||||x||||||
OASIS|2.11|17700|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure ulcers|835|2||x|x|x|x||||x||||||
OASIS|2.11|17800|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer|837|2||x|x|x|x||||x||||||
OASIS|2.11|17900|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2||x|x|x|x||||x||||||
OASIS|2.11|18000|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2||x|x|x|x||||x||||||
OASIS|2.11|18100|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2||x|x|x|x||||x||||||
OASIS|2.11|18200|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2||x|x|x|x||||x||||||
OASIS|2.11|18300|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2||x|x|x|x||||x||||||
OASIS|2.11|18400|M1350_LESION_OPEN_WND|Has skin lesion or open wound|849|1||x|x||||||||||||
OASIS|2.11|18500|M1400_WHEN_DYSPNEIC|When dyspneic|850|2||x|x|x|x||||x||||||
OASIS|2.11|18600|M1410_RESPTX_OXYGEN|Respiratory treatments: oxygen|852|1||x|x| |||||||||||
OASIS|2.11|18700|M1410_RESPTX_VENTILATOR|Respiratory treatments: ventilator|853|1||x|x| |||||||||||
OASIS|2.11|18800|M1410_RESPTX_AIRPRESS|Respiratory treatments: airway pressure|854|1||x|x| |||||||||||
OASIS|2.11|18900|M1410_RESPTX_NONE|Respiratory treatments: none of the above|855|1||x|x| |||||||||||
OASIS|2.11|19000|M1500_SYMTM_HRT_FAILR_PTNTS|Symptoms in heart failure patients|856|2|| | | ||x|x||x||||||
OASIS|2.11|19100|M1510_HRT_FAILR_NO_ACTN|Heart failure follow up:  no action|858|1|| | | ||x|x||x||||||
OASIS|2.11|19200|M1510_HRT_FAILR_PHYSN_CNTCT|Heart failure follow up:  physician contacted|859|1|| | | ||x|x||x||||||
OASIS|2.11|19300|M1510_HRT_FAILR_ER_TRTMT|Heart failure follow up:  ER treatment advised|860|1|| | | ||x|x||x||||||
OASIS|2.11|19400|M1510_HRT_FAILR_PHYSN_TRTMT|Heart failure follow up:  phys-ordered treatmnt|861|1|| | | ||x|x||x||||||
OASIS|2.11|19500|M1510_HRT_FAILR_CLNCL_INTRVTN|Heart failure follow up: pt educ/other clinical|862|1|| | | ||x|x||x||||||
OASIS|2.11|19600|M1510_HRT_FAILR_CARE_PLAN_CHG|Heart failure follow up: change in care plan|863|1|| | | ||x|x||x||||||
OASIS|2.11|19700|M1600_UTI|Treated for urinary tract infection past 14 days|864|2||x|x| |||||x||||||
OASIS|2.11|19800|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2||x|x|x|x||||x||||||
OASIS|2.11|19900|M1615_INCNTNT_TIMING|When urinary incontinence occurs|868|2||x|x| |||||x||||||
OASIS|2.11|20000|M1620_BWL_INCONT|Bowel incontinence frequency|870|2||x|x|x|x||||x||||||
OASIS|2.11|20100|M1630_OSTOMY|Ostomy for bowel elimination|872|2||x|x|x|x||||||||||
OASIS|2.11|20200|M1700_COG_FUNCTION|Cognitive functioning|874|2||x|x| |||||x||||||
OASIS|2.11|20300|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2||x|x| |||||x||||||
OASIS|2.11|20400|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2||x|x| |||||x||||||
OASIS|2.11|20500|M1730_STDZ_DPRSN_SCRNG|Screened for depression using validated tool|880|2||x|x| |||||||||||
OASIS|2.11|20600|M1730_PHQ2_LACK_INTRST|PHQ2: little interest or pleasure in doing things|882|2||x|x| |||||||||||
OASIS|2.11|20700|M1730_PHQ2_DPRSN|PHQ2: feeling down depressed or hopeless|884|2||x|x| |||||||||||
OASIS|2.11|20800|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1||x|x| |||||x||||||
OASIS|2.11|20900|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1||x|x| |||||x||||||
OASIS|2.11|21000|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1||x|x| |||||x||||||
OASIS|2.11|21100|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1||x|x| |||||x||||||
OASIS|2.11|21200|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1||x|x| |||||x||||||
OASIS|2.11|21300|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1||x|x| |||||x||||||
OASIS|2.11|21400|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1||x|x| |||||x||||||
OASIS|2.11|21500|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2||x|x| |||||x||||||
OASIS|2.11|21600|M1750_REC_PSYCH_NURS|Receives psychiatric nursing|895|1||x|x| |||||||||||
OASIS|2.11|21700|M1800_CRNT_GROOMING|Current: grooming|896|2||x|x| |||||x||||||
OASIS|2.11|21800|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2||x|x|x|x||||x||||||
OASIS|2.11|21900|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2||x|x|x|x||||x||||||
OASIS|2.11|22000|M1830_CRNT_BATHG|Current: bathing|902|2||x|x|x|x||||x||||||
OASIS|2.11|22100|M1840_CRNT_TOILTG|Current: toileting|904|2||x|x|x|x||||x||||||
OASIS|2.11|22200|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2||x|x| |||||x||||||
OASIS|2.11|22300|M1850_CRNT_TRNSFRNG|Current: transferring|908|2||x|x|x|x||||x||||||
OASIS|2.11|22400|M1860_CRNT_AMBLTN|Current: ambulation|910|2||x|x|x|x||||x||||||
OASIS|2.11|22500|M1870_CRNT_FEEDING|Current: feeding|912|2||x|x| |||||x||||||
OASIS|2.11|22600|M1880_CRNT_PREP_LT_MEALS|Current: prepare light meals|914|2||x|x| |||||x||||||
OASIS|2.11|22700|M1890_CRNT_PHONE_USE|Current: telephone use|916|2||x|x| |||||x||||||
OASIS|2.11|22800|M1900_PRIOR_ADLIADL_SELF|Prior functioning ADL/IADL: self-care|918|2||x|x| |||||||||||
OASIS|2.11|22900|M1900_PRIOR_ADLIADL_AMBLTN|Prior functioning ADL/IADL: ambulation|920|2||x|x| |||||||||||
OASIS|2.11|23000|M1900_PRIOR_ADLIADL_TRNSFR|Prior functioning ADL/IADL: transfer|922|2||x|x| |||||||||||
OASIS|2.11|23100|M1900_PRIOR_ADLIADL_HSEHOLD|Prior functioning ADL/IADL: household tasks|924|2||x|x| |||||||||||
OASIS|2.11|23200|M1910_MLT_FCTR_FALL_RISK_ASMT|Has patient had a multi-factor fall risk asmt|926|2||x|x| |||||||||||
OASIS|2.11|23300|M2000_DRUG_RGMN_RVW|Drug regimen review|928|2||x|x| |||||||||||
OASIS|2.11|23400|M2002_MDCTN_FLWP|Medication follow-up|930|1||x|x| |||||||||||
OASIS|2.11|23500|M2004_MDCTN_INTRVTN|Medication intervention|931|2|| | | ||x|x||x||||||
OASIS|2.11|23600|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2||x|x| |||||||||||
OASIS|2.11|23700|M2015_DRUG_EDCTN_INTRVTN|Patient/caregiver drug education intervention|935|2|| | | ||x|x||x||||||
OASIS|2.11|23800|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2||x|x| |||||x||||||
OASIS|2.11|23900|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2||x|x|x|x||||x||||||
OASIS|2.11|24000|M2040_PRIOR_MGMT_ORAL_MDCTN|Prior med mgmt: oral medications|941|2||x|x| |||||||||||
OASIS|2.11|24100|M2040_PRIOR_MGMT_INJCTN_MDCTN|Prior med mgmt: injectable medications|943|2||x|x| |||||||||||
OASIS|2.11|24210|M2102_CARE_TYPE_SRC_ADL|Care mgmt types/sources: ADL|1537|2||x|x||||||x||||||
OASIS|2.11|24310|M2102_CARE_TYPE_SRC_IADL|Care mgmt types/sources: IADL|1539|2||x|x||||||x||||||
OASIS|2.11|24410|M2102_CARE_TYPE_SRC_MDCTN|Care mgmt types/sources: med admin|1541|2||x|x||||||x||||||
OASIS|2.11|24510|M2102_CARE_TYPE_SRC_PRCDR|Care mgmt types/sources: med procs tx|1543|2||x|x||||||x||||||
OASIS|2.11|24610|M2102_CARE_TYPE_SRC_EQUIP|Care mgmt types/sources: equipment|1545|2||x|x||||||x||||||
OASIS|2.11|24710|M2102_CARE_TYPE_SRC_SPRVSN|Care mgmt types/sources: supervision and safety|1547|2||x|x||||||x||||||
OASIS|2.11|24810|M2102_CARE_TYPE_SRC_ADVCY|Care mgmt types/sources: advocacy or facilitation|1549|2||x|x||||||x||||||
OASIS|2.11|24900|M2110_ADL_IADL_ASTNC_FREQ|How often recv non-HHA caregiver ADL/IADL assist|959|2||x|x| |||||||||||
OASIS|2.11|25000|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3||x|x|x|x||||||||||
OASIS|2.11|25100|M2200_THER_NEED_NA|Therapy need: not applicable|964|1||x|x|x|x||||||||||
OASIS|2.11|25200|M2250_PLAN_SMRY_PTNT_SPECF|Plan of care synopsis: patient specific parameters|965|2||x|x| |||||||||||
OASIS|2.11|25300|M2250_PLAN_SMRY_DBTS_FT_CARE|Plan of care synopsis: diabetic foot care|967|2||x|x| |||||||||||
OASIS|2.11|25400|M2250_PLAN_SMRY_FALL_PRVNT|Plan of care synopsis: falls prevention|969|2||x|x| |||||||||||
OASIS|2.11|25500|M2250_PLAN_SMRY_DPRSN_INTRVTN|Plan of care synopsis: depression interventions|971|2||x|x| |||||||||||
OASIS|2.11|25600|M2250_PLAN_SMRY_PAIN_INTRVTN|Plan of care synopsis: pain interventions|973|2||x|x| |||||||||||
OASIS|2.11|25700|M2250_PLAN_SMRY_PRSULC_PRVNT|Plan of care synopsis: PU prevention|975|2||x|x| |||||||||||
OASIS|2.11|25800|M2250_PLAN_SMRY_PRSULC_TRTMT|Plan of care synopsis: PU moist treatment|977|2||x|x| |||||||||||
OASIS|2.11|25900|M2300_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since previous OASIS|979|2|| | | ||x|x||x||||||
OASIS|2.11|26000|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1|| | | ||x|x||x||||||
OASIS|2.11|26100|M2310_ECR_INJRY_BY_FALL|Emergent care reason: injury caused by fall|982|1|| | | ||x|x||x||||||
OASIS|2.11|26200|M2310_ECR_RSPRTRY_INFCTN|Emergent care reason: respiratory infection|983|1|| | | ||x|x||x||||||
OASIS|2.11|26300|M2310_ECR_RSPRTRY_OTHR|Emergent care reason: respiratory other|984|1|| | | ||x|x||x||||||
OASIS|2.11|26400|M2310_ECR_HRT_FAILR|Emergent care reason: heart failure|985|1|| | | ||x|x||x||||||
OASIS|2.11|26500|M2310_ECR_CRDC_DSRTHM|Emergent care reason: cardiac dysrhythmia|986|1|| | | ||x|x||x||||||
OASIS|2.11|26600|M2310_ECR_MI_CHST_PAIN|Emergent care reason: myocard infarct/chest pain|987|1|| | | ||x|x||x||||||
OASIS|2.11|26700|M2310_ECR_OTHR_HRT_DEASE|Emergent care reason: other heart disease|988|1|| | | ||x|x||x||||||
OASIS|2.11|26800|M2310_ECR_STROKE_TIA|Emergent care reason: stroke (CVA) or TIA|989|1|| | | ||x|x||x||||||
OASIS|2.11|26900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1|| | | ||x|x||x||||||
OASIS|2.11|27000|M2310_ECR_GI_PRBLM|Emergent care: GI bleed/obstruct/constip/impact|991|1|| | | ||x|x||x||||||
OASIS|2.11|27100|M2310_ECR_DHYDRTN_MALNTR|Emergent care reason: dehydration malnutrition|992|1|| | | ||x|x||x||||||
OASIS|2.11|27200|M2310_ECR_UTI|Emergent care reason: urinary tract infection|993|1|| | | ||x|x||x||||||
OASIS|2.11|27300|M2310_ECR_CTHTR_CMPLCTN|Emergent care reason: IV catheter infect/complic|994|1|| | | ||x|x||x||||||
OASIS|2.11|27400|M2310_ECR_WND_INFCTN_DTRORTN|Emergent care reason: wound infect/deterioration|995|1|| | | ||x|x||x||||||
OASIS|2.11|27500|M2310_ECR_UNCNTLD_PAIN|Emergent care reason: uncontrolled pain|996|1|| | | ||x|x||x||||||
OASIS|2.11|27600|M2310_ECR_MENTL_BHVRL_PRBLM|Emergent care reason: acute mental/behav problem|997|1|| | | ||x|x||x||||||
OASIS|2.11|27700|M2310_ECR_DVT_PULMNRY|Emergent care reason: deep vein thromb/pulm embol|998|1|| | | ||x|x||x||||||
OASIS|2.11|27800|M2310_ECR_OTHER|Emergent care reason: other than above|999|1|| | | ||x|x||x||||||
OASIS|2.11|27900|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1|| | | ||x|x||x||||||
OASIS|2.11|28000|M2400_INTRVTN_SMRY_DBTS_FT|Intervention synopsis: diabetic foot care|1001|2|| | | ||x|x||x||||||
OASIS|2.11|28100|M2400_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1003|2|| | | ||x|x||x||||||
OASIS|2.11|28200|M2400_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1005|2|| | | ||x|x||x||||||
OASIS|2.11|28300|M2400_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1007|2|| | | ||x|x||x||||||
OASIS|2.11|28400|M2400_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1009|2|| | | ||x|x||x||||||
OASIS|2.11|28500|M2400_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1011|2|| | | ||x|x||x||||||
OASIS|2.11|28600|M2410_INPAT_FACILITY|Inpatient facility|1013|2|| | | ||x|x||x||||||
OASIS|2.11|28700|M2420_DSCHRG_DISP|Discharge disposition|1015|2|| | | |||||x||||||
OASIS|2.11|28800|M2430_HOSP_MED|Hospitalized: medication|1017|1|| | | ||x|x||||||||
OASIS|2.11|28900|M2430_HOSP_INJRY_BY_FALL|Hospitalized: injury caused by fall|1018|1|| | | ||x|x||||||||
OASIS|2.11|29000|M2430_HOSP_RSPRTRY_INFCTN|Hospitalized: respiratory infection|1019|1|| | | ||x|x||||||||
OASIS|2.11|29100|M2430_HOSP_RSPRTRY_OTHR|Hospitalized: other respiratory|1020|1|| | | ||x|x||||||||
OASIS|2.11|29200|M2430_HOSP_HRT_FAILR|Hospitalized: heart failure|1021|1|| | | ||x|x||||||||
OASIS|2.11|29300|M2430_HOSP_CRDC_DSRTHM|Hospitalized: cardiac dysrhythmia|1022|1|| | | ||x|x||||||||
OASIS|2.11|29400|M2430_HOSP_MI_CHST_PAIN|Hospitalized: myocardial infarction or chest pain|1023|1|| | | ||x|x||||||||
OASIS|2.11|29500|M2430_HOSP_OTHR_HRT_DEASE|Hospitalized: other heart disease|1024|1|| | | ||x|x||||||||
OASIS|2.11|29600|M2430_HOSP_STROKE_TIA|Hospitalized: stroke (CVA) or TIA|1025|1|| | | ||x|x||||||||
OASIS|2.11|29700|M2430_HOSP_HYPOGLYC|Hospitalized: hypoglycemia/hyperglycemia|1026|1|| | | ||x|x||||||||
OASIS|2.11|29800|M2430_HOSP_GI_PRBLM|Hospitalized: GI bleed/obstruct/constip/impact|1027|1|| | | ||x|x||||||||
OASIS|2.11|29900|M2430_HOSP_DHYDRTN_MALNTR|Hospitalized: dehydration malnutrition|1028|1|| | | ||x|x||||||||
OASIS|2.11|30000|M2430_HOSP_UR_TRACT|Hospitalized: urinary tract infection|1029|1|| | | ||x|x||||||||
OASIS|2.11|30100|M2430_HOSP_CTHTR_CMPLCTN|Hospitalized: IV catheter infect/complic|1030|1|| | | ||x|x||||||||
OASIS|2.11|30200|M2430_HOSP_WND_INFCTN|Hospitalized: wound infect/deterioration|1031|1|| | | ||x|x||||||||
OASIS|2.11|30300|M2430_HOSP_PAIN|Hospitalized: uncontrolled pain|1032|1|| | | ||x|x||||||||
OASIS|2.11|30400|M2430_HOSP_MENTL_BHVRL_PRBLM|Hospitalized: acute mental/behav problem|1033|1|| | | ||x|x||||||||
OASIS|2.11|30500|M2430_HOSP_DVT_PULMNRY|Hospitalized: deep vein thromb/pulm embol|1034|1|| | | ||x|x||||||||
OASIS|2.11|30600|M2430_HOSP_SCHLD_TRTMT|Hospitalized: scheduled treatment or procedure|1035|1|| | | ||x|x||||||||
OASIS|2.11|30700|M2430_HOSP_OTHER|Hospitalized: other|1036|1|| | | ||x|x||||||||
OASIS|2.11|30800|M2430_HOSP_UK|Hospitalized: UK|1037|1|| | | ||x|x||||||||
OASIS|2.11|31600|M0903_LAST_HOME_VISIT|Date of last home visit|1045|8|| | | ||x|x|x|x||||||
OASIS|2.11|31700|M0906_DC_TRAN_DTH_DT|Discharge - transfer -  death date|1053|8|| | | ||x|x|x|x|x|||||
OASIS|2.12|50|ASMT_SYS_CD|Assessment system code|1|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|100|TRANS_TYPE_CD|Transaction type code|11|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|150|ITM_SBST_CD|Item subset code|12|3||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|200|ITM_SET_VRSN_CD|Item set version code|15|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|250|SPEC_VRSN_CD|Specifications version code|25|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|300|CORRECTION_NUM|Correction number|35|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|350|STATE_CD|Agency's state postal code|37|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|400|HHA_AGENCY_ID|Assigned agency submission ID|39|16||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|500|SFW_ID|Software vendor federal employer tax ID|65|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|550|SFW_NAME|Software vendor company name|74|30||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|600|SFW_EMAIL_ADR|Software vendor email address|104|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|650|SFW_PROD_NAME|Software product name|154|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|700|SFW_PROD_VRSN_CD|Software product version code|204|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|750|ACY_DOC_CD|Document ID code (agency use)|224|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|800|SUBM_HIPPS_CODE|HIPPS group code: submitted|244|5||x|x|x|x||||||||||
OASIS|2.12|850|SUBM_HIPPS_VERSION|HIPPS version code: submitted|249|5||x|x|x|x||||||||||
OASIS|2.12|1500|M0010_CCN|Facility CMS certification number (CCN)|254|6||x|x|x|x|x|x|x|x||||||
OASIS|2.12|1600|M0014_BRANCH_STATE|Branch state|260|2||x|x|x|x|x|x|x|x||||||
OASIS|2.12|1700|M0016_BRANCH_ID|Branch ID|262|10||x|x|x|x|x|x|x|x||||||
OASIS|2.12|1800|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10||x|x|x|x|x|x|x|x||||||
OASIS|2.12|1900|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|2000|M0020_PAT_ID|Patient ID number|283|20||x|x|x|x|x|x|x|x||||||
OASIS|2.12|2100|M0030_START_CARE_DT|Start of care date|303|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|2200|M0032_ROC_DT|Resumption of care date|311|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|2300|M0032_ROC_DT_NA|No resumption of care date|319|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|2400|M0040_PAT_FNAME|Patient's first name|320|12||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|2500|M0040_PAT_MI|Patient's middle initial|332|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|2600|M0040_PAT_LNAME|Patient's last name|333|18||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|2700|M0040_PAT_SUFFIX|Patient's suffix|351|3||x|x|x|x|x|x|x|x||||||
OASIS|2.12|2800|M0050_PAT_ST|Patient state of residence|354|2||x|x|x|x|x|x|x|x||||||
OASIS|2.12|2900|M0060_PAT_ZIP|Patient zip code|356|11||x|x|x|x|x|x|x|x||||||
OASIS|2.12|3000|M0063_MEDICARE_NUM|Medicare number including suffix|367|12||x|x|x|x|x|x|x|x||||||
OASIS|2.12|3100|M0063_MEDICARE_NA|No Medicare number|379|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|3200|M0064_SSN|Patient's Social Security number|380|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|3300|M0064_SSN_UK|No Social Security number|389|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|3400|M0065_MEDICAID_NUM|Medicaid number|390|14||x|x|x|x|x|x|x|x||||||
OASIS|2.12|3500|M0065_MEDICAID_NA|No Medicaid number|404|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|3600|M0066_PAT_BIRTH_DT|Date of birth|405|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|3700|M0069_PAT_GENDER|Gender|413|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|3800|M0140_ETHNIC_AI_AN|Ethnicity: American Indian or Alaska Native|414|1||x|x| |||||||||||
OASIS|2.12|3900|M0140_ETHNIC_ASIAN|Ethnicity: Asian|415|1||x|x| |||||||||||
OASIS|2.12|4000|M0140_ETHNIC_BLACK|Ethnicity: Black or African American|416|1||x|x| |||||||||||
OASIS|2.12|4100|M0140_ETHNIC_HISP|Ethnicity: Hispanic or Latino|417|1||x|x| |||||||||||
OASIS|2.12|4200|M0140_ETHNIC_NH_PI|Ethnicity: Native Hawaiian/Pacific Islander|418|1||x|x| |||||||||||
OASIS|2.12|4300|M0140_ETHNIC_WHITE|Ethnicity: White|419|1||x|x| |||||||||||
OASIS|2.12|4400|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|4500|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|4600|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|4700|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|4800|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|4900|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5000|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5100|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5200|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5300|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5400|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5500|M0150_CPAY_OTHER|Payment sources: other|431|1||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5600|M0150_CPAY_UK|Payment sources: unknown|432|1||x|x| |||||||||||
OASIS|2.12|5700|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2||x|x|x|x|x|x|x|x||||||
OASIS|2.12|5800|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|5900|M0100_ASSMT_REASON|Reason for assessment|443|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.12|6000|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8||x|x| |||||||||||
OASIS|2.12|6100|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1||x|x| |||||||||||
OASIS|2.12|6200|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8||x|x| |||||||||||
OASIS|2.12|6300|M0110_EPISODE_TIMING|Episode timing|462|2||x|x|x|x||||||||||
OASIS|2.12|6400|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1||x|x| |||||||||||
OASIS|2.12|6500|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1||x|x| |||||||||||
OASIS|2.12|6600|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1||x|x| |||||||||||
OASIS|2.12|6700|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1||x|x| |||||||||||
OASIS|2.12|6800|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1||x|x| |||||||||||
OASIS|2.12|6900|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1||x|x| |||||||||||
OASIS|2.12|7000|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1||x|x| |||||||||||
OASIS|2.12|7100|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1||x|x| |||||||||||
OASIS|2.12|7200|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8||x|x| |||||||||||
OASIS|2.12|7300|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1||x|x| |||||||||||
OASIS|2.12|7400|M1011_14_DAY_INP1_ICD|Inpatient stay within last 14 days: ICD code 1|1261|8||x|x|x|x||||||||||
OASIS|2.12|7500|M1011_14_DAY_INP2_ICD|Inpatient stay within last 14 days: ICD code 2|1269|8||x|x|x|x||||||||||
OASIS|2.12|7600|M1011_14_DAY_INP3_ICD|Inpatient stay within last 14 days: ICD code 3|1277|8||x|x|x|x||||||||||
OASIS|2.12|7700|M1011_14_DAY_INP4_ICD|Inpatient stay within last 14 days: ICD code 4|1285|8||x|x|x|x||||||||||
OASIS|2.12|7800|M1011_14_DAY_INP5_ICD|Inpatient stay within last 14 days: ICD code 5|1293|8||x|x|x|x||||||||||
OASIS|2.12|7900|M1011_14_DAY_INP6_ICD|Inpatient stay within last 14 days: ICD code 6|1301|8||x|x|x|x||||||||||
OASIS|2.12|7950|M1011_14_DAY_INP_NA|Inpatient stay within last 14 days: not applicable|1309|1||||x|x||||||||||
OASIS|2.12|8700|M1017_CHGREG_ICD1|Regimen change in past 14 days: ICD code 1|1310|8||x|x| |||||||||||
OASIS|2.12|8800|M1017_CHGREG_ICD2|Regimen change in past 14 days: ICD code 2|1318|8||x|x| |||||||||||
OASIS|2.12|8900|M1017_CHGREG_ICD3|Regimen change in past 14 days: ICD code 3|1326|8||x|x| |||||||||||
OASIS|2.12|9000|M1017_CHGREG_ICD4|Regimen change in past 14 days: ICD code 4|1334|8||x|x| |||||||||||
OASIS|2.12|9100|M1017_CHGREG_ICD5|Regimen change in past 14 days: ICD code 5|1342|8||x|x| |||||||||||
OASIS|2.12|9200|M1017_CHGREG_ICD6|Regimen change in past 14 days: ICD code 6|1350|8||x|x| |||||||||||
OASIS|2.12|9300|M1017_CHGREG_ICD_NA|Regimen change in past 14 days: not applicable|1358|1||x|x| |||||||||||
OASIS|2.12|9400|M1018_PRIOR_UR_INCON|Prior condition: urinary incontinence|596|1||x|x| |||||||||||
OASIS|2.12|9500|M1018_PRIOR_CATH|Prior condition: indwelling/suprapubic catheter|597|1||x|x| |||||||||||
OASIS|2.12|9600|M1018_PRIOR_INTRACT_PAIN|Prior condition: intractable pain|598|1||x|x| |||||||||||
OASIS|2.12|9700|M1018_PRIOR_IMPR_DECSN|Prior condition: impaired decision-making|599|1||x|x| |||||||||||
OASIS|2.12|9800|M1018_PRIOR_DISRUPTIVE|Prior condition: disruptive/inappropriate behav|600|1||x|x| |||||||||||
OASIS|2.12|9900|M1018_PRIOR_MEM_LOSS|Prior condition: memory loss supervision required|601|1||x|x| |||||||||||
OASIS|2.12|10000|M1018_PRIOR_NONE|Prior condition: none of the above|602|1||x|x| |||||||||||
OASIS|2.12|10100|M1018_PRIOR_NOCHG_14D|Prior condition: no inpt disch/no change regimen|603|1||x|x| |||||||||||
OASIS|2.12|10200|M1018_PRIOR_UNKNOWN|Prior condition: unknown|604|1||x|x| |||||||||||
OASIS|2.12|10300|M1021_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|1359|8||x|x|x|x||||||||||
OASIS|2.12|10400|M1021_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|1367|2||x|x|x|x||||||||||
OASIS|2.12|10500|M1023_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|1369|8||x|x|x|x||||||||||
OASIS|2.12|10600|M1023_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|1377|2||x|x|x|x||||||||||
OASIS|2.12|10700|M1023_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|1379|8||x|x|x|x||||||||||
OASIS|2.12|10800|M1023_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|1387|2||x|x|x|x||||||||||
OASIS|2.12|10900|M1023_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|1389|8||x|x|x|x||||||||||
OASIS|2.12|11000|M1023_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|1397|2||x|x|x|x||||||||||
OASIS|2.12|11100|M1023_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|1399|8||x|x|x|x||||||||||
OASIS|2.12|11200|M1023_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|1407|2||x|x|x|x||||||||||
OASIS|2.12|11300|M1023_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|1409|8||x|x|x|x||||||||||
OASIS|2.12|11400|M1023_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|1417|2||x|x|x|x||||||||||
OASIS|2.12|11500|M1025_OPT_DIAG_ICD_A3|Case mix diagnosis: primary column 3|1419|8||x|x|x|x||||||||||
OASIS|2.12|11600|M1025_OPT_DIAG_ICD_B3|Case mix diagnosis: first secondary column 3|1435|8||x|x|x|x||||||||||
OASIS|2.12|11700|M1025_OPT_DIAG_ICD_C3|Case mix diagnosis: second secondary column 3|1451|8||x|x|x|x||||||||||
OASIS|2.12|11800|M1025_OPT_DIAG_ICD_D3|Case mix diagnosis: third secondary column 3|1467|8||x|x|x|x||||||||||
OASIS|2.12|11900|M1025_OPT_DIAG_ICD_E3|Case mix diagnosis: fourth secondary column 3|1483|8||x|x|x|x||||||||||
OASIS|2.12|12000|M1025_OPT_DIAG_ICD_F3|Case mix diagnosis: fifth secondary column 3|1499|8||x|x|x|x||||||||||
OASIS|2.12|12100|M1025_OPT_DIAG_ICD_A4|Case mix diagnosis: primary column 4|1427|8||x|x|x|x||||||||||
OASIS|2.12|12200|M1025_OPT_DIAG_ICD_B4|Case mix diagnosis: first secondary column 4|1443|8||x|x|x|x||||||||||
OASIS|2.12|12300|M1025_OPT_DIAG_ICD_C4|Case mix diagnosis: second secondary column 4|1459|8||x|x|x|x||||||||||
OASIS|2.12|12400|M1025_OPT_DIAG_ICD_D4|Case mix diagnosis: third secondary column 4|1475|8||x|x|x|x||||||||||
OASIS|2.12|12500|M1025_OPT_DIAG_ICD_E4|Case mix diagnosis: fourth secondary column 4|1491|8||x|x|x|x||||||||||
OASIS|2.12|12600|M1025_OPT_DIAG_ICD_F4|Case mix diagnosis: fifth secondary column 4|1507|8||x|x|x|x||||||||||
OASIS|2.12|12700|M1030_THH_IV_INFUSION|Therapies received at home: intravenous infusion|743|1||x|x|x|x||||||||||
OASIS|2.12|12800|M1030_THH_PAR_NUTRITION|Therapies received at home: parenteral nutrition|744|1||x|x|x|x||||||||||
OASIS|2.12|12900|M1030_THH_ENT_NUTRITION|Therapies received at home: enteral nutrition|745|1||x|x|x|x||||||||||
OASIS|2.12|13000|M1030_THH_NONE_ABOVE|Therapies received at home: none of the above|746|1||x|x|x|x||||||||||
OASIS|2.12|13110|M1033_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|1515|1||x|x||||||||||||
OASIS|2.12|13210|M1033_HOSP_RISK_WEIGHT_LOSS|Hosp risk: unintentional weight loss|1516|1||x|x||||||||||||
OASIS|2.12|13310|M1033_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 12 months|1517|1||x|x||||||||||||
OASIS|2.12|13410|M1033_HOSP_RISK_MLTPL_ED_VISIT|Hosp risk: 2+ emergcy dept visits in past 6 months|1518|1||x|x||||||||||||
OASIS|2.12|13510|M1033_HOSP_RISK_MNTL_BHV_DCLN|Hosp risk: decline mental/emotional/behav status|1519|1||x|x||||||||||||
OASIS|2.12|13610|M1033_HOSP_RISK_COMPLIANCE|Hosp risk: difficulty with medical instructions|1520|1||x|x||||||||||||
OASIS|2.12|13710|M1033_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|1521|1||x|x||||||||||||
OASIS|2.12|13720|M1033_HOSP_RISK_CRNT_EXHSTN|Hosp risk: current exhaustion|1522|1||x|x||||||||||||
OASIS|2.12|13730|M1033_HOSP_RISK_OTHR_RISK|Hosp risk: other risk(s) not listed|1523|1||x|x||||||||||||
OASIS|2.12|13740|M1033_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|1524|1||x|x||||||||||||
OASIS|2.12|13800|M1034_PTNT_OVRAL_STUS|Patient's overall status|754|2||x|x| |||||||||||
OASIS|2.12|13900|M1036_RSK_SMOKING|High risk factor: smoking|756|1||x|x| |||||||||||
OASIS|2.12|14000|M1036_RSK_OBESITY|High risk factor: obesity|757|1||x|x| |||||||||||
OASIS|2.12|14100|M1036_RSK_ALCOHOLISM|High risk factor: alcoholism|758|1||x|x| |||||||||||
OASIS|2.12|14200|M1036_RSK_DRUGS|High risk factor: drugs|759|1||x|x| |||||||||||
OASIS|2.12|14300|M1036_RSK_NONE|High risk factor: none of the above|760|1||x|x| |||||||||||
OASIS|2.12|14400|M1036_RSK_UNKNOWN|High risk factor: unknown|761|1||x|x| |||||||||||
OASIS|2.12|14510|M1041_IN_INFLNZ_SEASON|Does episode include Oct 1 thru Mar 31|1525|1||||||x|x||x||||||
OASIS|2.12|14610|M1046_INFLNZ_RECD_CRNT_SEASON|Did patient receive influenza vaccine|1526|2||||||x|x||x||||||
OASIS|2.12|14710|M1051_PVX_RCVD_AGNCY|Was pneumococcal vaccine received|1528|1||||||x|x||x||||||
OASIS|2.12|14810|M1056_PVX_RSN_NOT_RCVD_AGNCY|If pneumococcal vacc not received state reason|1529|2||||||x|x||x||||||
OASIS|2.12|14900|M1100_PTNT_LVG_STUTN|Patient living situation|769|2||x|x| |||||||||||
OASIS|2.12|15000|M1200_VISION|Sensory status: vision|771|2||x|x|x|x||||||||||
OASIS|2.12|15100|M1210_HEARG_ABLTY|Ability to hear|773|2||x|x| |||||||||||
OASIS|2.12|15200|M1220_UNDRSTG_VERBAL_CNTNT|Understanding verbal content in patient's language|775|2||x|x| |||||||||||
OASIS|2.12|15300|M1230_SPEECH|Sensory status: speech|777|2||x|x| |||||x||||||
OASIS|2.12|15400|M1240_FRML_PAIN_ASMT|Has patient had a formal validated pain assessment|779|2||x|x| |||||||||||
OASIS|2.12|15500|M1242_PAIN_FREQ_ACTVTY_MVMT|Freq of pain interfering with pt activity/movement|781|2||x|x|x|x||||x||||||
OASIS|2.12|15600|M1300_PRSR_ULCR_RISK_ASMT|Was patient assessed for risk of developing PUs|783|2||x|x| |||||||||||
OASIS|2.12|15700|M1302_RISK_OF_PRSR_ULCR|Does this patient have a risk of developing PUs|785|1||x|x| |||||||||||
OASIS|2.12|15800|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU at stage 2 or higher|786|1||x|x|x|x||||x||||||
OASIS|2.12|16000|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2|| | | |||||x||||||
OASIS|2.12|16010|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8|| | | |||||x||||||
OASIS|2.12|16100|M1308_NBR_PRSULC_STG2|Number of stage 2 pressure ulcers|797|2||x|x|x|x||||x||||||
OASIS|2.12|16300|M1308_NBR_PRSULC_STG3|Number of stage 3 pressure ulcers|801|2||x|x|x|x||||x||||||
OASIS|2.12|16500|M1308_NBR_PRSULC_STG4|Number of stage 4 pressure ulcers|805|2||x|x|x|x||||x||||||
OASIS|2.12|16700|M1308_NSTG_DRSG|Unstageable: non-removable dressing/device|809|2||x|x|x|x||||x||||||
OASIS|2.12|16900|M1308_NSTG_CVRG|Unstageable: coverage by slough or eschar|813|2||x|x|x|x||||x||||||
OASIS|2.12|17100|M1308_NSTG_DEEP_TISUE|Unstageable: suspect deep tissue injury|817|2||x|x|x|x||||x||||||
OASIS|2.12|17210|M1309_NBR_NEW_WRS_PRSULC_STG2|Number of new or worsening stage 2|1531|2|||||||||x||||||
OASIS|2.12|17220|M1309_NBR_NEW_WRS_PRSULC_STG3|Number of new or worsening stage 3|1533|2|||||||||x||||||
OASIS|2.12|17230|M1309_NBR_NEW_WRS_PRSULC_STG4|Number of new or worsening stage 4|1535|2|||||||||x||||||
OASIS|2.12|17240|M1309_NBR_NEW_WRS_PRSULC_NSTG|Number of new or worsening unstageable|1551|2|||||||||x||||||
OASIS|2.12|17600|M1320_STUS_PRBLM_PRSR_ULCR|Status of most problematic pressure ulcer|833|2||x|x| |||||x||||||
OASIS|2.12|17700|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure ulcers|835|2||x|x|x|x||||x||||||
OASIS|2.12|17800|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer|837|2||x|x|x|x||||x||||||
OASIS|2.12|17900|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2||x|x|x|x||||x||||||
OASIS|2.12|18000|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2||x|x|x|x||||x||||||
OASIS|2.12|18100|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2||x|x|x|x||||x||||||
OASIS|2.12|18200|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2||x|x|x|x||||x||||||
OASIS|2.12|18300|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2||x|x|x|x||||x||||||
OASIS|2.12|18400|M1350_LESION_OPEN_WND|Has skin lesion or open wound|849|1||x|x||||||||||||
OASIS|2.12|18500|M1400_WHEN_DYSPNEIC|When dyspneic|850|2||x|x|x|x||||x||||||
OASIS|2.12|18600|M1410_RESPTX_OXYGEN|Respiratory treatments: oxygen|852|1||x|x| |||||||||||
OASIS|2.12|18700|M1410_RESPTX_VENTILATOR|Respiratory treatments: ventilator|853|1||x|x| |||||||||||
OASIS|2.12|18800|M1410_RESPTX_AIRPRESS|Respiratory treatments: airway pressure|854|1||x|x| |||||||||||
OASIS|2.12|18900|M1410_RESPTX_NONE|Respiratory treatments: none of the above|855|1||x|x| |||||||||||
OASIS|2.12|19000|M1500_SYMTM_HRT_FAILR_PTNTS|Symptoms in heart failure patients|856|2|| | | ||x|x||x||||||
OASIS|2.12|19100|M1510_HRT_FAILR_NO_ACTN|Heart failure follow up:  no action|858|1|| | | ||x|x||x||||||
OASIS|2.12|19200|M1510_HRT_FAILR_PHYSN_CNTCT|Heart failure follow up:  physician contacted|859|1|| | | ||x|x||x||||||
OASIS|2.12|19300|M1510_HRT_FAILR_ER_TRTMT|Heart failure follow up:  ER treatment advised|860|1|| | | ||x|x||x||||||
OASIS|2.12|19400|M1510_HRT_FAILR_PHYSN_TRTMT|Heart failure follow up:  phys-ordered treatmnt|861|1|| | | ||x|x||x||||||
OASIS|2.12|19500|M1510_HRT_FAILR_CLNCL_INTRVTN|Heart failure follow up: pt educ/other clinical|862|1|| | | ||x|x||x||||||
OASIS|2.12|19600|M1510_HRT_FAILR_CARE_PLAN_CHG|Heart failure follow up: change in care plan|863|1|| | | ||x|x||x||||||
OASIS|2.12|19700|M1600_UTI|Treated for urinary tract infection past 14 days|864|2||x|x| |||||x||||||
OASIS|2.12|19800|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2||x|x|x|x||||x||||||
OASIS|2.12|19900|M1615_INCNTNT_TIMING|When urinary incontinence occurs|868|2||x|x| |||||x||||||
OASIS|2.12|20000|M1620_BWL_INCONT|Bowel incontinence frequency|870|2||x|x|x|x||||x||||||
OASIS|2.12|20100|M1630_OSTOMY|Ostomy for bowel elimination|872|2||x|x|x|x||||||||||
OASIS|2.12|20200|M1700_COG_FUNCTION|Cognitive functioning|874|2||x|x| |||||x||||||
OASIS|2.12|20300|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2||x|x| |||||x||||||
OASIS|2.12|20400|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2||x|x| |||||x||||||
OASIS|2.12|20500|M1730_STDZ_DPRSN_SCRNG|Screened for depression using validated tool|880|2||x|x| |||||||||||
OASIS|2.12|20600|M1730_PHQ2_LACK_INTRST|PHQ2: little interest or pleasure in doing things|882|2||x|x| |||||||||||
OASIS|2.12|20700|M1730_PHQ2_DPRSN|PHQ2: feeling down depressed or hopeless|884|2||x|x| |||||||||||
OASIS|2.12|20800|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1||x|x| |||||x||||||
OASIS|2.12|20900|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1||x|x| |||||x||||||
OASIS|2.12|21000|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1||x|x| |||||x||||||
OASIS|2.12|21100|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1||x|x| |||||x||||||
OASIS|2.12|21200|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1||x|x| |||||x||||||
OASIS|2.12|21300|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1||x|x| |||||x||||||
OASIS|2.12|21400|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1||x|x| |||||x||||||
OASIS|2.12|21500|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2||x|x| |||||x||||||
OASIS|2.12|21600|M1750_REC_PSYCH_NURS|Receives psychiatric nursing|895|1||x|x| |||||||||||
OASIS|2.12|21700|M1800_CRNT_GROOMING|Current: grooming|896|2||x|x| |||||x||||||
OASIS|2.12|21800|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2||x|x|x|x||||x||||||
OASIS|2.12|21900|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2||x|x|x|x||||x||||||
OASIS|2.12|22000|M1830_CRNT_BATHG|Current: bathing|902|2||x|x|x|x||||x||||||
OASIS|2.12|22100|M1840_CRNT_TOILTG|Current: toileting|904|2||x|x|x|x||||x||||||
OASIS|2.12|22200|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2||x|x| |||||x||||||
OASIS|2.12|22300|M1850_CRNT_TRNSFRNG|Current: transferring|908|2||x|x|x|x||||x||||||
OASIS|2.12|22400|M1860_CRNT_AMBLTN|Current: ambulation|910|2||x|x|x|x||||x||||||
OASIS|2.12|22500|M1870_CRNT_FEEDING|Current: feeding|912|2||x|x| |||||x||||||
OASIS|2.12|22600|M1880_CRNT_PREP_LT_MEALS|Current: prepare light meals|914|2||x|x| |||||x||||||
OASIS|2.12|22700|M1890_CRNT_PHONE_USE|Current: telephone use|916|2||x|x| |||||x||||||
OASIS|2.12|22800|M1900_PRIOR_ADLIADL_SELF|Prior functioning ADL/IADL: self-care|918|2||x|x| |||||||||||
OASIS|2.12|22900|M1900_PRIOR_ADLIADL_AMBLTN|Prior functioning ADL/IADL: ambulation|920|2||x|x| |||||||||||
OASIS|2.12|23000|M1900_PRIOR_ADLIADL_TRNSFR|Prior functioning ADL/IADL: transfer|922|2||x|x| |||||||||||
OASIS|2.12|23100|M1900_PRIOR_ADLIADL_HSEHOLD|Prior functioning ADL/IADL: household tasks|924|2||x|x| |||||||||||
OASIS|2.12|23200|M1910_MLT_FCTR_FALL_RISK_ASMT|Has patient had a multi-factor fall risk asmt|926|2||x|x| |||||||||||
OASIS|2.12|23300|M2000_DRUG_RGMN_RVW|Drug regimen review|928|2||x|x| |||||||||||
OASIS|2.12|23400|M2002_MDCTN_FLWP|Medication follow-up|930|1||x|x| |||||||||||
OASIS|2.12|23500|M2004_MDCTN_INTRVTN|Medication intervention|931|2|| | | ||x|x||x||||||
OASIS|2.12|23600|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2||x|x| |||||||||||
OASIS|2.12|23700|M2015_DRUG_EDCTN_INTRVTN|Patient/caregiver drug education intervention|935|2|| | | ||x|x||x||||||
OASIS|2.12|23800|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2||x|x| |||||x||||||
OASIS|2.12|23900|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2||x|x|x|x||||x||||||
OASIS|2.12|24000|M2040_PRIOR_MGMT_ORAL_MDCTN|Prior med mgmt: oral medications|941|2||x|x| |||||||||||
OASIS|2.12|24100|M2040_PRIOR_MGMT_INJCTN_MDCTN|Prior med mgmt: injectable medications|943|2||x|x| |||||||||||
OASIS|2.12|24210|M2102_CARE_TYPE_SRC_ADL|Care mgmt types/sources: ADL|1537|2||x|x||||||x||||||
OASIS|2.12|24310|M2102_CARE_TYPE_SRC_IADL|Care mgmt types/sources: IADL|1539|2||x|x||||||x||||||
OASIS|2.12|24410|M2102_CARE_TYPE_SRC_MDCTN|Care mgmt types/sources: med admin|1541|2||x|x||||||x||||||
OASIS|2.12|24510|M2102_CARE_TYPE_SRC_PRCDR|Care mgmt types/sources: med procs tx|1543|2||x|x||||||x||||||
OASIS|2.12|24610|M2102_CARE_TYPE_SRC_EQUIP|Care mgmt types/sources: equipment|1545|2||x|x||||||x||||||
OASIS|2.12|24710|M2102_CARE_TYPE_SRC_SPRVSN|Care mgmt types/sources: supervision and safety|1547|2||x|x||||||x||||||
OASIS|2.12|24810|M2102_CARE_TYPE_SRC_ADVCY|Care mgmt types/sources: advocacy or facilitation|1549|2||x|x||||||x||||||
OASIS|2.12|24900|M2110_ADL_IADL_ASTNC_FREQ|How often recv non-HHA caregiver ADL/IADL assist|959|2||x|x| |||||||||||
OASIS|2.12|25000|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3||x|x|x|x||||||||||
OASIS|2.12|25100|M2200_THER_NEED_NA|Therapy need: not applicable|964|1||x|x|x|x||||||||||
OASIS|2.12|25200|M2250_PLAN_SMRY_PTNT_SPECF|Plan of care synopsis: patient specific parameters|965|2||x|x| |||||||||||
OASIS|2.12|25300|M2250_PLAN_SMRY_DBTS_FT_CARE|Plan of care synopsis: diabetic foot care|967|2||x|x| |||||||||||
OASIS|2.12|25400|M2250_PLAN_SMRY_FALL_PRVNT|Plan of care synopsis: falls prevention|969|2||x|x| |||||||||||
OASIS|2.12|25500|M2250_PLAN_SMRY_DPRSN_INTRVTN|Plan of care synopsis: depression interventions|971|2||x|x| |||||||||||
OASIS|2.12|25600|M2250_PLAN_SMRY_PAIN_INTRVTN|Plan of care synopsis: pain interventions|973|2||x|x| |||||||||||
OASIS|2.12|25700|M2250_PLAN_SMRY_PRSULC_PRVNT|Plan of care synopsis: PU prevention|975|2||x|x| |||||||||||
OASIS|2.12|25800|M2250_PLAN_SMRY_PRSULC_TRTMT|Plan of care synopsis: PU moist treatment|977|2||x|x| |||||||||||
OASIS|2.12|25900|M2300_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since previous OASIS|979|2|| | | ||x|x||x||||||
OASIS|2.12|26000|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1|| | | ||x|x||x||||||
OASIS|2.12|26100|M2310_ECR_INJRY_BY_FALL|Emergent care reason: injury caused by fall|982|1|| | | ||x|x||x||||||
OASIS|2.12|26200|M2310_ECR_RSPRTRY_INFCTN|Emergent care reason: respiratory infection|983|1|| | | ||x|x||x||||||
OASIS|2.12|26300|M2310_ECR_RSPRTRY_OTHR|Emergent care reason: respiratory other|984|1|| | | ||x|x||x||||||
OASIS|2.12|26400|M2310_ECR_HRT_FAILR|Emergent care reason: heart failure|985|1|| | | ||x|x||x||||||
OASIS|2.12|26500|M2310_ECR_CRDC_DSRTHM|Emergent care reason: cardiac dysrhythmia|986|1|| | | ||x|x||x||||||
OASIS|2.12|26600|M2310_ECR_MI_CHST_PAIN|Emergent care reason: myocard infarct/chest pain|987|1|| | | ||x|x||x||||||
OASIS|2.12|26700|M2310_ECR_OTHR_HRT_DEASE|Emergent care reason: other heart disease|988|1|| | | ||x|x||x||||||
OASIS|2.12|26800|M2310_ECR_STROKE_TIA|Emergent care reason: stroke (CVA) or TIA|989|1|| | | ||x|x||x||||||
OASIS|2.12|26900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1|| | | ||x|x||x||||||
OASIS|2.12|27000|M2310_ECR_GI_PRBLM|Emergent care: GI bleed/obstruct/constip/impact|991|1|| | | ||x|x||x||||||
OASIS|2.12|27100|M2310_ECR_DHYDRTN_MALNTR|Emergent care reason: dehydration malnutrition|992|1|| | | ||x|x||x||||||
OASIS|2.12|27200|M2310_ECR_UTI|Emergent care reason: urinary tract infection|993|1|| | | ||x|x||x||||||
OASIS|2.12|27300|M2310_ECR_CTHTR_CMPLCTN|Emergent care reason: IV catheter infect/complic|994|1|| | | ||x|x||x||||||
OASIS|2.12|27400|M2310_ECR_WND_INFCTN_DTRORTN|Emergent care reason: wound infect/deterioration|995|1|| | | ||x|x||x||||||
OASIS|2.12|27500|M2310_ECR_UNCNTLD_PAIN|Emergent care reason: uncontrolled pain|996|1|| | | ||x|x||x||||||
OASIS|2.12|27600|M2310_ECR_MENTL_BHVRL_PRBLM|Emergent care reason: acute mental/behav problem|997|1|| | | ||x|x||x||||||
OASIS|2.12|27700|M2310_ECR_DVT_PULMNRY|Emergent care reason: deep vein thromb/pulm embol|998|1|| | | ||x|x||x||||||
OASIS|2.12|27800|M2310_ECR_OTHER|Emergent care reason: other than above|999|1|| | | ||x|x||x||||||
OASIS|2.12|27900|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1|| | | ||x|x||x||||||
OASIS|2.12|28000|M2400_INTRVTN_SMRY_DBTS_FT|Intervention synopsis: diabetic foot care|1001|2|| | | ||x|x||x||||||
OASIS|2.12|28100|M2400_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1003|2|| | | ||x|x||x||||||
OASIS|2.12|28200|M2400_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1005|2|| | | ||x|x||x||||||
OASIS|2.12|28300|M2400_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1007|2|| | | ||x|x||x||||||
OASIS|2.12|28400|M2400_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1009|2|| | | ||x|x||x||||||
OASIS|2.12|28500|M2400_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1011|2|| | | ||x|x||x||||||
OASIS|2.12|28600|M2410_INPAT_FACILITY|Inpatient facility|1013|2|| | | ||x|x||x||||||
OASIS|2.12|28700|M2420_DSCHRG_DISP|Discharge disposition|1015|2|| | | |||||x||||||
OASIS|2.12|28800|M2430_HOSP_MED|Hospitalized: medication|1017|1|| | | ||x|x||||||||
OASIS|2.12|28900|M2430_HOSP_INJRY_BY_FALL|Hospitalized: injury caused by fall|1018|1|| | | ||x|x||||||||
OASIS|2.12|29000|M2430_HOSP_RSPRTRY_INFCTN|Hospitalized: respiratory infection|1019|1|| | | ||x|x||||||||
OASIS|2.12|29100|M2430_HOSP_RSPRTRY_OTHR|Hospitalized: other respiratory|1020|1|| | | ||x|x||||||||
OASIS|2.12|29200|M2430_HOSP_HRT_FAILR|Hospitalized: heart failure|1021|1|| | | ||x|x||||||||
OASIS|2.12|29300|M2430_HOSP_CRDC_DSRTHM|Hospitalized: cardiac dysrhythmia|1022|1|| | | ||x|x||||||||
OASIS|2.12|29400|M2430_HOSP_MI_CHST_PAIN|Hospitalized: myocardial infarction or chest pain|1023|1|| | | ||x|x||||||||
OASIS|2.12|29500|M2430_HOSP_OTHR_HRT_DEASE|Hospitalized: other heart disease|1024|1|| | | ||x|x||||||||
OASIS|2.12|29600|M2430_HOSP_STROKE_TIA|Hospitalized: stroke (CVA) or TIA|1025|1|| | | ||x|x||||||||
OASIS|2.12|29700|M2430_HOSP_HYPOGLYC|Hospitalized: hypoglycemia/hyperglycemia|1026|1|| | | ||x|x||||||||
OASIS|2.12|29800|M2430_HOSP_GI_PRBLM|Hospitalized: GI bleed/obstruct/constip/impact|1027|1|| | | ||x|x||||||||
OASIS|2.12|29900|M2430_HOSP_DHYDRTN_MALNTR|Hospitalized: dehydration malnutrition|1028|1|| | | ||x|x||||||||
OASIS|2.12|30000|M2430_HOSP_UR_TRACT|Hospitalized: urinary tract infection|1029|1|| | | ||x|x||||||||
OASIS|2.12|30100|M2430_HOSP_CTHTR_CMPLCTN|Hospitalized: IV catheter infect/complic|1030|1|| | | ||x|x||||||||
OASIS|2.12|30200|M2430_HOSP_WND_INFCTN|Hospitalized: wound infect/deterioration|1031|1|| | | ||x|x||||||||
OASIS|2.12|30300|M2430_HOSP_PAIN|Hospitalized: uncontrolled pain|1032|1|| | | ||x|x||||||||
OASIS|2.12|30400|M2430_HOSP_MENTL_BHVRL_PRBLM|Hospitalized: acute mental/behav problem|1033|1|| | | ||x|x||||||||
OASIS|2.12|30500|M2430_HOSP_DVT_PULMNRY|Hospitalized: deep vein thromb/pulm embol|1034|1|| | | ||x|x||||||||
OASIS|2.12|30600|M2430_HOSP_SCHLD_TRTMT|Hospitalized: scheduled treatment or procedure|1035|1|| | | ||x|x||||||||
OASIS|2.12|30700|M2430_HOSP_OTHER|Hospitalized: other|1036|1|| | | ||x|x||||||||
OASIS|2.12|30800|M2430_HOSP_UK|Hospitalized: UK|1037|1|| | | ||x|x||||||||
OASIS|2.12|31600|M0903_LAST_HOME_VISIT|Date of last home visit|1045|8|| | | ||x|x|x|x||||||
OASIS|2.12|31700|M0906_DC_TRAN_DTH_DT|Discharge - transfer -  death date|1053|8|| | | ||x|x|x|x|x|||||
OASIS|2.20|50|ASMT_SYS_CD|Assessment system code|1|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|100|TRANS_TYPE_CD|Transaction type code|11|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|150|ITM_SBST_CD|Item subset code|12|3||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|200|ITM_SET_VRSN_CD|Item set version code|15|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|250|SPEC_VRSN_CD|Specifications version code|25|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|300|CORRECTION_NUM|Correction number|35|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|350|STATE_CD|Agency's state postal code|37|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|400|HHA_AGENCY_ID|Assigned agency submission ID|39|16||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|500|SFW_ID|Software vendor federal employer tax ID|65|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|550|SFW_NAME|Software vendor company name|74|30||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|600|SFW_EMAIL_ADR|Software vendor email address|104|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|650|SFW_PROD_NAME|Software product name|154|50||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|700|SFW_PROD_VRSN_CD|Software product version code|204|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|750|ACY_DOC_CD|Document ID code (agency use)|224|20||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|800|SUBM_HIPPS_CODE|HIPPS group code: submitted|244|5||x|x|x|x||||||||||
OASIS|2.20|850|SUBM_HIPPS_VERSION|HIPPS version code: submitted|249|5||x|x|x|x||||||||||
OASIS|2.20|1500|M0010_CCN|Facility CMS certification number (CCN)|254|6||x|x|x|x|x|x|x|x||||||
OASIS|2.20|1600|M0014_BRANCH_STATE|Branch state|260|2||x|x|x|x|x|x|x|x||||||
OASIS|2.20|1700|M0016_BRANCH_ID|Branch ID|262|10||x|x|x|x|x|x|x|x||||||
OASIS|2.20|1800|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10||x|x|x|x|x|x|x|x||||||
OASIS|2.20|1900|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|2000|M0020_PAT_ID|Patient ID number|283|20||x|x|x|x|x|x|x|x||||||
OASIS|2.20|2100|M0030_START_CARE_DT|Start of care date|303|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|2200|M0032_ROC_DT|Resumption of care date|311|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|2300|M0032_ROC_DT_NA|No resumption of care date|319|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|2400|M0040_PAT_FNAME|Patient's first name|320|12||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|2500|M0040_PAT_MI|Patient's middle initial|332|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|2600|M0040_PAT_LNAME|Patient's last name|333|18||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|2700|M0040_PAT_SUFFIX|Patient's suffix|351|3||x|x|x|x|x|x|x|x||||||
OASIS|2.20|2800|M0050_PAT_ST|Patient state of residence|354|2||x|x|x|x|x|x|x|x||||||
OASIS|2.20|2900|M0060_PAT_ZIP|Patient zip code|356|11||x|x|x|x|x|x|x|x||||||
OASIS|2.20|3000|M0063_MEDICARE_NUM|Medicare number including suffix|367|12||x|x|x|x|x|x|x|x||||||
OASIS|2.20|3100|M0063_MEDICARE_NA|No Medicare number|379|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|3200|M0064_SSN|Patient's Social Security number|380|9||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|3300|M0064_SSN_UK|No Social Security number|389|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|3400|M0065_MEDICAID_NUM|Medicaid number|390|14||x|x|x|x|x|x|x|x||||||
OASIS|2.20|3500|M0065_MEDICAID_NA|No Medicaid number|404|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|3600|M0066_PAT_BIRTH_DT|Date of birth|405|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|3700|M0069_PAT_GENDER|Gender|413|1||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|3800|M0140_ETHNIC_AI_AN|Ethnicity: American Indian or Alaska Native|414|1||x|x| |||||||||||
OASIS|2.20|3900|M0140_ETHNIC_ASIAN|Ethnicity: Asian|415|1||x|x| |||||||||||
OASIS|2.20|4000|M0140_ETHNIC_BLACK|Ethnicity: Black or African American|416|1||x|x| |||||||||||
OASIS|2.20|4100|M0140_ETHNIC_HISP|Ethnicity: Hispanic or Latino|417|1||x|x| |||||||||||
OASIS|2.20|4200|M0140_ETHNIC_NH_PI|Ethnicity: Native Hawaiian/Pacific Islander|418|1||x|x| |||||||||||
OASIS|2.20|4300|M0140_ETHNIC_WHITE|Ethnicity: White|419|1||x|x| |||||||||||
OASIS|2.20|4400|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|4500|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|4600|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|4700|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|4800|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|4900|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5000|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5100|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5200|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5300|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5400|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5500|M0150_CPAY_OTHER|Payment sources: other|431|1||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5600|M0150_CPAY_UK|Payment sources: unknown|432|1||x|x| |||||||||||
OASIS|2.20|5700|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2||x|x|x|x|x|x|x|x||||||
OASIS|2.20|5800|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|5900|M0100_ASSMT_REASON|Reason for assessment|443|2||x|x|x|x|x|x|x|x|x|||||
OASIS|2.20|6000|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8||x|x| |||||||||||
OASIS|2.20|6100|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1||x|x| |||||||||||
OASIS|2.20|6200|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8||x|x| |||||||||||
OASIS|2.20|6300|M0110_EPISODE_TIMING|Episode timing|462|2||x|x|x|x||||||||||
OASIS|2.20|6400|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1||x|x| |||||||||||
OASIS|2.20|6500|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1||x|x| |||||||||||
OASIS|2.20|6600|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1||x|x| |||||||||||
OASIS|2.20|6700|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1||x|x| |||||||||||
OASIS|2.20|6800|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1||x|x| |||||||||||
OASIS|2.20|6900|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1||x|x| |||||||||||
OASIS|2.20|7000|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1||x|x| |||||||||||
OASIS|2.20|7100|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1||x|x| |||||||||||
OASIS|2.20|7200|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8||x|x| |||||||||||
OASIS|2.20|7300|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1||x|x| |||||||||||
OASIS|2.20|7400|M1011_14_DAY_INP1_ICD|Inpatient stay within last 14 days: ICD code 1|1261|8||x|x|x|x||||||||||
OASIS|2.20|7500|M1011_14_DAY_INP2_ICD|Inpatient stay within last 14 days: ICD code 2|1269|8||x|x|x|x||||||||||
OASIS|2.20|7600|M1011_14_DAY_INP3_ICD|Inpatient stay within last 14 days: ICD code 3|1277|8||x|x|x|x||||||||||
OASIS|2.20|7700|M1011_14_DAY_INP4_ICD|Inpatient stay within last 14 days: ICD code 4|1285|8||x|x|x|x||||||||||
OASIS|2.20|7800|M1011_14_DAY_INP5_ICD|Inpatient stay within last 14 days: ICD code 5|1293|8||x|x|x|x||||||||||
OASIS|2.20|7900|M1011_14_DAY_INP6_ICD|Inpatient stay within last 14 days: ICD code 6|1301|8||x|x|x|x||||||||||
OASIS|2.20|7950|M1011_14_DAY_INP_NA|Inpatient stay within last 14 days: not applicable|1309|1||||x|x||||||||||
OASIS|2.20|8700|M1017_CHGREG_ICD1|Regimen change in past 14 days: ICD code 1|1310|8||x|x| |||||||||||
OASIS|2.20|8800|M1017_CHGREG_ICD2|Regimen change in past 14 days: ICD code 2|1318|8||x|x| |||||||||||
OASIS|2.20|8900|M1017_CHGREG_ICD3|Regimen change in past 14 days: ICD code 3|1326|8||x|x| |||||||||||
OASIS|2.20|9000|M1017_CHGREG_ICD4|Regimen change in past 14 days: ICD code 4|1334|8||x|x| |||||||||||
OASIS|2.20|9100|M1017_CHGREG_ICD5|Regimen change in past 14 days: ICD code 5|1342|8||x|x| |||||||||||
OASIS|2.20|9200|M1017_CHGREG_ICD6|Regimen change in past 14 days: ICD code 6|1350|8||x|x| |||||||||||
OASIS|2.20|9300|M1017_CHGREG_ICD_NA|Regimen change in past 14 days: not applicable|1358|1||x|x| |||||||||||
OASIS|2.20|9400|M1018_PRIOR_UR_INCON|Prior condition: urinary incontinence|596|1||x|x| |||||||||||
OASIS|2.20|9500|M1018_PRIOR_CATH|Prior condition: indwelling/suprapubic catheter|597|1||x|x| |||||||||||
OASIS|2.20|9600|M1018_PRIOR_INTRACT_PAIN|Prior condition: intractable pain|598|1||x|x| |||||||||||
OASIS|2.20|9700|M1018_PRIOR_IMPR_DECSN|Prior condition: impaired decision-making|599|1||x|x| |||||||||||
OASIS|2.20|9800|M1018_PRIOR_DISRUPTIVE|Prior condition: disruptive/inappropriate behav|600|1||x|x| |||||||||||
OASIS|2.20|9900|M1018_PRIOR_MEM_LOSS|Prior condition: memory loss supervision required|601|1||x|x| |||||||||||
OASIS|2.20|10000|M1018_PRIOR_NONE|Prior condition: none of the above|602|1||x|x| |||||||||||
OASIS|2.20|10100|M1018_PRIOR_NOCHG_14D|Prior condition: no inpt disch/no change regimen|603|1||x|x| |||||||||||
OASIS|2.20|10200|M1018_PRIOR_UNKNOWN|Prior condition: unknown|604|1||x|x| |||||||||||
OASIS|2.20|10300|M1021_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|1359|8||x|x|x|x||||||||||
OASIS|2.20|10400|M1021_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|1367|2||x|x|x|x||||||||||
OASIS|2.20|10500|M1023_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|1369|8||x|x|x|x||||||||||
OASIS|2.20|10600|M1023_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|1377|2||x|x|x|x||||||||||
OASIS|2.20|10700|M1023_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|1379|8||x|x|x|x||||||||||
OASIS|2.20|10800|M1023_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|1387|2||x|x|x|x||||||||||
OASIS|2.20|10900|M1023_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|1389|8||x|x|x|x||||||||||
OASIS|2.20|11000|M1023_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|1397|2||x|x|x|x||||||||||
OASIS|2.20|11100|M1023_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|1399|8||x|x|x|x||||||||||
OASIS|2.20|11200|M1023_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|1407|2||x|x|x|x||||||||||
OASIS|2.20|11300|M1023_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|1409|8||x|x|x|x||||||||||
OASIS|2.20|11400|M1023_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|1417|2||x|x|x|x||||||||||
OASIS|2.20|11500|M1025_OPT_DIAG_ICD_A3|Case mix diagnosis: primary column 3|1419|8||x|x|x|x||||||||||
OASIS|2.20|11600|M1025_OPT_DIAG_ICD_B3|Case mix diagnosis: first secondary column 3|1435|8||x|x|x|x||||||||||
OASIS|2.20|11700|M1025_OPT_DIAG_ICD_C3|Case mix diagnosis: second secondary column 3|1451|8||x|x|x|x||||||||||
OASIS|2.20|11800|M1025_OPT_DIAG_ICD_D3|Case mix diagnosis: third secondary column 3|1467|8||x|x|x|x||||||||||
OASIS|2.20|11900|M1025_OPT_DIAG_ICD_E3|Case mix diagnosis: fourth secondary column 3|1483|8||x|x|x|x||||||||||
OASIS|2.20|12000|M1025_OPT_DIAG_ICD_F3|Case mix diagnosis: fifth secondary column 3|1499|8||x|x|x|x||||||||||
OASIS|2.20|12100|M1025_OPT_DIAG_ICD_A4|Case mix diagnosis: primary column 4|1427|8||x|x|x|x||||||||||
OASIS|2.20|12200|M1025_OPT_DIAG_ICD_B4|Case mix diagnosis: first secondary column 4|1443|8||x|x|x|x||||||||||
OASIS|2.20|12300|M1025_OPT_DIAG_ICD_C4|Case mix diagnosis: second secondary column 4|1459|8||x|x|x|x||||||||||
OASIS|2.20|12400|M1025_OPT_DIAG_ICD_D4|Case mix diagnosis: third secondary column 4|1475|8||x|x|x|x||||||||||
OASIS|2.20|12500|M1025_OPT_DIAG_ICD_E4|Case mix diagnosis: fourth secondary column 4|1491|8||x|x|x|x||||||||||
OASIS|2.20|12600|M1025_OPT_DIAG_ICD_F4|Case mix diagnosis: fifth secondary column 4|1507|8||x|x|x|x||||||||||
OASIS|2.20|12700|M1030_THH_IV_INFUSION|Therapies received at home: intravenous infusion|743|1||x|x|x|x||||||||||
OASIS|2.20|12800|M1030_THH_PAR_NUTRITION|Therapies received at home: parenteral nutrition|744|1||x|x|x|x||||||||||
OASIS|2.20|12900|M1030_THH_ENT_NUTRITION|Therapies received at home: enteral nutrition|745|1||x|x|x|x||||||||||
OASIS|2.20|13000|M1030_THH_NONE_ABOVE|Therapies received at home: none of the above|746|1||x|x|x|x||||||||||
OASIS|2.20|13110|M1033_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|1515|1||x|x||||||||||||
OASIS|2.20|13210|M1033_HOSP_RISK_WEIGHT_LOSS|Hosp risk: unintentional weight loss|1516|1||x|x||||||||||||
OASIS|2.20|13310|M1033_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 12 months|1517|1||x|x||||||||||||
OASIS|2.20|13410|M1033_HOSP_RISK_MLTPL_ED_VISIT|Hosp risk: 2+ emergcy dept visits in past 6 months|1518|1||x|x||||||||||||
OASIS|2.20|13510|M1033_HOSP_RISK_MNTL_BHV_DCLN|Hosp risk: decline mental/emotional/behav status|1519|1||x|x||||||||||||
OASIS|2.20|13610|M1033_HOSP_RISK_COMPLIANCE|Hosp risk: difficulty with medical instructions|1520|1||x|x||||||||||||
OASIS|2.20|13710|M1033_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|1521|1||x|x||||||||||||
OASIS|2.20|13720|M1033_HOSP_RISK_CRNT_EXHSTN|Hosp risk: current exhaustion|1522|1||x|x||||||||||||
OASIS|2.20|13730|M1033_HOSP_RISK_OTHR_RISK|Hosp risk: other risk(s) not listed|1523|1||x|x||||||||||||
OASIS|2.20|13740|M1033_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|1524|1||x|x||||||||||||
OASIS|2.20|13800|M1034_PTNT_OVRAL_STUS|Patient's overall status|754|2||x|x| |||||||||||
OASIS|2.20|13900|M1036_RSK_SMOKING|High risk factor: smoking|756|1||x|x| |||||||||||
OASIS|2.20|14000|M1036_RSK_OBESITY|High risk factor: obesity|757|1||x|x| |||||||||||
OASIS|2.20|14100|M1036_RSK_ALCOHOLISM|High risk factor: alcoholism|758|1||x|x| |||||||||||
OASIS|2.20|14200|M1036_RSK_DRUGS|High risk factor: drugs|759|1||x|x| |||||||||||
OASIS|2.20|14300|M1036_RSK_NONE|High risk factor: none of the above|760|1||x|x| |||||||||||
OASIS|2.20|14400|M1036_RSK_UNKNOWN|High risk factor: unknown|761|1||x|x| |||||||||||
OASIS|2.20|14510|M1041_IN_INFLNZ_SEASON|Does episode include Oct 1 thru Mar 31|1525|1||||||x|x||x||||||
OASIS|2.20|14610|M1046_INFLNZ_RECD_CRNT_SEASON|Did patient receive influenza vaccine|1526|2||||||x|x||x||||||
OASIS|2.20|14710|M1051_PVX_RCVD_AGNCY|Was pneumococcal vaccine received|1528|1||||||x|x||x||||||
OASIS|2.20|14810|M1056_PVX_RSN_NOT_RCVD_AGNCY|If pneumococcal vacc not received state reason|1529|2||||||x|x||x||||||
OASIS|2.20|14900|M1100_PTNT_LVG_STUTN|Patient living situation|769|2||x|x| |||||||||||
OASIS|2.20|15000|M1200_VISION|Sensory status: vision|771|2||x|x|x|x||||||||||
OASIS|2.20|15100|M1210_HEARG_ABLTY|Ability to hear|773|2||x|x| |||||||||||
OASIS|2.20|15200|M1220_UNDRSTG_VERBAL_CNTNT|Understanding verbal content in patient's language|775|2||x|x| |||||||||||
OASIS|2.20|15300|M1230_SPEECH|Sensory status: speech|777|2||x|x| |||||x||||||
OASIS|2.20|15400|M1240_FRML_PAIN_ASMT|Has patient had a formal validated pain assessment|779|2||x|x| |||||||||||
OASIS|2.20|15500|M1242_PAIN_FREQ_ACTVTY_MVMT|Freq of pain interfering with pt activity/movement|781|2||x|x|x|x||||x||||||
OASIS|2.20|15600|M1300_PRSR_ULCR_RISK_ASMT|Was patient assessed for risk of developing PUs|783|2||x|x| |||||||||||
OASIS|2.20|15700|M1302_RISK_OF_PRSR_ULCR|Does this patient have a risk of developing PUs|785|1||x|x| |||||||||||
OASIS|2.20|15800|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU at stage 2 or higher|786|1||x|x|x|x||||x||||||
OASIS|2.20|16000|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2|| | | |||||x||||||
OASIS|2.20|16010|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8|| | | |||||x||||||
OASIS|2.20|17210|M1309_NBR_NEW_WRS_PRSULC_STG2|Number of new or worsening stage 2|1531|2|||||||||x||||||
OASIS|2.20|17220|M1309_NBR_NEW_WRS_PRSULC_STG3|Number of new or worsening stage 3|1533|2|||||||||x||||||
OASIS|2.20|17230|M1309_NBR_NEW_WRS_PRSULC_STG4|Number of new or worsening stage 4|1535|2|||||||||x||||||
OASIS|2.20|17240|M1309_NBR_NEW_WRS_PRSULC_NSTG|Number of new or worsening unstageable|1551|2|||||||||x||||||
OASIS|2.20|17600|M1320_STUS_PRBLM_PRSR_ULCR|Status of most problematic pressure ulcer|833|2||x|x| |||||x||||||
OASIS|2.20|17700|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure ulcers|835|2||x|x|x|x||||x||||||
OASIS|2.20|17800|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer|837|2||x|x|x|x||||x||||||
OASIS|2.20|17900|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2||x|x|x|x||||x||||||
OASIS|2.20|18000|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2||x|x|x|x||||x||||||
OASIS|2.20|18100|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2||x|x|x|x||||x||||||
OASIS|2.20|18200|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2||x|x|x|x||||x||||||
OASIS|2.20|18300|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2||x|x|x|x||||x||||||
OASIS|2.20|18400|M1350_LESION_OPEN_WND|Has skin lesion or open wound|849|1||x|x||||||||||||
OASIS|2.20|18500|M1400_WHEN_DYSPNEIC|When dyspneic|850|2||x|x|x|x||||x||||||
OASIS|2.20|18600|M1410_RESPTX_OXYGEN|Respiratory treatments: oxygen|852|1||x|x| |||||||||||
OASIS|2.20|18700|M1410_RESPTX_VENTILATOR|Respiratory treatments: ventilator|853|1||x|x| |||||||||||
OASIS|2.20|18800|M1410_RESPTX_AIRPRESS|Respiratory treatments: airway pressure|854|1||x|x| |||||||||||
OASIS|2.20|18900|M1410_RESPTX_NONE|Respiratory treatments: none of the above|855|1||x|x| |||||||||||
OASIS|2.20|19700|M1600_UTI|Treated for urinary tract infection past 14 days|864|2||x|x| |||||x||||||
OASIS|2.20|19800|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2||x|x|x|x||||x||||||
OASIS|2.20|19900|M1615_INCNTNT_TIMING|When urinary incontinence occurs|868|2||x|x| |||||x||||||
OASIS|2.20|20000|M1620_BWL_INCONT|Bowel incontinence frequency|870|2||x|x|x|x||||x||||||
OASIS|2.20|20100|M1630_OSTOMY|Ostomy for bowel elimination|872|2||x|x|x|x||||||||||
OASIS|2.20|20200|M1700_COG_FUNCTION|Cognitive functioning|874|2||x|x| |||||x||||||
OASIS|2.20|20300|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2||x|x| |||||x||||||
OASIS|2.20|20400|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2||x|x| |||||x||||||
OASIS|2.20|20500|M1730_STDZ_DPRSN_SCRNG|Screened for depression using validated tool|880|2||x|x| |||||||||||
OASIS|2.20|20600|M1730_PHQ2_LACK_INTRST|PHQ2: little interest or pleasure in doing things|882|2||x|x| |||||||||||
OASIS|2.20|20700|M1730_PHQ2_DPRSN|PHQ2: feeling down depressed or hopeless|884|2||x|x| |||||||||||
OASIS|2.20|20800|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1||x|x| |||||x||||||
OASIS|2.20|20900|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1||x|x| |||||x||||||
OASIS|2.20|21000|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1||x|x| |||||x||||||
OASIS|2.20|21100|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1||x|x| |||||x||||||
OASIS|2.20|21200|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1||x|x| |||||x||||||
OASIS|2.20|21300|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1||x|x| |||||x||||||
OASIS|2.20|21400|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1||x|x| |||||x||||||
OASIS|2.20|21500|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2||x|x| |||||x||||||
OASIS|2.20|21600|M1750_REC_PSYCH_NURS|Receives psychiatric nursing|895|1||x|x| |||||||||||
OASIS|2.20|21700|M1800_CRNT_GROOMING|Current: grooming|896|2||x|x| |||||x||||||
OASIS|2.20|21800|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2||x|x|x|x||||x||||||
OASIS|2.20|21900|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2||x|x|x|x||||x||||||
OASIS|2.20|22000|M1830_CRNT_BATHG|Current: bathing|902|2||x|x|x|x||||x||||||
OASIS|2.20|22100|M1840_CRNT_TOILTG|Current: toileting|904|2||x|x|x|x||||x||||||
OASIS|2.20|22200|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2||x|x| |||||x||||||
OASIS|2.20|22300|M1850_CRNT_TRNSFRNG|Current: transferring|908|2||x|x|x|x||||x||||||
OASIS|2.20|22400|M1860_CRNT_AMBLTN|Current: ambulation|910|2||x|x|x|x||||x||||||
OASIS|2.20|22500|M1870_CRNT_FEEDING|Current: feeding|912|2||x|x| |||||x||||||
OASIS|2.20|22600|M1880_CRNT_PREP_LT_MEALS|Current: prepare light meals|914|2||x|x| |||||x||||||
OASIS|2.20|22700|M1890_CRNT_PHONE_USE|Current: telephone use|916|2||x|x| |||||x||||||
OASIS|2.20|22800|M1900_PRIOR_ADLIADL_SELF|Prior functioning ADL/IADL: self-care|918|2||x|x| |||||||||||
OASIS|2.20|22900|M1900_PRIOR_ADLIADL_AMBLTN|Prior functioning ADL/IADL: ambulation|920|2||x|x| |||||||||||
OASIS|2.20|23000|M1900_PRIOR_ADLIADL_TRNSFR|Prior functioning ADL/IADL: transfer|922|2||x|x| |||||||||||
OASIS|2.20|23100|M1900_PRIOR_ADLIADL_HSEHOLD|Prior functioning ADL/IADL: household tasks|924|2||x|x| |||||||||||
OASIS|2.20|23200|M1910_MLT_FCTR_FALL_RISK_ASMT|Has patient had a multi-factor fall risk asmt|926|2||x|x| |||||||||||
OASIS|2.20|23600|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2||x|x| |||||||||||
OASIS|2.20|23800|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2||x|x| |||||x||||||
OASIS|2.20|23900|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2||x|x|x|x||||x||||||
OASIS|2.20|24000|M2040_PRIOR_MGMT_ORAL_MDCTN|Prior med mgmt: oral medications|941|2||x|x| |||||||||||
OASIS|2.20|24100|M2040_PRIOR_MGMT_INJCTN_MDCTN|Prior med mgmt: injectable medications|943|2||x|x| |||||||||||
OASIS|2.20|24210|M2102_CARE_TYPE_SRC_ADL|Care mgmt types/sources: ADL|1537|2||x|x||||||x||||||
OASIS|2.20|24310|M2102_CARE_TYPE_SRC_IADL|Care mgmt types/sources: IADL|1539|2||x|x||||||x||||||
OASIS|2.20|24410|M2102_CARE_TYPE_SRC_MDCTN|Care mgmt types/sources: med admin|1541|2||x|x||||||x||||||
OASIS|2.20|24510|M2102_CARE_TYPE_SRC_PRCDR|Care mgmt types/sources: med procs tx|1543|2||x|x||||||x||||||
OASIS|2.20|24610|M2102_CARE_TYPE_SRC_EQUIP|Care mgmt types/sources: equipment|1545|2||x|x||||||x||||||
OASIS|2.20|24710|M2102_CARE_TYPE_SRC_SPRVSN|Care mgmt types/sources: supervision and safety|1547|2||x|x||||||x||||||
OASIS|2.20|24810|M2102_CARE_TYPE_SRC_ADVCY|Care mgmt types/sources: advocacy or facilitation|1549|2||x|x||||||x||||||
OASIS|2.20|24900|M2110_ADL_IADL_ASTNC_FREQ|How often recv non-HHA caregiver ADL/IADL assist|959|2||x|x| |||||||||||
OASIS|2.20|25000|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3||x|x|x|x||||||||||
OASIS|2.20|25100|M2200_THER_NEED_NA|Therapy need: not applicable|964|1||x|x|x|x||||||||||
OASIS|2.20|25200|M2250_PLAN_SMRY_PTNT_SPECF|Plan of care synopsis: patient specific parameters|965|2||x|x| |||||||||||
OASIS|2.20|25300|M2250_PLAN_SMRY_DBTS_FT_CARE|Plan of care synopsis: diabetic foot care|967|2||x|x| |||||||||||
OASIS|2.20|25400|M2250_PLAN_SMRY_FALL_PRVNT|Plan of care synopsis: falls prevention|969|2||x|x| |||||||||||
OASIS|2.20|25500|M2250_PLAN_SMRY_DPRSN_INTRVTN|Plan of care synopsis: depression interventions|971|2||x|x| |||||||||||
OASIS|2.20|25600|M2250_PLAN_SMRY_PAIN_INTRVTN|Plan of care synopsis: pain interventions|973|2||x|x| |||||||||||
OASIS|2.20|25700|M2250_PLAN_SMRY_PRSULC_PRVNT|Plan of care synopsis: PU prevention|975|2||x|x| |||||||||||
OASIS|2.20|25800|M2250_PLAN_SMRY_PRSULC_TRTMT|Plan of care synopsis: PU moist treatment|977|2||x|x| |||||||||||
OASIS|2.20|26000|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1|| | | ||x|x||x||||||
OASIS|2.20|26100|M2310_ECR_INJRY_BY_FALL|Emergent care reason: injury caused by fall|982|1|| | | ||x|x||x||||||
OASIS|2.20|26200|M2310_ECR_RSPRTRY_INFCTN|Emergent care reason: respiratory infection|983|1|| | | ||x|x||x||||||
OASIS|2.20|26300|M2310_ECR_RSPRTRY_OTHR|Emergent care reason: respiratory other|984|1|| | | ||x|x||x||||||
OASIS|2.20|26400|M2310_ECR_HRT_FAILR|Emergent care reason: heart failure|985|1|| | | ||x|x||x||||||
OASIS|2.20|26500|M2310_ECR_CRDC_DSRTHM|Emergent care reason: cardiac dysrhythmia|986|1|| | | ||x|x||x||||||
OASIS|2.20|26600|M2310_ECR_MI_CHST_PAIN|Emergent care reason: myocard infarct/chest pain|987|1|| | | ||x|x||x||||||
OASIS|2.20|26700|M2310_ECR_OTHR_HRT_DEASE|Emergent care reason: other heart disease|988|1|| | | ||x|x||x||||||
OASIS|2.20|26800|M2310_ECR_STROKE_TIA|Emergent care reason: stroke (CVA) or TIA|989|1|| | | ||x|x||x||||||
OASIS|2.20|26900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1|| | | ||x|x||x||||||
OASIS|2.20|27000|M2310_ECR_GI_PRBLM|Emergent care: GI bleed/obstruct/constip/impact|991|1|| | | ||x|x||x||||||
OASIS|2.20|27100|M2310_ECR_DHYDRTN_MALNTR|Emergent care reason: dehydration malnutrition|992|1|| | | ||x|x||x||||||
OASIS|2.20|27200|M2310_ECR_UTI|Emergent care reason: urinary tract infection|993|1|| | | ||x|x||x||||||
OASIS|2.20|27300|M2310_ECR_CTHTR_CMPLCTN|Emergent care reason: IV catheter infect/complic|994|1|| | | ||x|x||x||||||
OASIS|2.20|27400|M2310_ECR_WND_INFCTN_DTRORTN|Emergent care reason: wound infect/deterioration|995|1|| | | ||x|x||x||||||
OASIS|2.20|27500|M2310_ECR_UNCNTLD_PAIN|Emergent care reason: uncontrolled pain|996|1|| | | ||x|x||x||||||
OASIS|2.20|27600|M2310_ECR_MENTL_BHVRL_PRBLM|Emergent care reason: acute mental/behav problem|997|1|| | | ||x|x||x||||||
OASIS|2.20|27700|M2310_ECR_DVT_PULMNRY|Emergent care reason: deep vein thromb/pulm embol|998|1|| | | ||x|x||x||||||
OASIS|2.20|27800|M2310_ECR_OTHER|Emergent care reason: other than above|999|1|| | | ||x|x||x||||||
OASIS|2.20|27900|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1|| | | ||x|x||x||||||
OASIS|2.20|28600|M2410_INPAT_FACILITY|Inpatient facility|1013|2|| | | ||x|x||x||||||
OASIS|2.20|28700|M2420_DSCHRG_DISP|Discharge disposition|1015|2|| | | |||||x||||||
OASIS|2.20|28800|M2430_HOSP_MED|Hospitalized: medication|1017|1|| | | ||x|x||||||||
OASIS|2.20|28900|M2430_HOSP_INJRY_BY_FALL|Hospitalized: injury caused by fall|1018|1|| | | ||x|x||||||||
OASIS|2.20|29000|M2430_HOSP_RSPRTRY_INFCTN|Hospitalized: respiratory infection|1019|1|| | | ||x|x||||||||
OASIS|2.20|29100|M2430_HOSP_RSPRTRY_OTHR|Hospitalized: other respiratory|1020|1|| | | ||x|x||||||||
OASIS|2.20|29200|M2430_HOSP_HRT_FAILR|Hospitalized: heart failure|1021|1|| | | ||x|x||||||||
OASIS|2.20|29300|M2430_HOSP_CRDC_DSRTHM|Hospitalized: cardiac dysrhythmia|1022|1|| | | ||x|x||||||||
OASIS|2.20|29400|M2430_HOSP_MI_CHST_PAIN|Hospitalized: myocardial infarction or chest pain|1023|1|| | | ||x|x||||||||
OASIS|2.20|29500|M2430_HOSP_OTHR_HRT_DEASE|Hospitalized: other heart disease|1024|1|| | | ||x|x||||||||
OASIS|2.20|29600|M2430_HOSP_STROKE_TIA|Hospitalized: stroke (CVA) or TIA|1025|1|| | | ||x|x||||||||
OASIS|2.20|29700|M2430_HOSP_HYPOGLYC|Hospitalized: hypoglycemia/hyperglycemia|1026|1|| | | ||x|x||||||||
OASIS|2.20|29800|M2430_HOSP_GI_PRBLM|Hospitalized: GI bleed/obstruct/constip/impact|1027|1|| | | ||x|x||||||||
OASIS|2.20|29900|M2430_HOSP_DHYDRTN_MALNTR|Hospitalized: dehydration malnutrition|1028|1|| | | ||x|x||||||||
OASIS|2.20|30000|M2430_HOSP_UR_TRACT|Hospitalized: urinary tract infection|1029|1|| | | ||x|x||||||||
OASIS|2.20|30100|M2430_HOSP_CTHTR_CMPLCTN|Hospitalized: IV catheter infect/complic|1030|1|| | | ||x|x||||||||
OASIS|2.20|30200|M2430_HOSP_WND_INFCTN|Hospitalized: wound infect/deterioration|1031|1|| | | ||x|x||||||||
OASIS|2.20|30300|M2430_HOSP_PAIN|Hospitalized: uncontrolled pain|1032|1|| | | ||x|x||||||||
OASIS|2.20|30400|M2430_HOSP_MENTL_BHVRL_PRBLM|Hospitalized: acute mental/behav problem|1033|1|| | | ||x|x||||||||
OASIS|2.20|30500|M2430_HOSP_DVT_PULMNRY|Hospitalized: deep vein thromb/pulm embol|1034|1|| | | ||x|x||||||||
OASIS|2.20|30600|M2430_HOSP_SCHLD_TRTMT|Hospitalized: scheduled treatment or procedure|1035|1|| | | ||x|x||||||||
OASIS|2.20|30700|M2430_HOSP_OTHER|Hospitalized: other|1036|1|| | | ||x|x||||||||
OASIS|2.20|30800|M2430_HOSP_UK|Hospitalized: UK|1037|1|| | | ||x|x||||||||
OASIS|2.20|31600|M0903_LAST_HOME_VISIT|Date of last home visit|1045|8|| | | ||x|x|x|x||||||
OASIS|2.20|31700|M0906_DC_TRAN_DTH_DT|Discharge - transfer -  death date|1053|8|| | | ||x|x|x|x|x|||||
OASIS|2.20|12620|M1028_ACTV_DIAG_PVD_PAD|Active Diagnoses - PVD or PAD|1553|1| |x|x| | | | | | | |||||
OASIS|2.20|12630|M1028_ACTV_DIAG_DM|Active Diagnoses - Diabetes Mellitus|1554|1| |x|x| | | | | | | |||||
OASIS|2.20|14830|M1060_HEIGHT_A|Height (in inches)|1555|2| |x|x| | | | | | | |||||
OASIS|2.20|14840|M1060_WEIGHT_B|Weight (in pounds)|1557|3| |x|x| | | | | | | |||||
OASIS|2.20|16020|M1311_NBR_PRSULC_STG2_A1|Number of Stage 2 Pressure Ulcers|1560|2| |x|x|x|x| | | |x| |||||
OASIS|2.20|16030|M1311_NBR_ULC_SOCROC_STG2_A2|Number of Stage 2 pressure ulcers at SOC/ROC|1562|2| | | |x|x| | | |x| |||||
OASIS|2.20|16040|M1311_NBR_PRSULC_STG3_B1|Number of Stage 3 Pressure Ulcers|1564|2| |x|x|x|x| | | |x| |||||
OASIS|2.20|16050|M1311_NBR_ULC_SOCROC_STG3_B2|Number of Stage 3 pressure ulcers at SOC/ROC|1566|2| | | |x|x| | | |x| |||||
OASIS|2.20|16060|M1311_NBR_PRSULC_STG4_C1|Number of Stage 4 Pressure Ulcers|1568|2| |x|x|x|x| | | |x| |||||
OASIS|2.20|16070|M1311_NBR_ULC_SOCROC_STG4_C2|Number of Stage 4 pressure ulcers at SOC/ROC|1570|2| | | |x|x| | | |x| |||||
OASIS|2.20|16080|M1311_NSTG_DRSG_D1|Num unstage pressure ulcer non-remov dress|1572|2| |x|x|x|x| | | |x| |||||
OASIS|2.20|16090|M1311_NSTG_DRSG_SOCROC_D2|Num unstage pressure ulcer non-remov dress SOC/ROC|1574|2| | | |x|x| | | |x| |||||
OASIS|2.20|16100|M1311_NSTG_CVRG_E1|Unstageable: coverage by slough or eschar|1576|2| |x|x|x|x| | | |x| |||||
OASIS|2.20|16110|M1311_NSTG_CVRG_SOCROC_E2|Unstageable: coverage by slough or eschar SOC/ROC|1578|2| | | |x|x| | | |x| |||||
OASIS|2.20|16120|M1311_NSTG_DEEP_TSUE_F1|Unstageable: suspect deep tissue injury|1580|2| |x|x|x|x| | | |x| |||||
OASIS|2.20|16130|M1311_NSTG_DEEP_TSUE_SOCROC_F2|Unstageable: suspect deep tissue injury SOC/ROC|1582|2| | | |x|x| | | |x| |||||
OASIS|2.20|16140|M1313_NW_WS_PRSULC_STG2_A|New/worsening - Stage 2|1584|2| | | | | | | | |x| |||||
OASIS|2.20|16150|M1313_NW_WS_PRSULC_STG3_B|New/worsening - Stage 3|1586|2| | | | | | | | |x| |||||
OASIS|2.20|16160|M1313_NW_WS_PRSULC_STG4_C|New/worsening - Stage 4|1588|2| | | | | | | | |x| |||||
OASIS|2.20|16170|M1313_NW_WS_PRSULC_NSTG_DRSG_D|New/worsening - unstageable - non-removable drs/dv|1590|2| | | | | | | | |x| |||||
OASIS|2.20|16180|M1313_NW_WS_PRSULC_NSTG_CVRG_E|New/worsening - unstageable coverage slough/eschar|1592|2| | | | | | | | |x| |||||
OASIS|2.20|16190|M1313_NW_WS_PRSULC_NSTG_TSUE_F|New/worsening - unstageable - deep tissue injury|1594|2| | | | | | | | |x| |||||
OASIS|2.20|19010|M1501_SYMTM_HRT_FAILR_PTNTS|Symptoms in heart failure patients|1596|2| | | | | |x|x| |x| |||||
OASIS|2.20|19610|M1511_HRT_FAILR_NO_ACTN|Heart failure follow up:  no action|1598|1| | | | | |x|x| |x| |||||
OASIS|2.20|19620|M1511_HRT_FAILR_PHYSN_CNTCT|Heart failure follow up:  physician contacted|1599|1| | | | | |x|x| |x| |||||
OASIS|2.20|19630|M1511_HRT_FAILR_ER_TRTMT|Heart failure follow up:  ER treatment advised|1600|1| | | | | |x|x| |x| |||||
OASIS|2.20|19640|M1511_HRT_FAILR_PHYSN_TRTMT|Heart failure follow up:  phys-ordered treatmnt|1601|1| | | | | |x|x| |x| |||||
OASIS|2.20|19650|M1511_HRT_FAILR_CLNCL_INTRVTN|Heart failure follow up: pt educ/other clinical|1602|1| | | | | |x|x| |x| |||||
OASIS|2.20|19660|M1511_HRT_FAILR_CARE_PLAN_CHG|Heart failure follow up: change in care plan|1603|1| | | | | |x|x| |x| |||||
OASIS|2.20|22310|GG0170C_MOBILITY_SOCROC_PERF|Mobility - SOC/ROC Performance - Lying to Sitting|1604|2| |x|x| | | | | | | |||||
OASIS|2.20|22320|GG0170C_MOBILITY_DSCHG_GOAL|Mobility - Discharge Goal - Lying to Sitting|1606|2| |x|x| | | | | | | |||||
OASIS|2.20|23310|M2001_DRUG_RGMN_RVW|Drug regimen review|1608|1| |x|x| | | | | | | |||||
OASIS|2.20|23410|M2003_MDCTN_FLWP|Medication follow-up|1609|1| |x|x| | | | | | | |||||
OASIS|2.20|23510|M2005_MDCTN_INTRVTN|Medication intervention|1610|1| | | | | |x|x|x|x| |||||
OASIS|2.20|23710|M2016_DRUG_EDCTN_INTRVTN|Patient/caregiver drug education intervention|1611|2| | | | | |x|x| |x| |||||
OASIS|2.20|25910|M2301_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since most recent SOC/ROC|1613|2| | | | | |x|x| |x| |||||
OASIS|2.20|28510|M2401_INTRVTN_SMRY_DBTS_FT|Intervention synopsis: diabetic foot care|1615|2| | | | | |x|x| |x| |||||
OASIS|2.20|28520|M2401_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1617|2| | | | | |x|x| |x| |||||
OASIS|2.20|28530|M2401_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1619|2| | | | | |x|x| |x| |||||
OASIS|2.20|28540|M2401_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1621|2| | | | | |x|x| |x| |||||
OASIS|2.20|28550|M2401_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1623|2| | | | | |x|x| |x| |||||
OASIS|2.20|28560|M2401_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1625|2| | | | | |x|x| |x| |||||
HOSPICE|2.00|100|ITM_SET_SYS_CD|Item set system code|1|10|Y|x| | | | | | |x|x||0||HOSPICE|
HOSPICE|2.00|200|ITM_SBST_CD|Item subset code|11|3|N|x| | | | | | |x|x||0||HA|
HOSPICE|2.00|300|ITM_SET_VRSN_CD|Item set version code|14|10|Y|x| | | | | | |x|x||0||2.00|
HOSPICE|2.00|400|SPEC_VRSN_CD|Specifications version code|24|10|Y|x| | | | | | |x|x||0||2.00|
HOSPICE|2.00|550|CRCTN_NUM|Correction number|34|2|Y|x| | | | | | |x|x||0||00|
HOSPICE|2.00|600|STATE_CD|Provider's state postal code|36|2|Y|x| | | | | | |x|x|Adm_Entity|0|State||
HOSPICE|2.00|700|FAC_ID|Assigned provider submission ID|38|16|Y|x| | | | | | |x|x|Adm_Entity|0|Taxonomy_Code||
HOSPICE|2.00|800|SFTWR_VNDR_ID|Software vendor federal employer tax ID|54|9|Y|x| | | | | | |x|x||0||270020344|
HOSPICE|2.00|900|SFTWR_VNDR_NAME|Software vendor company name|63|30|Y|x| | | | | | |x|x||0||Homecare Accounting Solutions LLC|
HOSPICE|2.00|1000|SFTWR_VNDR_EMAIL_ADR|Software vendor email address|93|50|Y|x| | | | | | |x|x||0||support@has-software.com|
HOSPICE|2.00|1100|SFTWR_PROD_NAME|Software product name|143|50|Y|x| | | | | | |x|x||0||HomeCare Billing Solutions|
HOSPICE|2.00|1200|SFTWR_PROD_VRSN_CD|Software product version code|193|20|Y|x| | | | | | |x|x||0||1.2.7.30|
HOSPICE|2.00|1500|A0050|Type of record|413|1|N|x| | | | | | |x|x||0||1|
HOSPICE|2.00|1600|A0100A|Facility National Provider Identifier (NPI)|414|10|Y|x| | | | | | |x| ||0|||
HOSPICE|2.00|1700|A0100B|Facility CMS Certification Number (CCN)|424|12|Y|x| | | | | | |x| ||0|||
HOSPICE|2.00|1800|A0205|Site of service at admission|436|2|N|x| | | | | | | | ||0|||
HOSPICE|2.00|1900|A0220|Admission date|438|8|N|x| | | | | | |x|x||0|||
HOSPICE|2.00|2000|A0245|Date initial nursing assessment initiated|446|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|2100|A0250|Reason for record|454|2|N|x| | | | | | |x|x||0|||
HOSPICE|2.00|2200|A0270|Discharge date|456|8|N| | | | | | | |x|x||0|||
HOSPICE|2.00|2300|A0500A|Patient first name|464|12|Y|x| | | | | | |x|x|Pat_Master|1|Name_First||
HOSPICE|2.00|2400|A0500B|Patient middle initial|476|1|Y|x| | | | | | |x| |Pat_Master|1|Name_Middle|^|
HOSPICE|2.00|2500|A0500C|Patient last name|477|18|Y|x| | | | | | |x|x|Pat_Master|1|Name_Last||
HOSPICE|2.00|2600|A0500D|Patient name suffix|495|3|Y|x| | | | | | |x| |Pat_Master|1|Name_Suffix|^|
HOSPICE|2.00|2700|A0600A|Social Security Number|498|9|Y|x| | | | | | |x|x|Pat_Master|1|Soc_Sec_No|^|
HOSPICE|2.00|2800|A0600B|Patient Medicare/railroad insurance number|507|12|Y|x| | | | | | |x| ||0||^|
HOSPICE|2.00|2900|A0700|Patient Medicaid number|519|14|Y|x| | | | | | |x| ||0|||
HOSPICE|2.00|3000|A0800|Gender|533|1|Y|x| | | | | | |x|x||0|||
HOSPICE|2.00|3100|A0900|Birthdate|534|8|Y|x| | | | | | |x|x||0|||
HOSPICE|2.00|3200|A1000A|Ethnicity: American Indian or Alaska Native|542|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3300|A1000B|Ethnicity: Asian|543|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3400|A1000C|Ethnicity: Black or African American|544|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3500|A1000D|Ethnicity: Hispanic or Latino|545|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3600|A1000E|Ethnicity: Native Hawaiian/Pacific Islander|546|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3700|A1000F|Ethnicity: White|547|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3800|A1802|Admitted from|548|2|N|x| | | | | | | | ||0|||
HOSPICE|2.00|3900|A2115|Reason for discharge|550|2|N| | | | | | | |x| ||0|||
HOSPICE|2.00|4000|F2000A|Was patient asked about CPR|552|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4100|F2000B|Date asked about CPR|553|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4200|F2100A|Was patient asked about treatments other than CPR|561|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4300|F2100B|Date asked about treatment other than CPR|562|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4400|F2200A|Was patient asked about hospitalization|570|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4500|F2200B|Date asked about hospitalization|571|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4600|F3000A|Was patient asked spiritual/existential concerns|579|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4700|F3000B|Date asked about spiritual/existential concerns|580|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|4800|I0010|Principal diagnosis|588|2|Y|x| | | | | | | | ||0|||
HOSPICE|2.00|4900|J0900A|Was patient screened for pain|590|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5000|J0900B|Date of first screening for pain|591|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5100|J0900C|Patient's pain severity was|599|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5200|J0900D|Type of standardized pain tool used|600|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5300|J0910A|Was comprehensive pain assessment done|601|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5400|J0910B|Date of comprehensive pain assessment|602|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5500|J0910C1|Pain asmt included: location|610|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5600|J0910C2|Pain asmt included: severity|611|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5700|J0910C3|Pain asmt included: character|612|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5800|J0910C4|Pain asmt included: duration|613|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|5900|J0910C5|Pain asmt included: frequency|614|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6000|J0910C6|Pain asmt included: what relieves/worsens|615|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6100|J0910C7|Pain asmt included: effect function/quality life|616|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6200|J0910C9|Pain asmt included: none of the above|617|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6300|J2030A|Was patient screened for shortness of breath|618|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6400|J2030B|Date of first screening for shortness of breath|619|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6500|J2030C|Did screening indicate pt had shortness of breath|627|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6600|J2040A|Was treatment for shortness of breath initiated|628|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6700|J2040B|Date treatment for shortness of breath initiated|629|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6800|J2040C1|Type(s) treat for shortness of breath: opioids|637|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|6900|J2040C2|Type(s) treat for shortness of breath: other med|638|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7000|J2040C3|Type(s) treat for shortness of breath: oxygen|639|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7100|J2040C4|Type(s) treat for shortness of breath: non-med|640|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7200|N0500A|Was scheduled opioid initiated or continued|641|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7300|N0500B|Date scheduled opioid initiated or continued|642|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7400|N0510A|Was PRN opioid initiated or continued|650|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7500|N0510B|Date PRN opioid initiated or continued|651|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7600|N0520A|Was bowel regimen initiated or continued|659|1|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7700|N0520B|Date bowel regimen initiated or continued|660|8|N|x| | | | | | | | ||0|||
HOSPICE|2.00|7800|Z0500B|Date of signature verifying record completion|668|8|N|x| | | | | | |x|x||0|||
HOSPICE|2.00|2650|A0550|Patient Zip|676|11|N|x||||||||||0|||
HOSPICE|2.00|3715|A1400B|Payor: Medicare (managed care/Part C/Mcr Advant.)|688|1|N|x||||||||||0|||
HOSPICE|2.00|3720|A1400C|Payor: Medicaid (FFS)|689|1|N|x||||||||||0|||
HOSPICE|2.00|3725|A1400D|Payor: Medicaid (managed care)|690|1|N|x||||||||||0|||
HOSPICE|2.00|3730|A1400G|Payor: Other Government|691|1|N|x||||||||||0|||
HOSPICE|2.00|3735|A1400H|Payor: Private insurance/Medigap|692|1|N|x||||||||||0|||
HOSPICE|2.00|3740|A1400I|Payor: Private managed care|693|1|N|x||||||||||0|||
HOSPICE|2.00|3745|A1400J|Payor: Self-pay|694|1|N|x||||||||||0|||
HOSPICE|2.00|3750|A1400K|Payor: No payor source|695|1|N|x||||||||||0|||
HOSPICE|2.00|3755|A1400X|Payor: Unknown|696|1|N|x||||||||||0|||
HOSPICE|2.00|3760|A1400Y|Payor: Other|697|1|N|x||||||||||0|||
HOSPICE|2.00|3710|A1400A|Payor: Medicare (FFS)|687|1|N|x||||||||||0|||
HOSPICE|2.00|5250|J0905|Is pain an active problem for the patient?|698|1|N|x|||||||||||||
HOSPICE|2.00|7710|O5000|Level of care in final 3 days|699|1|N||||||||x||||||
HOSPICE|2.00|7712|O5010A1|RN - Num visits - day of death|700|1|N||||||||x||||||
HOSPICE|2.00|7714|O5010A2|RN - Num visits - one day prior to death|701|1|N||||||||x||||||
HOSPICE|2.00|7716|O5010A3|RN - Num visits - two days prior to death|702|1|N||||||||x||||||
HOSPICE|2.00|7718|O5010B1|Phys - Num visits - day of death|703|1|N||||||||x||||||
HOSPICE|2.00|7720|O5010B2|Phys - Num visits - one day prior to death|704|1|N||||||||x||||||
HOSPICE|2.00|7722|O5010B3|Phys - Num visits - two days prior to death|705|1|N||||||||x||||||
HOSPICE|2.00|7724|O5010C1|Soc Wrk - Num visits - day of death|706|1|N||||||||x||||||
HOSPICE|2.00|7726|O5010C2|Soc Wrk - Num visits - one day prior to death|707|1|N||||||||x||||||
HOSPICE|2.00|7728|O5010C3|Soc Wrk - Num visits - two days prior to death|708|1|N||||||||x||||||
HOSPICE|2.00|7730|O5010D1|Chaplain - Num visits - day of death|709|1|N||||||||x||||||
HOSPICE|2.00|7732|O5010D2|Chaplain - Num visits - one day prior to death|710|1|N||||||||x||||||
HOSPICE|2.00|7734|O5010D3|Chaplain - Num visits - two days prior to death|711|1|N||||||||x||||||
HOSPICE|2.00|7736|O5010E1|Lic Nurse - Num visits - day of death|712|1|N||||||||x||||||
HOSPICE|2.00|7738|O5010E2|Lic Nurse - Num visits - one day prior to death|713|1|N||||||||x||||||
HOSPICE|2.00|7740|O5010E3|Lic Nurse - Num visits - two days prior to death|714|1|N||||||||x||||||
HOSPICE|2.00|7742|O5010F1|Aide - Num visits - day of death|715|1|N||||||||x||||||
HOSPICE|2.00|7744|O5010F2|Aide - Num visits - one day prior to death|716|1|N||||||||x||||||
HOSPICE|2.00|7746|O5010F3|Aide - Num visits - two days prior to death|717|1|N||||||||x||||||
HOSPICE|2.00|7748|O5020|Level of care in final 7 days|718|1|N||||||||x||||||
HOSPICE|2.00|7750|O5030A1|RN - Num visits - three days prior to death|719|1|N||||||||x||||||
HOSPICE|2.00|7752|O5030A2|RN - Num visits - four days prior to death|720|1|N||||||||x||||||
HOSPICE|2.00|7754|O5030A3|RN - Num visits - five days prior to death|721|1|N||||||||x||||||
HOSPICE|2.00|7756|O5030A4|RN - Num visits - six days prior to death|722|1|N||||||||x||||||
HOSPICE|2.00|7758|O5030B1|Phys - Num visits - three days prior to death|723|1|N||||||||x||||||
HOSPICE|2.00|7760|O5030B2|Phys - Num visits - four days prior to death|724|1|N||||||||x||||||
HOSPICE|2.00|7762|O5030B3|Phys - Num visits - five days prior to death|725|1|N||||||||x||||||
HOSPICE|2.00|7764|O5030B4|Phys - Num visits - six days prior to death|726|1|N||||||||x||||||
HOSPICE|2.00|7766|O5030C1|Soc Wrk - Num visits - three days prior to death|727|1|N||||||||x||||||
HOSPICE|2.00|7768|O5030C2|Soc Wrk - Num visits - four days prior to death|728|1|N||||||||x||||||
HOSPICE|2.00|7770|O5030C3|Soc Wrk - Num visits - five days prior to death|729|1|N||||||||x||||||
HOSPICE|2.00|7772|O5030C4|Soc Wrk - Num visits - six days prior to death|730|1|N||||||||x||||||
HOSPICE|2.00|7774|O5030D1|Chaplain - Num visits - three days prior to death|731|1|N||||||||x||||||
HOSPICE|2.00|7776|O5030D2|Chaplain - Num visits - four days prior to death|732|1|N||||||||x||||||
HOSPICE|2.00|7778|O5030D3|Chaplain - Num visits - five days prior to death|733|1|N||||||||x||||||
HOSPICE|2.00|7780|O5030D4|Chaplain - Num visits - six days prior to death|734|1|N||||||||x||||||
HOSPICE|2.00|7782|O5030E1|Lic Nurse - Num visits - three days prior to death|735|1|N||||||||x||||||
HOSPICE|2.00|7784|O5030E2|Lic Nurse - Num visits - four days prior to death|736|1|N||||||||x||||||
HOSPICE|2.00|7786|O5030E3|Lic Nurse - Num visits - five days prior to death|737|1|N||||||||x||||||
HOSPICE|2.00|7788|O5030E4|Lic Nurse - Num visits - six days prior to death|738|1|N||||||||x||||||
HOSPICE|2.00|7790|O5030F1|Aide - Num visits - three days prior to death|739|1|N||||||||x||||||
HOSPICE|2.00|7792|O5030F2|Aide - Num visits - four days prior to death|740|1|N||||||||x||||||
HOSPICE|2.00|7794|O5030F3|Aide - Num visits - five days prior to death|741|1|N||||||||x||||||
HOSPICE|2.00|7796|O5030F4|Aide - Num visits - six days prior to death|742|1|N||||||||x||||||
OASIS|2.30|50|ASMT_SYS_CD|Assessment system code|1|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|150|ITM_SBST_CD|Item subset code|12|3| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|200|ITM_SET_VRSN_CD|Item set version code|15|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|250|SPEC_VRSN_CD|Specifications version code|25|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|300|CORRECTION_NUM|Correction number|35|2| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|350|STATE_CD|Agency's state postal code|37|2| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|400|HHA_AGENCY_ID|Assigned agency submission ID|39|16| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|500|SFW_ID|Software vendor federal employer tax ID|65|9| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|550|SFW_NAME|Software vendor company name|74|30| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|600|SFW_EMAIL_ADR|Software vendor email address|104|50| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|650|SFW_PROD_NAME|Software product name|154|50| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|700|SFW_PROD_VRSN_CD|Software product version code|204|20| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|750|ACY_DOC_CD|Document ID code (agency use)|224|20| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|900|CONTROL_ITEMS_FILLER|Control items filler|1061|200| | | | | | | | | | |||||
OASIS|2.30|1500|M0010_CCN|Facility CMS certification number (CCN)|254|6| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|1600|M0014_BRANCH_STATE|Branch state|260|2| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|1700|M0016_BRANCH_ID|Branch ID|262|10| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|1800|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|1900|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|2000|M0020_PAT_ID|Patient ID number|283|20| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|2100|M0030_START_CARE_DT|Start of care date|303|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|2200|M0032_ROC_DT|Resumption of care date|311|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|2300|M0032_ROC_DT_NA|No resumption of care date|319|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|2400|M0040_PAT_FNAME|Patient's first name|320|12| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|2500|M0040_PAT_MI|Patient's middle initial|332|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|2600|M0040_PAT_LNAME|Patient's last name|333|18| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|2700|M0040_PAT_SUFFIX|Patient's suffix|351|3| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|2800|M0050_PAT_ST|Patient state of residence|354|2| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|2900|M0060_PAT_ZIP|Patient zip code|356|11| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|3000|M0063_MEDICARE_NUM|Medicare number, including suffix|367|12| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|3100|M0063_MEDICARE_NA|No Medicare number|379|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|3200|M0064_SSN|Patient's Social Security number|380|9| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|3300|M0064_SSN_UK|No Social Security number|389|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|3400|M0065_MEDICAID_NUM|Medicaid number|390|14| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|3500|M0065_MEDICAID_NA|No Medicaid number|404|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|3600|M0066_PAT_BIRTH_DT|Date of birth|405|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|3700|M0069_PAT_GENDER|Gender|413|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|3800|M0140_ETHNIC_AI_AN|Ethnicity: American Indian or Alaska Native|414|1| |x|x| | | | | | | |||||
OASIS|2.30|3900|M0140_ETHNIC_ASIAN|Ethnicity: Asian|415|1| |x|x| | | | | | | |||||
OASIS|2.30|4000|M0140_ETHNIC_BLACK|Ethnicity: Black or African American|416|1| |x|x| | | | | | | |||||
OASIS|2.30|4100|M0140_ETHNIC_HISP|Ethnicity: Hispanic or Latino|417|1| |x|x| | | | | | | |||||
OASIS|2.30|4200|M0140_ETHNIC_NH_PI|Ethnicity: Native Hawaiian/Pacific Islander|418|1| |x|x| | | | | | | |||||
OASIS|2.30|4300|M0140_ETHNIC_WHITE|Ethnicity: White|419|1| |x|x| | | | | | | |||||
OASIS|2.30|4400|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|4500|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|4600|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|4700|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|4800|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|4900|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5000|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5100|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5200|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5300|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5400|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5500|M0150_CPAY_OTHER|Payment sources: other|431|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5600|M0150_CPAY_UK|Payment sources: unknown|432|1| |x|x| | | | | | | |||||
OASIS|2.30|5700|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2| |x|x|x|x|x|x|x|x| |||||
OASIS|2.30|5800|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|5900|M0100_ASSMT_REASON|Reason for assessment|443|2| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|6000|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8| |x|x| | | | | | | |||||
OASIS|2.30|6100|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1| |x|x| | | | | | | |||||
OASIS|2.30|6200|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8| |x|x| | | | | | | |||||
OASIS|2.30|6300|M0110_EPISODE_TIMING|Episode timing|462|2| |x|x|x|x| | | | | |||||
OASIS|2.30|6400|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1| |x|x| | | | | | | |||||
OASIS|2.30|6500|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1| |x|x| | | | | | | |||||
OASIS|2.30|6600|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1| |x|x| | | | | | | |||||
OASIS|2.30|6700|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1| |x|x| | | | | | | |||||
OASIS|2.30|6800|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1| |x|x| | | | | | | |||||
OASIS|2.30|6900|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1| |x|x| | | | | | | |||||
OASIS|2.30|7000|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1| |x|x| | | | | | | |||||
OASIS|2.30|7100|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1| |x|x| | | | | | | |||||
OASIS|2.30|7200|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8| |x|x| | | | | | | |||||
OASIS|2.30|7300|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1| |x|x| | | | | | | |||||
OASIS|2.30|12700|M1030_THH_IV_INFUSION|Therapies received at home: intravenous, infusion|743|1| |x|x|x|x| | | | | |||||
OASIS|2.30|12800|M1030_THH_PAR_NUTRITION|Therapies received at home: parenteral nutrition|744|1| |x|x|x|x| | | | | |||||
OASIS|2.30|12900|M1030_THH_ENT_NUTRITION|Therapies received at home: enteral nutrition|745|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13000|M1030_THH_NONE_ABOVE|Therapies received at home: none of the above|746|1| |x|x|x|x| | | | | |||||
OASIS|2.30|14900|M1100_PTNT_LVG_STUTN|Patient living situation|769|2| |x|x| | | | | | | |||||
OASIS|2.30|15000|M1200_VISION|Sensory status: vision|771|2| |x|x|x|x| | | | | |||||
OASIS|2.30|15500|M1242_PAIN_FREQ_ACTVTY_MVMT|Freq of pain interfering with pt activity/movement|781|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|15800|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU/injury at stage 2+|786|1| |x|x|x|x| | | |x| |||||
OASIS|2.30|16010|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8| | | | | | | | |x| |||||
OASIS|2.30|16000|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2| | | | | | | | |x| |||||
OASIS|2.30|17700|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure injuries|835|2| |x|x|x|x| | | | | |||||
OASIS|2.30|17800|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer/injury|837|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|17900|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|18000|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2| |x|x|x|x| | | | | |||||
OASIS|2.30|18100|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|18200|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|18300|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|18500|M1400_WHEN_DYSPNEIC|When dyspneic|850|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|19700|M1600_UTI|Treated for urinary tract infection past 14 days|864|2| |x|x| | | | | |x| |||||
OASIS|2.30|19800|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2| |x|x|x|x| | | | | |||||
OASIS|2.30|20000|M1620_BWL_INCONT|Bowel incontinence frequency|870|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|20100|M1630_OSTOMY|Ostomy for bowel elimination|872|2| |x|x|x|x| | | | | |||||
OASIS|2.30|20200|M1700_COG_FUNCTION|Cognitive functioning|874|2| |x|x| | | | | |x| |||||
OASIS|2.30|20300|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2| |x|x| | | | | |x| |||||
OASIS|2.30|20400|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2| |x|x| | | | | |x| |||||
OASIS|2.30|20500|M1730_STDZ_DPRSN_SCRNG|Screened for depression using validated tool|880|2| |x|x| | | | | | | |||||
OASIS|2.30|20600|M1730_PHQ2_LACK_INTRST|PHQ2: little interest or pleasure in doing things|882|2| |x|x| | | | | | | |||||
OASIS|2.30|20700|M1730_PHQ2_DPRSN|PHQ2: feeling down, depressed or hopeless|884|2| |x|x| | | | | | | |||||
OASIS|2.30|20800|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1| |x|x| | | | | |x| |||||
OASIS|2.30|20900|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1| |x|x| | | | | |x| |||||
OASIS|2.30|21000|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1| |x|x| | | | | |x| |||||
OASIS|2.30|21100|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1| |x|x| | | | | |x| |||||
OASIS|2.30|21200|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1| |x|x| | | | | |x| |||||
OASIS|2.30|21300|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1| |x|x| | | | | |x| |||||
OASIS|2.30|21400|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1| |x|x| | | | | |x| |||||
OASIS|2.30|21500|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2| |x|x| | | | | |x| |||||
OASIS|2.30|21700|M1800_CRNT_GROOMING|Current: grooming|896|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|21800|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|21900|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|22000|M1830_CRNT_BATHG|Current: bathing|902|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|22100|M1840_CRNT_TOILTG|Current: toileting|904|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|22200|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2| |x|x| | | | | |x| |||||
OASIS|2.30|22300|M1850_CRNT_TRNSFRNG|Current: transferring|908|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|22400|M1860_CRNT_AMBLTN|Current: ambulation|910|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|22500|M1870_CRNT_FEEDING|Current: feeding|912|2| |x|x| | | | | |x| |||||
OASIS|2.30|23200|M1910_MLT_FCTR_FALL_RISK_ASMT|Has patient had a multi-factor fall risk asmt|926|2| |x|x| | | | | | | |||||
OASIS|2.30|23600|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2| |x|x| | | | | | | |||||
OASIS|2.30|23800|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2| |x|x| | | | | |x| |||||
OASIS|2.30|23900|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2| |x|x|x|x| | | | | |||||
OASIS|2.30|25000|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3| |x|x|x|x| | | | | |||||
OASIS|2.30|25100|M2200_THER_NEED_NA|Therapy need: not applicable|964|1| |x|x|x|x| | | | | |||||
OASIS|2.30|26000|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1| | | | | |x|x| |x| |||||
OASIS|2.30|26900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1| | | | | |x|x| |x| |||||
OASIS|2.30|27800|M2310_ECR_OTHER|Emergent care reason: other than above|999|1| | | | | |x|x| |x| |||||
OASIS|2.30|27900|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1| | | | | |x|x| |x| |||||
OASIS|2.30|28600|M2410_INPAT_FACILITY|Inpatient facility|1013|2| | | | | |x|x| |x| |||||
OASIS|2.30|28700|M2420_DSCHRG_DISP|Discharge disposition|1015|2| | | | | | | | |x| |||||
OASIS|2.30|31700|M0906_DC_TRAN_DTH_DT|Discharge, transfer, death date|1053|8| | | | | |x|x|x|x|x|||||
OASIS|2.30|100|TRANS_TYPE_CD|Transaction type code|11|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.30|13110|M1033_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|1515|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13210|M1033_HOSP_RISK_WEIGHT_LOSS|Hosp risk: unintentional weight loss|1516|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13310|M1033_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 6 months|1517|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13410|M1033_HOSP_RISK_MLTPL_ED_VISIT|Hosp risk: 2+ emergcy dept visits in past 6 months|1518|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13510|M1033_HOSP_RISK_MNTL_BHV_DCLN|Hosp risk: decline mental/emotional/behav status|1519|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13610|M1033_HOSP_RISK_COMPLIANCE|Hosp risk: difficulty with medical instructions|1520|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13710|M1033_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|1521|1| |x|x|x| | | | | | |||||
OASIS|2.30|13720|M1033_HOSP_RISK_CRNT_EXHSTN|Hosp risk: current exhaustion|1522|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13730|M1033_HOSP_RISK_OTHR_RISK|Hosp risk: other risk(s) not listed|1523|1| |x|x|x|x| | | | | |||||
OASIS|2.30|13740|M1033_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|1524|1| |x|x|x|x| | | | | |||||
OASIS|2.30|14510|M1041_IN_INFLNZ_SEASON|Does episode include Oct 1 thru Mar 31|1525|1| | | | | |x|x| |x| |||||
OASIS|2.30|14610|M1046_INFLNZ_RECD_CRNT_SEASON|Did patient receive influenza vaccine|1526|2| | | | | |x|x| |x| |||||
OASIS|2.30|14710|M1051_PVX_RCVD_AGNCY|Was pneumococcal vaccine received|1528|1| | | | | |x|x| |x| |||||
OASIS|2.30|14810|M1056_PVX_RSN_NOT_RCVD_AGNCY|If pneumococcal vacc not received, state reason|1529|2| | | | | |x|x| |x| |||||
OASIS|2.30|24210|M2102_CARE_TYPE_SRC_ADL|Care mgmt, types/sources: ADL|1537|2| | | | | | | | |x| |||||
OASIS|2.30|24410|M2102_CARE_TYPE_SRC_MDCTN|Care mgmt, types/sources: med admin|1541|2| | | | | | | | |x| |||||
OASIS|2.30|24510|M2102_CARE_TYPE_SRC_PRCDR|Care mgmt, types/sources: med procs tx|1543|2| | | | | | | | |x| |||||
OASIS|2.30|24710|M2102_CARE_TYPE_SRC_SPRVSN|Care mgmt, types/sources: supervision and safety|1547|2| |x|x| | | | | |x| |||||
OASIS|2.30|10310|M1021_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|1359|8| |x|x|x|x| | | | | |||||
OASIS|2.30|10410|M1021_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|1367|2| |x|x|x|x| | | | | |||||
OASIS|2.30|10510|M1023_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|1369|8| |x|x|x|x| | | | | |||||
OASIS|2.30|10610|M1023_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|1377|2| |x|x|x|x| | | | | |||||
OASIS|2.30|10710|M1023_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|1379|8| |x|x|x|x| | | | | |||||
OASIS|2.30|10810|M1023_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|1387|2| |x|x|x|x| | | | | |||||
OASIS|2.30|10910|M1023_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|1389|8| |x|x|x|x| | | | | |||||
OASIS|2.30|11010|M1023_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|1397|2| |x|x|x|x| | | | | |||||
OASIS|2.30|11110|M1023_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|1399|8| |x|x|x|x| | | | | |||||
OASIS|2.30|11210|M1023_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|1407|2| |x|x|x|x| | | | | |||||
OASIS|2.30|11310|M1023_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|1409|8| |x|x|x|x| | | | | |||||
OASIS|2.30|11410|M1023_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|1417|2| |x|x|x|x| | | | | |||||
OASIS|2.30|12620|M1028_ACTV_DIAG_PVD_PAD|Active Diagnoses - PVD or PAD|1553|1| |x|x| | | | | | | |||||
OASIS|2.30|12630|M1028_ACTV_DIAG_DM|Active Diagnoses - Diabetes Mellitus|1554|1| |x|x| | | | | | | |||||
OASIS|2.30|14830|M1060_HEIGHT_A|Height (in inches)|1555|2| |x|x| | | | | | | |||||
OASIS|2.30|14840|M1060_WEIGHT_B|Weight (in pounds)|1557|3| |x|x| | | | | | | |||||
OASIS|2.30|16020|M1311_NBR_PRSULC_STG2_A1|Number of Stage 2 Pressure Ulcers|1560|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|16030|M1311_NBR_ULC_SOCROC_STG2_A2|Number of Stage 2 pressure ulcers at SOC/ROC|1562|2| | | | | | | | |x| |||||
OASIS|2.30|16040|M1311_NBR_PRSULC_STG3_B1|Number of Stage 3 Pressure Ulcers|1564|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|16050|M1311_NBR_ULC_SOCROC_STG3_B2|Number of Stage 3 pressure ulcers at SOC/ROC|1566|2| | | | | | | | |x| |||||
OASIS|2.30|16060|M1311_NBR_PRSULC_STG4_C1|Number of Stage 4 Pressure Ulcers|1568|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|16070|M1311_NBR_ULC_SOCROC_STG4_C2|Number of Stage 4 pressure ulcers at SOC/ROC|1570|2| | | | | | | | |x| |||||
OASIS|2.30|16080|M1311_NSTG_DRSG_D1|Num unstage pressure ulcer non-remov dress|1572|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|16090|M1311_NSTG_DRSG_SOCROC_D2|Num unstage pressure ulcer non-remov dress SOC/ROC|1574|2| | | | | | | | |x| |||||
OASIS|2.30|16100|M1311_NSTG_CVRG_E1|Unstageable: coverage by slough or eschar|1576|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|16110|M1311_NSTG_CVRG_SOCROC_E2|Unstageable: coverage by slough or eschar SOC/ROC|1578|2| | | | | | | | |x| |||||
OASIS|2.30|16120|M1311_NSTG_DEEP_TSUE_F1|Unstageable: deep tissue injury|1580|2| |x|x|x|x| | | |x| |||||
OASIS|2.30|16130|M1311_NSTG_DEEP_TSUE_SOCROC_F2|Unstageable: deep tissue injury SOC/ROC|1582|2| | | | | | | | |x| |||||
OASIS|2.30|32480|GG0170C_MOBILITY_SOCROC_PERF|Lying to sitting on bed side (SOC/ROC Perf)|1604|2| |x|x| | | | | | | |||||
OASIS|2.30|32490|GG0170C_MOBILITY_DSCHG_GOAL|Lying to sitting on bed side (Dschrg Goal)|1606|2| |x|x| | | | | | | |||||
OASIS|2.30|23310|M2001_DRUG_RGMN_RVW|Drug regimen review|1608|1| |x|x| | | | | | | |||||
OASIS|2.30|23410|M2003_MDCTN_FLWP|Medication follow-up|1609|1| |x|x| | | | | | | |||||
OASIS|2.30|23510|M2005_MDCTN_INTRVTN|Medication intervention|1610|1| | | | | |x|x|x|x| |||||
OASIS|2.30|23710|M2016_DRUG_EDCTN_INTRVTN|Patient/caregiver drug education intervention|1611|2| | | | | |x|x| |x| |||||
OASIS|2.30|25910|M2301_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since most recent SOC/ROC|1613|2| | | | | |x|x| |x| |||||
OASIS|2.30|28510|M2401_INTRVTN_SMRY_DBTS_FT|Intervention synopsis: diabetic foot care|1615|2| | | | | |x|x| |x| |||||
OASIS|2.30|28520|M2401_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1617|2| | | | | |x|x| |x| |||||
OASIS|2.30|28530|M2401_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1619|2| | | | | |x|x| |x| |||||
OASIS|2.30|28540|M2401_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1621|2| | | | | |x|x| |x| |||||
OASIS|2.30|28550|M2401_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1623|2| | | | | |x|x| |x| |||||
OASIS|2.30|28560|M2401_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1625|2| | | | | |x|x| |x| |||||
OASIS|2.30|12640|M1028_ACTV_DIAG_NOA|Active Diagnoses - None of the above|1627|1| |x|x| | | | | | | |||||
OASIS|2.30|32000|GG0100A|Prior Function - Self Care|1628|1| |x|x| | | | | | | |||||
OASIS|2.30|32010|GG0100B|Prior Function - Indoor Mobility (Ambulation)|1629|1| |x|x| | | | | | | |||||
OASIS|2.30|32020|GG0100C|Prior Function - Stairs|1630|1| |x|x| | | | | | | |||||
OASIS|2.30|32030|GG0100D|Prior Function - Functional Cognition|1631|1| |x|x| | | | | | | |||||
OASIS|2.30|32040|GG0110A|Prior Device - Manual wheelchair|1632|1| |x|x| | | | | | | |||||
OASIS|2.30|32050|GG0110B|Prior Device - Motorized wheelchair and/or scooter|1633|1| |x|x| | | | | | | |||||
OASIS|2.30|32060|GG0110C|Prior Device - Mechanical lift|1634|1| |x|x| | | | | | | |||||
OASIS|2.30|32070|GG0110D|Prior Device - Walker|1635|1| |x|x| | | | | | | |||||
OASIS|2.30|32080|GG0110E|Prior Device - Orthotics/Prosthetics|1636|1| |x|x| | | | | | | |||||
OASIS|2.30|32090|GG0110Z|Prior Device - None of the above|1637|1| |x|x| | | | | | | |||||
OASIS|2.30|32100|GG0130A1|Eating (SOC/ROC Perf)|1638|2| |x|x| | | | | | | |||||
OASIS|2.30|32110|GG0130A2|Eating (Dschg Goal)|1640|2| |x|x| | | | | | | |||||
OASIS|2.30|32120|GG0130A3|Eating (Dischg Perf)|1642|2| | | | | | | | |x| |||||
OASIS|2.30|32130|GG0130A4|Eating (Follow-Up Perf)|1644|2| | | |x|x| | | | | |||||
OASIS|2.30|32140|GG0130B1|Oral Hygiene (SOC/ROC Perf)|1646|2| |x|x| | | | | | | |||||
OASIS|2.30|32150|GG0130B2|Oral Hygiene (Dschrg Goal)|1648|2| |x|x| | | | | | | |||||
OASIS|2.30|32160|GG0130B3|Oral Hygiene (Dschrg Perf)|1650|2| | | | | | | | |x| |||||
OASIS|2.30|32170|GG0130B4|Oral Hygiene (Follow-Up Perf)|1652|2| | | |x|x| | | | | |||||
OASIS|2.30|32180|GG0130C1|Toileting hygiene (SOC/ROC Perf)|1654|2| |x|x| | | | | | | |||||
OASIS|2.30|32190|GG0130C2|Toileting hygiene (Dschrg Goal)|1656|2| |x|x| | | | | | | |||||
OASIS|2.30|32200|GG0130C3|Toileting hygiene (Dschrg Perf)|1658|2| | | | | | | | |x| |||||
OASIS|2.30|32210|GG0130C4|Toileting hygiene (Follow-Up Perf)|1660|2| | | |x|x| | | | | |||||
OASIS|2.30|32220|GG0130E1|Shower/bathe self (SOC/ROC Perf)|1662|2| |x|x| | | | | | | |||||
OASIS|2.30|32230|GG0130E2|Shower/bathe self (Dschrg Goal)|1664|2| |x|x| | | | | | | |||||
OASIS|2.30|32240|GG0130E3|Shower/bathe self (Dschrg Perf)|1666|2| | | | | | | | |x| |||||
OASIS|2.30|32250|GG0130F1|Upper body dressing (SOC/ROC Perf)|1668|2| |x|x| | | | | | | |||||
OASIS|2.30|32260|GG0130F2|Upper body dressing (Dschrg Goal)|1670|2| |x|x| | | | | | | |||||
OASIS|2.30|32270|GG0130F3|Upper body dressing (Dschrg Perf)|1672|2| | | | | | | | |x| |||||
OASIS|2.30|32280|GG0130G1|Lower body dressing (SOC/ROC Perf)|1674|2| |x|x| | | | | | | |||||
OASIS|2.30|32290|GG0130G2|Lower body dressing (Dschrg Goal)|1676|2| |x|x| | | | | | | |||||
OASIS|2.30|32300|GG0130G3|Lower body dressing (Dschrg Perf)|1678|2| | | | | | | | |x| |||||
OASIS|2.30|32310|GG0130H1|Put on/take off footwear (SOC/ROC Perf)|1680|2| |x|x| | | | | | | |||||
OASIS|2.30|32320|GG0130H2|Put on/take off footwear (Dschrg Goal)|1682|2| |x|x| | | | | | | |||||
OASIS|2.30|32330|GG0130H3|Put on/take off footwear (Dschrg Perf)|1684|2| | | | | | | | |x| |||||
OASIS|2.30|32400|GG0170A1|Roll left and right (SOC/ROC Perf)|1686|2| |x|x| | | | | | | |||||
OASIS|2.30|32410|GG0170A2|Roll left and right (Dschrg Goal)|1688|2| |x|x| | | | | | | |||||
OASIS|2.30|32420|GG0170A3|Roll left and right (Dschrg Perf)|1690|2| | | | | | | | |x| |||||
OASIS|2.30|32430|GG0170A4|Roll left and right (Follow-Up Perf)|1692|2| | | |x|x| | | | | |||||
OASIS|2.30|32440|GG0170B1|Sit to lying (SOC/ROC Perf)|1694|2| |x|x| | | | | | | |||||
OASIS|2.30|32450|GG0170B2|Sit to lying (Dschrg Goal)|1696|2| |x|x| | | | | | | |||||
OASIS|2.30|32460|GG0170B3|Sit to lying (Dschrg Perf)|1698|2| | | | | | | | |x| |||||
OASIS|2.30|32470|GG0170B4|Sit to lying (Follow-Up Perf)|1700|2| | | |x|x| | | | | |||||
OASIS|2.30|32500|GG0170C3|Lying to sitting on bed side (Dschrg Perf)|1702|2| | | | | | | | |x| |||||
OASIS|2.30|32510|GG0170C4|Lying to sitting on bed side (Follow-Up Perf)|1704|2| | | |x|x| | | | | |||||
OASIS|2.30|32520|GG0170D1|Sit to stand (SOC/ROC Perf)|1706|2| |x|x| | | | | | | |||||
OASIS|2.30|32530|GG0170D2|Sit to stand (Dschrg Goal)|1708|2| |x|x| | | | | | | |||||
OASIS|2.30|32540|GG0170D3|Sit to stand (Dschrg Perf)|1710|2| | | | | | | | |x| |||||
OASIS|2.30|32550|GG0170D4|Sit to stand (Follow-Up Perf)|1712|2| | | |x|x| | | | | |||||
OASIS|2.30|32560|GG0170E1|Chair/bed-to-chair transfer (SOC/ROC Perf)|1714|2| |x|x| | | | | | | |||||
OASIS|2.30|32570|GG0170E2|Chair/bed-to-chair transfer (Dschrg Goal)|1716|2| |x|x| | | | | | | |||||
OASIS|2.30|32580|GG0170E3|Chair/bed-to-chair transfer (Dschrg Perf)|1718|2| | | | | | | | |x| |||||
OASIS|2.30|32590|GG0170E4|Chair/bed-to-chair transfer (Follow-Up Perf)|1720|2| | | |x|x| | | | | |||||
OASIS|2.30|32600|GG0170F1|Toilet transfer (SOC/ROC Perf)|1722|2| |x|x| | | | | | | |||||
OASIS|2.30|32610|GG0170F2|Toilet transfer (Dschrg Goal)|1724|2| |x|x| | | | | | | |||||
OASIS|2.30|32620|GG0170F3|Toilet transfer (Dschrg Perf)|1726|2| | | | | | | | |x| |||||
OASIS|2.30|32630|GG0170F4|Toilet transfer (Follow-Up Perf)|1728|2| | | |x|x| | | | | |||||
OASIS|2.30|32640|GG0170G1|Car transfer (SOC/ROC Perf)|1730|2| |x|x| | | | | | | |||||
OASIS|2.30|32650|GG0170G2|Car transfer (Dschrg Goal)|1732|2| |x|x| | | | | | | |||||
OASIS|2.30|32660|GG0170G3|Car transfer (Dschrg Perf)|1734|2| | | | | | | | |x| |||||
OASIS|2.30|32670|GG0170I1|Walk 10 feet (SOC/ROC Perf)|1736|2| |x|x| | | | | | | |||||
OASIS|2.30|32680|GG0170I2|Walk 10 feet (Dschrg Goal)|1738|2| |x|x| | | | | | | |||||
OASIS|2.30|32690|GG0170I3|Walk 10 feet (Dschrg Perf)|1740|2| | | | | | | | |x| |||||
OASIS|2.30|32700|GG0170I4|Walk 10 feet (Follow-Up Perf)|1742|2| | | |x|x| | | | | |||||
OASIS|2.30|32710|GG0170J1|Walk 50 feet with two turns (SOC/ROC Perf)|1744|2| |x|x| | | | | | | |||||
OASIS|2.30|32720|GG0170J2|Walk 50 feet with two turns (Dschrg Goal)|1746|2| |x|x| | | | | | | |||||
OASIS|2.30|32730|GG0170J3|Walk 50 feet with two turns (Dschrg Perf)|1748|2| | | | | | | | |x| |||||
OASIS|2.30|32740|GG0170J4|Walk 50 feet with two turns (Follow-Up Perf)|1750|2| | | |x|x| | | | | |||||
OASIS|2.30|32750|GG0170K1|Walk 150 feet (SOC/ROC Perf)|1752|2| |x|x| | | | | | | |||||
OASIS|2.30|32760|GG0170K2|Walk 150 feet (Dschrg Goal)|1754|2| |x|x| | | | | | | |||||
OASIS|2.30|32770|GG0170K3|Walk 150 feet (Dschrg Perf)|1756|2| | | | | | | | |x| |||||
OASIS|2.30|32780|GG0170L1|Walking 10 feet uneven surf (SOC/ROC Perf)|1758|2| |x|x| | | | | | | |||||
OASIS|2.30|32790|GG0170L2|Walking 10 feet uneven surf (Dschrg Goal)|1760|2| |x|x| | | | | | | |||||
OASIS|2.30|32800|GG0170L3|Walking 10 feet uneven surf (Dschrg Perf)|1762|2| | | | | | | | |x| |||||
OASIS|2.30|32810|GG0170L4|Walking 10 feet uneven surf (Follow-Up Perf)|1764|2| | | |x|x| | | | | |||||
OASIS|2.30|32820|GG0170M1|1 step (curb) (SOC/ROC Perf)|1766|2| |x|x| | | | | | | |||||
OASIS|2.30|32830|GG0170M2|1 step (curb) (Dschrg Goal)|1768|2| |x|x| | | | | | | |||||
OASIS|2.30|32840|GG0170M3|1 step (curb) (Dschrg Perf)|1770|2| | | | | | | | |x| |||||
OASIS|2.30|32850|GG0170M4|1 step (curb) (Follow-Up Perf)|1772|2| | | |x|x| | | | | |||||
OASIS|2.30|32860|GG0170N1|4 steps (SOC/ROC Perf)|1774|2| |x|x| | | | | | | |||||
OASIS|2.30|32870|GG0170N2|4 steps (Dschrg Goal)|1776|2| |x|x| | | | | | | |||||
OASIS|2.30|32880|GG0170N3|4 steps (Dschrg Perf)|1778|2| | | | | | | | |x| |||||
OASIS|2.30|32890|GG0170N4|4 steps (Follow-Up Perf)|1780|2| | | |x|x| | | | | |||||
OASIS|2.30|32900|GG0170O1|12 steps (SOC/ROC Perf)|1782|2| |x|x| | | | | | | |||||
OASIS|2.30|32910|GG0170O2|12 steps (Dschrg Goal)|1784|2| |x|x| | | | | | | |||||
OASIS|2.30|32920|GG0170O3|12 steps (Dschrg Perf)|1786|2| | | | | | | | |x| |||||
OASIS|2.30|32930|GG0170P1|Picking up object (SOC/ROC Perf)|1788|2| |x|x| | | | | | | |||||
OASIS|2.30|32940|GG0170P2|Picking up object (Dschrg Goal)|1790|2| |x|x| | | | | | | |||||
OASIS|2.30|32950|GG0170P3|Picking up object (Dschrg Perf)|1792|2| | | | | | | | |x| |||||
OASIS|2.30|32960|GG0170Q1|Use wheelchair and/or scooter (SOC/ROC Perf)|1794|1| |x|x| | | | | | | |||||
OASIS|2.30|32970|GG0170Q3|Use wheelchair and/or scooter (Dschrg Perf)|1795|1| | | | | | | | |x| |||||
OASIS|2.30|32980|GG0170Q4|Use wheelchair and/or scooter (Follow-Up Perf)|1796|1| | | |x|x| | | | | |||||
OASIS|2.30|32990|GG0170R1|Wheel 50 feet with two turns (SOC/ROC Perf)|1797|2| |x|x| | | | | | | |||||
OASIS|2.30|33010|GG0170R2|Wheel 50 feet with two turns (Dschrg Goal)|1799|2| |x|x| | | | | | | |||||
OASIS|2.30|33020|GG0170R3|Wheel 50 feet with two turns (Dschrg Perf)|1801|2| | | | | | | | |x| |||||
OASIS|2.30|33030|GG0170R4|Wheel 50 feet with two turns (Follow-Up Perf)|1803|2| | | |x|x| | | | | |||||
OASIS|2.30|33040|GG0170RR1|Type of wheelchair or scooter (SOC/ROC Perf)|1805|1| |x|x| | | | | | | |||||
OASIS|2.30|33050|GG0170RR3|Type of wheelchair or scooter (Dschg Perf)|1806|1| | | | | | | | |x| |||||
OASIS|2.30|33060|GG0170S1|Wheel 150 feet (SOC/ROC Perf)|1807|2| |x|x| | | | | | | |||||
OASIS|2.30|33070|GG0170S2|Wheel 150 feet (Dschrg Goal)|1809|2| |x|x| | | | | | | |||||
OASIS|2.30|33080|GG0170S3|Wheel 150 feet (Dschrg Perf)|1811|2| | | | | | | | |x| |||||
OASIS|2.30|33090|GG0170SS1|Type of wheelchair or scooter (SOC/ROC Perf)|1813|1| |x|x| | | | | | | |||||
OASIS|2.30|33100|GG0170SS3|Type of wheelchair or scooter (Dschrg Perf)|1814|1| | | | | | | | |x| |||||
OASIS|2.30|34000|J1800|Falls since SOC/ROC: any falls|1815|1| | | | | |x|x|x|x| |||||
OASIS|2.30|34010|J1900A|Num falls since SOC/ROC: no injury|1816|1| | | | | |x|x|x|x| |||||
OASIS|2.30|34020|J1900B|Num falls since SOC/ROC: injury (except major)|1817|1| | | | | |x|x|x|x| |||||
OASIS|2.30|34030|J1900C|Num falls since SOC/ROC: major injury|1818|1| | | | | |x|x|x|x| |||||
OASIS|2.30|800|SUBM_HIPPS_CODE|HIPPS group code: submitted|244|5| |x|x|x|x| | | | | |||||
OASIS|2.30|850|SUBM_HIPPS_VERSION|HIPPS version code: submitted|249|5| |x|x|x|x| | | | | |||||
OASIS|2.31|50|ASMT_SYS_CD|Assessment system code|1|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|150|ITM_SBST_CD|Item subset code|12|3| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|200|ITM_SET_VRSN_CD|Item set version code|15|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|250|SPEC_VRSN_CD|Specifications version code|25|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|300|CORRECTION_NUM|Correction number|35|2| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|350|STATE_CD|Agency's state postal code|37|2| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|400|HHA_AGENCY_ID|Assigned agency submission ID|39|16| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|500|SFW_ID|Software vendor federal employer tax ID|65|9| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|550|SFW_NAME|Software vendor company name|74|30| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|600|SFW_EMAIL_ADR|Software vendor email address|104|50| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|650|SFW_PROD_NAME|Software product name|154|50| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|700|SFW_PROD_VRSN_CD|Software product version code|204|20| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|750|ACY_DOC_CD|Document ID code (agency use)|224|20| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|900|CONTROL_ITEMS_FILLER|Control items filler|1061|200| | | | | | | | | | |||||
OASIS|2.31|1500|M0010_CCN|Facility CMS certification number (CCN)|254|6| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|1600|M0014_BRANCH_STATE|Branch state|260|2| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|1700|M0016_BRANCH_ID|Branch ID|262|10| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|1800|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|1900|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|2000|M0020_PAT_ID|Patient ID number|283|20| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|2100|M0030_START_CARE_DT|Start of care date|303|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|2200|M0032_ROC_DT|Resumption of care date|311|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|2300|M0032_ROC_DT_NA|No resumption of care date|319|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|2400|M0040_PAT_FNAME|Patient's first name|320|12| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|2500|M0040_PAT_MI|Patient's middle initial|332|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|2600|M0040_PAT_LNAME|Patient's last name|333|18| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|2700|M0040_PAT_SUFFIX|Patient's suffix|351|3| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|2800|M0050_PAT_ST|Patient state of residence|354|2| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|2900|M0060_PAT_ZIP|Patient zip code|356|11| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|3000|M0063_MEDICARE_NUM|Medicare number, including suffix|367|12| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|3100|M0063_MEDICARE_NA|No Medicare number|379|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|3200|M0064_SSN|Patient's Social Security number|380|9| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|3300|M0064_SSN_UK|No Social Security number|389|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|3400|M0065_MEDICAID_NUM|Medicaid number|390|14| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|3500|M0065_MEDICAID_NA|No Medicaid number|404|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|3600|M0066_PAT_BIRTH_DT|Date of birth|405|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|3700|M0069_PAT_GENDER|Gender|413|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|3800|M0140_ETHNIC_AI_AN|Ethnicity: American Indian or Alaska Native|414|1| |x|x| | | | | | | |||||
OASIS|2.31|3900|M0140_ETHNIC_ASIAN|Ethnicity: Asian|415|1| |x|x| | | | | | | |||||
OASIS|2.31|4000|M0140_ETHNIC_BLACK|Ethnicity: Black or African American|416|1| |x|x| | | | | | | |||||
OASIS|2.31|4100|M0140_ETHNIC_HISP|Ethnicity: Hispanic or Latino|417|1| |x|x| | | | | | | |||||
OASIS|2.31|4200|M0140_ETHNIC_NH_PI|Ethnicity: Native Hawaiian/Pacific Islander|418|1| |x|x| | | | | | | |||||
OASIS|2.31|4300|M0140_ETHNIC_WHITE|Ethnicity: White|419|1| |x|x| | | | | | | |||||
OASIS|2.31|4400|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|4500|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|4600|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|4700|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|4800|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|4900|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5000|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5100|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5200|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5300|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5400|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5500|M0150_CPAY_OTHER|Payment sources: other|431|1| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5600|M0150_CPAY_UK|Payment sources: unknown|432|1| |x|x| | | | | | | |||||
OASIS|2.31|5700|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2| |x|x|x|x|x|x|x|x| |||||
OASIS|2.31|5800|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|5900|M0100_ASSMT_REASON|Reason for assessment|443|2| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|6000|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8| |x|x| | | | | | | |||||
OASIS|2.31|6100|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1| |x|x| | | | | | | |||||
OASIS|2.31|6200|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8| |x|x| | | | | | | |||||
OASIS|2.31|6300|M0110_EPISODE_TIMING|Episode timing|462|2| |x|x|x|x| | | | | |||||
OASIS|2.31|6400|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1| |x|x| | | | | | | |||||
OASIS|2.31|6500|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1| |x|x| | | | | | | |||||
OASIS|2.31|6600|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1| |x|x| | | | | | | |||||
OASIS|2.31|6700|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1| |x|x| | | | | | | |||||
OASIS|2.31|6800|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1| |x|x| | | | | | | |||||
OASIS|2.31|6900|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1| |x|x| | | | | | | |||||
OASIS|2.31|7000|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1| |x|x| | | | | | | |||||
OASIS|2.31|7100|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1| |x|x| | | | | | | |||||
OASIS|2.31|7200|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8| |x|x| | | | | | | |||||
OASIS|2.31|7300|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1| |x|x| | | | | | | |||||
OASIS|2.31|12700|M1030_THH_IV_INFUSION|Therapies received at home: intravenous, infusion|743|1| |x|x|x|x| | | | | |||||
OASIS|2.31|12800|M1030_THH_PAR_NUTRITION|Therapies received at home: parenteral nutrition|744|1| |x|x|x|x| | | | | |||||
OASIS|2.31|12900|M1030_THH_ENT_NUTRITION|Therapies received at home: enteral nutrition|745|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13000|M1030_THH_NONE_ABOVE|Therapies received at home: none of the above|746|1| |x|x|x|x| | | | | |||||
OASIS|2.31|14900|M1100_PTNT_LVG_STUTN|Patient living situation|769|2| |x|x| | | | | | | |||||
OASIS|2.31|15000|M1200_VISION|Sensory status: vision|771|2| |x|x|x|x| | | | | |||||
OASIS|2.31|15500|M1242_PAIN_FREQ_ACTVTY_MVMT|Freq of pain interfering with pt activity/movement|781|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|15800|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU/injury at stage 2+|786|1| |x|x|x|x| | | |x| |||||
OASIS|2.31|16010|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8| | | | | | | | |x| |||||
OASIS|2.31|16000|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2| | | | | | | | |x| |||||
OASIS|2.31|17700|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure injuries|835|2| |x|x|x|x| | | | | |||||
OASIS|2.31|17800|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer/injury|837|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|17900|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|18000|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2| |x|x|x|x| | | | | |||||
OASIS|2.31|18100|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|18200|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|18300|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|18500|M1400_WHEN_DYSPNEIC|When dyspneic|850|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|19700|M1600_UTI|Treated for urinary tract infection past 14 days|864|2| |x|x| | | | | |x| |||||
OASIS|2.31|19800|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2| |x|x|x|x| | | | | |||||
OASIS|2.31|20000|M1620_BWL_INCONT|Bowel incontinence frequency|870|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|20100|M1630_OSTOMY|Ostomy for bowel elimination|872|2| |x|x|x|x| | | | | |||||
OASIS|2.31|20200|M1700_COG_FUNCTION|Cognitive functioning|874|2| |x|x| | | | | |x| |||||
OASIS|2.31|20300|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2| |x|x| | | | | |x| |||||
OASIS|2.31|20400|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2| |x|x| | | | | |x| |||||
OASIS|2.31|20500|M1730_STDZ_DPRSN_SCRNG|Screened for depression using validated tool|880|2| |x|x| | | | | | | |||||
OASIS|2.31|20600|M1730_PHQ2_LACK_INTRST|PHQ2: little interest or pleasure in doing things|882|2| |x|x| | | | | | | |||||
OASIS|2.31|20700|M1730_PHQ2_DPRSN|PHQ2: feeling down, depressed or hopeless|884|2| |x|x| | | | | | | |||||
OASIS|2.31|20800|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1| |x|x| | | | | |x| |||||
OASIS|2.31|20900|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1| |x|x| | | | | |x| |||||
OASIS|2.31|21000|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1| |x|x| | | | | |x| |||||
OASIS|2.31|21100|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1| |x|x| | | | | |x| |||||
OASIS|2.31|21200|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1| |x|x| | | | | |x| |||||
OASIS|2.31|21300|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1| |x|x| | | | | |x| |||||
OASIS|2.31|21400|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1| |x|x| | | | | |x| |||||
OASIS|2.31|21500|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2| |x|x| | | | | |x| |||||
OASIS|2.31|21700|M1800_CRNT_GROOMING|Current: grooming|896|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|21800|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|21900|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|22000|M1830_CRNT_BATHG|Current: bathing|902|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|22100|M1840_CRNT_TOILTG|Current: toileting|904|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|22200|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2| |x|x| | | | | |x| |||||
OASIS|2.31|22300|M1850_CRNT_TRNSFRNG|Current: transferring|908|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|22400|M1860_CRNT_AMBLTN|Current: ambulation|910|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|22500|M1870_CRNT_FEEDING|Current: feeding|912|2| |x|x| | | | | |x| |||||
OASIS|2.31|23200|M1910_MLT_FCTR_FALL_RISK_ASMT|Has patient had a multi-factor fall risk asmt|926|2| |x|x| | | | | | | |||||
OASIS|2.31|23600|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2| |x|x| | | | | | | |||||
OASIS|2.31|23800|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2| |x|x| | | | | |x| |||||
OASIS|2.31|23900|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2| |x|x|x|x| | | | | |||||
OASIS|2.31|25000|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3| |x|x|x|x| | | | | |||||
OASIS|2.31|25100|M2200_THER_NEED_NA|Therapy need: not applicable|964|1| |x|x|x|x| | | | | |||||
OASIS|2.31|26000|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1| | | | | |x|x| |x| |||||
OASIS|2.31|26900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1| | | | | |x|x| |x| |||||
OASIS|2.31|27800|M2310_ECR_OTHER|Emergent care reason: other than above|999|1| | | | | |x|x| |x| |||||
OASIS|2.31|27900|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1| | | | | |x|x| |x| |||||
OASIS|2.31|28600|M2410_INPAT_FACILITY|Inpatient facility|1013|2| | | | | |x|x| |x| |||||
OASIS|2.31|28700|M2420_DSCHRG_DISP|Discharge disposition|1015|2| | | | | | | | |x| |||||
OASIS|2.31|31700|M0906_DC_TRAN_DTH_DT|Discharge, transfer, death date|1053|8| | | | | |x|x|x|x|x|||||
OASIS|2.31|100|TRANS_TYPE_CD|Transaction type code|11|1| |x|x|x|x|x|x|x|x|x|||||
OASIS|2.31|13110|M1033_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|1515|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13210|M1033_HOSP_RISK_WEIGHT_LOSS|Hosp risk: unintentional weight loss|1516|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13310|M1033_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 6 months|1517|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13410|M1033_HOSP_RISK_MLTPL_ED_VISIT|Hosp risk: 2+ emergcy dept visits in past 6 months|1518|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13510|M1033_HOSP_RISK_MNTL_BHV_DCLN|Hosp risk: decline mental/emotional/behav status|1519|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13610|M1033_HOSP_RISK_COMPLIANCE|Hosp risk: difficulty with medical instructions|1520|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13710|M1033_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|1521|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13720|M1033_HOSP_RISK_CRNT_EXHSTN|Hosp risk: current exhaustion|1522|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13730|M1033_HOSP_RISK_OTHR_RISK|Hosp risk: other risk(s) not listed|1523|1| |x|x|x|x| | | | | |||||
OASIS|2.31|13740|M1033_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|1524|1| |x|x|x|x| | | | | |||||
OASIS|2.31|14510|M1041_IN_INFLNZ_SEASON|Does episode include Oct 1 thru Mar 31|1525|1| | | | | |x|x| |x| |||||
OASIS|2.31|14610|M1046_INFLNZ_RECD_CRNT_SEASON|Did patient receive influenza vaccine|1526|2| | | | | |x|x| |x| |||||
OASIS|2.31|14710|M1051_PVX_RCVD_AGNCY|Was pneumococcal vaccine received|1528|1| | | | | |x|x| |x| |||||
OASIS|2.31|14810|M1056_PVX_RSN_NOT_RCVD_AGNCY|If pneumococcal vacc not received, state reason|1529|2| | | | | |x|x| |x| |||||
OASIS|2.31|24210|M2102_CARE_TYPE_SRC_ADL|Care mgmt, types/sources: ADL|1537|2| | | | | | | | |x| |||||
OASIS|2.31|24410|M2102_CARE_TYPE_SRC_MDCTN|Care mgmt, types/sources: med admin|1541|2| | | | | | | | |x| |||||
OASIS|2.31|24510|M2102_CARE_TYPE_SRC_PRCDR|Care mgmt, types/sources: med procs tx|1543|2| | | | | | | | |x| |||||
OASIS|2.31|24710|M2102_CARE_TYPE_SRC_SPRVSN|Care mgmt, types/sources: supervision and safety|1547|2| |x|x| | | | | |x| |||||
OASIS|2.31|10310|M1021_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|1359|8| |x|x|x|x| | | | | |||||
OASIS|2.31|10410|M1021_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|1367|2| |x|x|x|x| | | | | |||||
OASIS|2.31|10510|M1023_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|1369|8| |x|x|x|x| | | | | |||||
OASIS|2.31|10610|M1023_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|1377|2| |x|x|x|x| | | | | |||||
OASIS|2.31|10710|M1023_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|1379|8| |x|x|x|x| | | | | |||||
OASIS|2.31|10810|M1023_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|1387|2| |x|x|x|x| | | | | |||||
OASIS|2.31|10910|M1023_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|1389|8| |x|x|x|x| | | | | |||||
OASIS|2.31|11010|M1023_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|1397|2| |x|x|x|x| | | | | |||||
OASIS|2.31|11110|M1023_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|1399|8| |x|x|x|x| | | | | |||||
OASIS|2.31|11210|M1023_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|1407|2| |x|x|x|x| | | | | |||||
OASIS|2.31|11310|M1023_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|1409|8| |x|x|x|x| | | | | |||||
OASIS|2.31|11410|M1023_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|1417|2| |x|x|x|x| | | | | |||||
OASIS|2.31|12620|M1028_ACTV_DIAG_PVD_PAD|Active Diagnoses - PVD or PAD|1553|1| |x|x| | | | | | | |||||
OASIS|2.31|12630|M1028_ACTV_DIAG_DM|Active Diagnoses - Diabetes Mellitus|1554|1| |x|x| | | | | | | |||||
OASIS|2.31|14830|M1060_HEIGHT_A|Height (in inches)|1555|2| |x|x| | | | | | | |||||
OASIS|2.31|14840|M1060_WEIGHT_B|Weight (in pounds)|1557|3| |x|x| | | | | | | |||||
OASIS|2.31|16020|M1311_NBR_PRSULC_STG2_A1|Number of Stage 2 Pressure Ulcers|1560|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|16030|M1311_NBR_ULC_SOCROC_STG2_A2|Number of Stage 2 pressure ulcers at SOC/ROC|1562|2| | | | | | | | |x| |||||
OASIS|2.31|16040|M1311_NBR_PRSULC_STG3_B1|Number of Stage 3 Pressure Ulcers|1564|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|16050|M1311_NBR_ULC_SOCROC_STG3_B2|Number of Stage 3 pressure ulcers at SOC/ROC|1566|2| | | | | | | | |x| |||||
OASIS|2.31|16060|M1311_NBR_PRSULC_STG4_C1|Number of Stage 4 Pressure Ulcers|1568|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|16070|M1311_NBR_ULC_SOCROC_STG4_C2|Number of Stage 4 pressure ulcers at SOC/ROC|1570|2| | | | | | | | |x| |||||
OASIS|2.31|16080|M1311_NSTG_DRSG_D1|Num unstage pressure ulcer non-remov dress|1572|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|16090|M1311_NSTG_DRSG_SOCROC_D2|Num unstage pressure ulcer non-remov dress SOC/ROC|1574|2| | | | | | | | |x| |||||
OASIS|2.31|16100|M1311_NSTG_CVRG_E1|Unstageable: coverage by slough or eschar|1576|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|16110|M1311_NSTG_CVRG_SOCROC_E2|Unstageable: coverage by slough or eschar SOC/ROC|1578|2| | | | | | | | |x| |||||
OASIS|2.31|16120|M1311_NSTG_DEEP_TSUE_F1|Unstageable: deep tissue injury|1580|2| |x|x|x|x| | | |x| |||||
OASIS|2.31|16130|M1311_NSTG_DEEP_TSUE_SOCROC_F2|Unstageable: deep tissue injury SOC/ROC|1582|2| | | | | | | | |x| |||||
OASIS|2.31|32480|GG0170C_MOBILITY_SOCROC_PERF|Lying to sitting on bed side (SOC/ROC Perf)|1604|2| |x|x| | | | | | | |||||
OASIS|2.31|32490|GG0170C_MOBILITY_DSCHG_GOAL|Lying to sitting on bed side (Dschrg Goal)|1606|2| |x|x| | | | | | | |||||
OASIS|2.31|23310|M2001_DRUG_RGMN_RVW|Drug regimen review|1608|1| |x|x| | | | | | | |||||
OASIS|2.31|23410|M2003_MDCTN_FLWP|Medication follow-up|1609|1| |x|x| | | | | | | |||||
OASIS|2.31|23510|M2005_MDCTN_INTRVTN|Medication intervention|1610|1| | | | | |x|x|x|x| |||||
OASIS|2.31|23710|M2016_DRUG_EDCTN_INTRVTN|Patient/caregiver drug education intervention|1611|2| | | | | |x|x| |x| |||||
OASIS|2.31|25910|M2301_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since most recent SOC/ROC|1613|2| | | | | |x|x| |x| |||||
OASIS|2.31|28510|M2401_INTRVTN_SMRY_DBTS_FT|Intervention synopsis: diabetic foot care|1615|2| | | | | |x|x| |x| |||||
OASIS|2.31|28520|M2401_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1617|2| | | | | |x|x| |x| |||||
OASIS|2.31|28530|M2401_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1619|2| | | | | |x|x| |x| |||||
OASIS|2.31|28540|M2401_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1621|2| | | | | |x|x| |x| |||||
OASIS|2.31|28550|M2401_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1623|2| | | | | |x|x| |x| |||||
OASIS|2.31|28560|M2401_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1625|2| | | | | |x|x| |x| |||||
OASIS|2.31|12640|M1028_ACTV_DIAG_NOA|Active Diagnoses - None of the above|1627|1| |x|x| | | | | | | |||||
OASIS|2.31|32000|GG0100A|Prior Function - Self Care|1628|1| |x|x| | | | | | | |||||
OASIS|2.31|32010|GG0100B|Prior Function - Indoor Mobility (Ambulation)|1629|1| |x|x| | | | | | | |||||
OASIS|2.31|32020|GG0100C|Prior Function - Stairs|1630|1| |x|x| | | | | | | |||||
OASIS|2.31|32030|GG0100D|Prior Function - Functional Cognition|1631|1| |x|x| | | | | | | |||||
OASIS|2.31|32040|GG0110A|Prior Device - Manual wheelchair|1632|1| |x|x| | | | | | | |||||
OASIS|2.31|32050|GG0110B|Prior Device - Motorized wheelchair and/or scooter|1633|1| |x|x| | | | | | | |||||
OASIS|2.31|32060|GG0110C|Prior Device - Mechanical lift|1634|1| |x|x| | | | | | | |||||
OASIS|2.31|32070|GG0110D|Prior Device - Walker|1635|1| |x|x| | | | | | | |||||
OASIS|2.31|32080|GG0110E|Prior Device - Orthotics/Prosthetics|1636|1| |x|x| | | | | | | |||||
OASIS|2.31|32090|GG0110Z|Prior Device - None of the above|1637|1| |x|x| | | | | | | |||||
OASIS|2.31|32100|GG0130A1|Eating (SOC/ROC Perf)|1638|2| |x|x| | | | | | | |||||
OASIS|2.31|32110|GG0130A2|Eating (Dschg Goal)|1640|2| |x|x| | | | | | | |||||
OASIS|2.31|32120|GG0130A3|Eating (Dischg Perf)|1642|2| | | | | | | | |x| |||||
OASIS|2.31|32130|GG0130A4|Eating (Follow-Up Perf)|1644|2| | | |x|x| | | | | |||||
OASIS|2.31|32140|GG0130B1|Oral Hygiene (SOC/ROC Perf)|1646|2| |x|x| | | | | | | |||||
OASIS|2.31|32150|GG0130B2|Oral Hygiene (Dschrg Goal)|1648|2| |x|x| | | | | | | |||||
OASIS|2.31|32160|GG0130B3|Oral Hygiene (Dschrg Perf)|1650|2| | | | | | | | |x| |||||
OASIS|2.31|32170|GG0130B4|Oral Hygiene (Follow-Up Perf)|1652|2| | | |x|x| | | | | |||||
OASIS|2.31|32180|GG0130C1|Toileting hygiene (SOC/ROC Perf)|1654|2| |x|x| | | | | | | |||||
OASIS|2.31|32190|GG0130C2|Toileting hygiene (Dschrg Goal)|1656|2| |x|x| | | | | | | |||||
OASIS|2.31|32200|GG0130C3|Toileting hygiene (Dschrg Perf)|1658|2| | | | | | | | |x| |||||
OASIS|2.31|32210|GG0130C4|Toileting hygiene (Follow-Up Perf)|1660|2| | | |x|x| | | | | |||||
OASIS|2.31|32220|GG0130E1|Shower/bathe self (SOC/ROC Perf)|1662|2| |x|x| | | | | | | |||||
OASIS|2.31|32230|GG0130E2|Shower/bathe self (Dschrg Goal)|1664|2| |x|x| | | | | | | |||||
OASIS|2.31|32240|GG0130E3|Shower/bathe self (Dschrg Perf)|1666|2| | | | | | | | |x| |||||
OASIS|2.31|32250|GG0130F1|Upper body dressing (SOC/ROC Perf)|1668|2| |x|x| | | | | | | |||||
OASIS|2.31|32260|GG0130F2|Upper body dressing (Dschrg Goal)|1670|2| |x|x| | | | | | | |||||
OASIS|2.31|32270|GG0130F3|Upper body dressing (Dschrg Perf)|1672|2| | | | | | | | |x| |||||
OASIS|2.31|32280|GG0130G1|Lower body dressing (SOC/ROC Perf)|1674|2| |x|x| | | | | | | |||||
OASIS|2.31|32290|GG0130G2|Lower body dressing (Dschrg Goal)|1676|2| |x|x| | | | | | | |||||
OASIS|2.31|32300|GG0130G3|Lower body dressing (Dschrg Perf)|1678|2| | | | | | | | |x| |||||
OASIS|2.31|32310|GG0130H1|Put on/take off footwear (SOC/ROC Perf)|1680|2| |x|x| | | | | | | |||||
OASIS|2.31|32320|GG0130H2|Put on/take off footwear (Dschrg Goal)|1682|2| |x|x| | | | | | | |||||
OASIS|2.31|32330|GG0130H3|Put on/take off footwear (Dschrg Perf)|1684|2| | | | | | | | |x| |||||
OASIS|2.31|32400|GG0170A1|Roll left and right (SOC/ROC Perf)|1686|2| |x|x| | | | | | | |||||
OASIS|2.31|32410|GG0170A2|Roll left and right (Dschrg Goal)|1688|2| |x|x| | | | | | | |||||
OASIS|2.31|32420|GG0170A3|Roll left and right (Dschrg Perf)|1690|2| | | | | | | | |x| |||||
OASIS|2.31|32430|GG0170A4|Roll left and right (Follow-Up Perf)|1692|2| | | |x|x| | | | | |||||
OASIS|2.31|32440|GG0170B1|Sit to lying (SOC/ROC Perf)|1694|2| |x|x| | | | | | | |||||
OASIS|2.31|32450|GG0170B2|Sit to lying (Dschrg Goal)|1696|2| |x|x| | | | | | | |||||
OASIS|2.31|32460|GG0170B3|Sit to lying (Dschrg Perf)|1698|2| | | | | | | | |x| |||||
OASIS|2.31|32470|GG0170B4|Sit to lying (Follow-Up Perf)|1700|2| | | |x|x| | | | | |||||
OASIS|2.31|32500|GG0170C3|Lying to sitting on bed side (Dschrg Perf)|1702|2| | | | | | | | |x| |||||
OASIS|2.31|32510|GG0170C4|Lying to sitting on bed side (Follow-Up Perf)|1704|2| | | |x|x| | | | | |||||
OASIS|2.31|32520|GG0170D1|Sit to stand (SOC/ROC Perf)|1706|2| |x|x| | | | | | | |||||
OASIS|2.31|32530|GG0170D2|Sit to stand (Dschrg Goal)|1708|2| |x|x| | | | | | | |||||
OASIS|2.31|32540|GG0170D3|Sit to stand (Dschrg Perf)|1710|2| | | | | | | | |x| |||||
OASIS|2.31|32550|GG0170D4|Sit to stand (Follow-Up Perf)|1712|2| | | |x|x| | | | | |||||
OASIS|2.31|32560|GG0170E1|Chair/bed-to-chair transfer (SOC/ROC Perf)|1714|2| |x|x| | | | | | | |||||
OASIS|2.31|32570|GG0170E2|Chair/bed-to-chair transfer (Dschrg Goal)|1716|2| |x|x| | | | | | | |||||
OASIS|2.31|32580|GG0170E3|Chair/bed-to-chair transfer (Dschrg Perf)|1718|2| | | | | | | | |x| |||||
OASIS|2.31|32590|GG0170E4|Chair/bed-to-chair transfer (Follow-Up Perf)|1720|2| | | |x|x| | | | | |||||
OASIS|2.31|32600|GG0170F1|Toilet transfer (SOC/ROC Perf)|1722|2| |x|x| | | | | | | |||||
OASIS|2.31|32610|GG0170F2|Toilet transfer (Dschrg Goal)|1724|2| |x|x| | | | | | | |||||
OASIS|2.31|32620|GG0170F3|Toilet transfer (Dschrg Perf)|1726|2| | | | | | | | |x| |||||
OASIS|2.31|32630|GG0170F4|Toilet transfer (Follow-Up Perf)|1728|2| | | |x|x| | | | | |||||
OASIS|2.31|32640|GG0170G1|Car transfer (SOC/ROC Perf)|1730|2| |x|x| | | | | | | |||||
OASIS|2.31|32650|GG0170G2|Car transfer (Dschrg Goal)|1732|2| |x|x| | | | | | | |||||
OASIS|2.31|32660|GG0170G3|Car transfer (Dschrg Perf)|1734|2| | | | | | | | |x| |||||
OASIS|2.31|32670|GG0170I1|Walk 10 feet (SOC/ROC Perf)|1736|2| |x|x| | | | | | | |||||
OASIS|2.31|32680|GG0170I2|Walk 10 feet (Dschrg Goal)|1738|2| |x|x| | | | | | | |||||
OASIS|2.31|32690|GG0170I3|Walk 10 feet (Dschrg Perf)|1740|2| | | | | | | | |x| |||||
OASIS|2.31|32700|GG0170I4|Walk 10 feet (Follow-Up Perf)|1742|2| | | |x|x| | | | | |||||
OASIS|2.31|32710|GG0170J1|Walk 50 feet with two turns (SOC/ROC Perf)|1744|2| |x|x| | | | | | | |||||
OASIS|2.31|32720|GG0170J2|Walk 50 feet with two turns (Dschrg Goal)|1746|2| |x|x| | | | | | | |||||
OASIS|2.31|32730|GG0170J3|Walk 50 feet with two turns (Dschrg Perf)|1748|2| | | | | | | | |x| |||||
OASIS|2.31|32740|GG0170J4|Walk 50 feet with two turns (Follow-Up Perf)|1750|2| | | |x|x| | | | | |||||
OASIS|2.31|32750|GG0170K1|Walk 150 feet (SOC/ROC Perf)|1752|2| |x|x| | | | | | | |||||
OASIS|2.31|32760|GG0170K2|Walk 150 feet (Dschrg Goal)|1754|2| |x|x| | | | | | | |||||
OASIS|2.31|32770|GG0170K3|Walk 150 feet (Dschrg Perf)|1756|2| | | | | | | | |x| |||||
OASIS|2.31|32780|GG0170L1|Walking 10 feet uneven surf (SOC/ROC Perf)|1758|2| |x|x| | | | | | | |||||
OASIS|2.31|32790|GG0170L2|Walking 10 feet uneven surf (Dschrg Goal)|1760|2| |x|x| | | | | | | |||||
OASIS|2.31|32800|GG0170L3|Walking 10 feet uneven surf (Dschrg Perf)|1762|2| | | | | | | | |x| |||||
OASIS|2.31|32810|GG0170L4|Walking 10 feet uneven surf (Follow-Up Perf)|1764|2| | | |x|x| | | | | |||||
OASIS|2.31|32820|GG0170M1|1 step (curb) (SOC/ROC Perf)|1766|2| |x|x| | | | | | | |||||
OASIS|2.31|32830|GG0170M2|1 step (curb) (Dschrg Goal)|1768|2| |x|x| | | | | | | |||||
OASIS|2.31|32840|GG0170M3|1 step (curb) (Dschrg Perf)|1770|2| | | | | | | | |x| |||||
OASIS|2.31|32850|GG0170M4|1 step (curb) (Follow-Up Perf)|1772|2| | | |x|x| | | | | |||||
OASIS|2.31|32860|GG0170N1|4 steps (SOC/ROC Perf)|1774|2| |x|x| | | | | | | |||||
OASIS|2.31|32870|GG0170N2|4 steps (Dschrg Goal)|1776|2| |x|x| | | | | | | |||||
OASIS|2.31|32880|GG0170N3|4 steps (Dschrg Perf)|1778|2| | | | | | | | |x| |||||
OASIS|2.31|32890|GG0170N4|4 steps (Follow-Up Perf)|1780|2| | | |x|x| | | | | |||||
OASIS|2.31|32900|GG0170O1|12 steps (SOC/ROC Perf)|1782|2| |x|x| | | | | | | |||||
OASIS|2.31|32910|GG0170O2|12 steps (Dschrg Goal)|1784|2| |x|x| | | | | | | |||||
OASIS|2.31|32920|GG0170O3|12 steps (Dschrg Perf)|1786|2| | | | | | | | |x| |||||
OASIS|2.31|32930|GG0170P1|Picking up object (SOC/ROC Perf)|1788|2| |x|x| | | | | | | |||||
OASIS|2.31|32940|GG0170P2|Picking up object (Dschrg Goal)|1790|2| |x|x| | | | | | | |||||
OASIS|2.31|32950|GG0170P3|Picking up object (Dschrg Perf)|1792|2| | | | | | | | |x| |||||
OASIS|2.31|32960|GG0170Q1|Use wheelchair and/or scooter (SOC/ROC Perf)|1794|1| |x|x| | | | | | | |||||
OASIS|2.31|32970|GG0170Q3|Use wheelchair and/or scooter (Dschrg Perf)|1795|1| | | | | | | | |x| |||||
OASIS|2.31|32980|GG0170Q4|Use wheelchair and/or scooter (Follow-Up Perf)|1796|1| | | |x|x| | | | | |||||
OASIS|2.31|32990|GG0170R1|Wheel 50 feet with two turns (SOC/ROC Perf)|1797|2| |x|x| | | | | | | |||||
OASIS|2.31|33010|GG0170R2|Wheel 50 feet with two turns (Dschrg Goal)|1799|2| |x|x| | | | | | | |||||
OASIS|2.31|33020|GG0170R3|Wheel 50 feet with two turns (Dschrg Perf)|1801|2| | | | | | | | |x| |||||
OASIS|2.31|33030|GG0170R4|Wheel 50 feet with two turns (Follow-Up Perf)|1803|2| | | |x|x| | | | | |||||
OASIS|2.31|33040|GG0170RR1|Type of wheelchair or scooter (SOC/ROC Perf)|1805|1| |x|x| | | | | | | |||||
OASIS|2.31|33050|GG0170RR3|Type of wheelchair or scooter (Dschg Perf)|1806|1| | | | | | | | |x| |||||
OASIS|2.31|33060|GG0170S1|Wheel 150 feet (SOC/ROC Perf)|1807|2| |x|x| | | | | | | |||||
OASIS|2.31|33070|GG0170S2|Wheel 150 feet (Dschrg Goal)|1809|2| |x|x| | | | | | | |||||
OASIS|2.31|33080|GG0170S3|Wheel 150 feet (Dschrg Perf)|1811|2| | | | | | | | |x| |||||
OASIS|2.31|33090|GG0170SS1|Type of wheelchair or scooter (SOC/ROC Perf)|1813|1| |x|x| | | | | | | |||||
OASIS|2.31|33100|GG0170SS3|Type of wheelchair or scooter (Dschrg Perf)|1814|1| | | | | | | | |x| |||||
OASIS|2.31|34000|J1800|Falls since SOC/ROC: any falls|1815|1| | | | | |x|x|x|x| |||||
OASIS|2.31|34010|J1900A|Num falls since SOC/ROC: no injury|1816|1| | | | | |x|x|x|x| |||||
OASIS|2.31|34020|J1900B|Num falls since SOC/ROC: injury (except major)|1817|1| | | | | |x|x|x|x| |||||
OASIS|2.31|34030|J1900C|Num falls since SOC/ROC: major injury|1818|1| | | | | |x|x|x|x| |||||
OASIS|2.31|800|SUBM_HIPPS_CODE|HIPPS group code: submitted|244|5| |x|x|x|x| | | | | |||||
OASIS|2.31|850|SUBM_HIPPS_VERSION|HIPPS version code: submitted|249|5| |x|x|x|x| | | | | |||||
HOSPICE|3.00|100|ITM_SET_SYS_CD|Item set system code|1|10|Y|x| | | | | | |x|x||0||HOSPICE|
HOSPICE|3.00|200|ITM_SBST_CD|Item subset code|11|3|N|x| | | | | | |x|x||0||HA|
HOSPICE|3.00|300|ITM_SET_VRSN_CD|Item set version code|14|10|Y|x| | | | | | |x|x||0||3.00|
HOSPICE|3.00|400|SPEC_VRSN_CD|Specifications version code|24|10|Y|x| | | | | | |x|x||0||3.00|
HOSPICE|3.00|550|CRCTN_NUM|Correction number|34|2|Y|x| | | | | | |x|x||0||00|
HOSPICE|3.00|600|STATE_CD|Provider's state postal code|36|2|Y|x| | | | | | |x|x|Adm_Entity|0|State||
HOSPICE|3.00|700|FAC_ID|Assigned provider submission ID|38|16|Y|x| | | | | | |x|x|Adm_Entity|0|Taxonomy_Code||
HOSPICE|3.00|800|SFTWR_VNDR_ID|Software vendor federal employer tax ID|54|9|Y|x| | | | | | |x|x||0||270020344|
OASIS|3.00      |30100|M1322_NBR_PRSULC_STG1|Number of stage 1 pressure injuries|835|2||x|x| | | | | | | |||||
OASIS|3.00      |30200|M1324_STG_PRBLM_ULCER|Stage of most problematic pressure ulcer/injury|837|2||x|x| | | | | |x| |||||
OASIS|3.00      |30300|M1330_STAS_ULCR_PRSNT|Does this patient have a stasis ulcer|839|2||x|x| | | | | |x| |||||
OASIS|3.00      |30400|M1332_NBR_STAS_ULCR|Number of stasis ulcers|841|2||x|x| | | | | | | |||||
OASIS|3.00      |30500|M1334_STUS_PRBLM_STAS_ULCR|Status of most problematic stasis ulcer|843|2||x|x| | | | | |x| |||||
OASIS|3.00      |30600|M1340_SRGCL_WND_PRSNT|Does this patient have a surgical wound|845|2||x|x| | | | | |x| |||||
OASIS|3.00      |30700|M1342_STUS_PRBLM_SRGCL_WND|Status of most problematic surgical wound|847|2||x|x| | | | | |x| |||||
OASIS|3.00      |27300|M1400_WHEN_DYSPNEIC|When dyspneic|850|2||x|x| | | | | |x| |||||
OASIS|3.00      |22900|M1600_UTI|Treated for urinary tract infection past 14 days|864|2||x|x| | | | | |x| |||||
OASIS|3.00      |23000|M1610_UR_INCONT|Urinary incontinence or urinary catheter present|866|2||x|x| | | | | | | |||||
OASIS|3.00      |23100|M1620_BWL_INCONT|Bowel incontinence frequency|870|2||x|x| | | | | |x| |||||
OASIS|3.00      |23200|M1630_OSTOMY|Ostomy for bowel elimination|872|2||x|x| | | | | | | |||||
OASIS|3.00      |10740|M1700_COG_FUNCTION|Cognitive functioning|874|2||x|x| | | | | |x| |||||
OASIS|3.00      |10750|M1710_WHEN_CONFUSED|When confused (reported or observed)|876|2||x|x| | | | | |x| |||||
OASIS|3.00      |10760|M1720_WHEN_ANXIOUS|When anxious (reported or observed)|878|2||x|x| | | | | |x| |||||
OASIS|3.00      |12300|M1740_BD_MEM_DEFICIT|Behavior demonstrated: memory deficit|886|1||x|x| | | | | |x| |||||
OASIS|3.00      |12400|M1740_BD_IMP_DECISN|Behavior demonstrated: impaired decision-making|887|1||x|x| | | | | |x| |||||
OASIS|3.00      |12500|M1740_BD_VERBAL|Behavior demonstrated: verbal disruption|888|1||x|x| | | | | |x| |||||
OASIS|3.00      |12600|M1740_BD_PHYSICAL|Behavior demonstrated: physical aggression|889|1||x|x| | | | | |x| |||||
OASIS|3.00      |12700|M1740_BD_SOC_INAPPRO|Behavior demonstrated: socially inappropriate|890|1||x|x| | | | | |x| |||||
OASIS|3.00      |12800|M1740_BD_DELUSIONS|Behavior demonstrated: delusions|891|1||x|x| | | | | |x| |||||
OASIS|3.00      |12900|M1740_BD_NONE|Behavior demonstrated: none of the above|892|1||x|x| | | | | |x| |||||
OASIS|3.00      |13000|M1745_BEH_PROB_FREQ|Frequency of behavior problems|893|2||x|x| | | | | |x| |||||
OASIS|3.00      |20000|M1800_CRNT_GROOMING|Current: grooming|896|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |20100|M1810_CRNT_DRESS_UPPER|Current: dress upper body|898|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |20200|M1820_CRNT_DRESS_LOWER|Current: dress lower body|900|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |20300|M1830_CRNT_BATHG|Current: bathing|902|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |20400|M1840_CRNT_TOILTG|Current: toileting|904|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |20500|M1845_CRNT_TOILTG_HYGN|Current: toileting hygiene|906|2||x|x| | | | | |x| |||||
OASIS|3.00      |20600|M1850_CRNT_TRNSFRNG|Current: transferring|908|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |20700|M1860_CRNT_AMBLTN|Current: ambulation|910|2||x|x|x|x| | | |x| |||||
OASIS|3.00      |29320|M1870_CRNT_FEEDING|Current: feeding|912|2||x|x| | | | | |x| |||||
OASIS|3.00      |31900|M2010_HIGH_RISK_DRUG_EDCTN|Patient/caregiver high risk drug education|933|2||x|x| | | | | | | |||||
OASIS|3.00      |32100|M2020_CRNT_MGMT_ORAL_MDCTN|Current: management of oral medications|937|2||x|x| | | | | |x| |||||
OASIS|3.00      |32200|M2030_CRNT_MGMT_INJCTN_MDCTN|Current: management of injectable medications|939|2||x|x| | | | | | | |||||
OASIS|3.00      |33700|M2200_THER_NEED_NBR|Therapy need: number of visits indicated|961|3||x|x| | | | | | | |||||
OASIS|3.00      |33800|M2200_THER_NEED_NA|Therapy need: not applicable|964|1||x|x| | | | | | | |||||
OASIS|3.00      |7800|M2310_ECR_MEDICATION|Emergent care reason: medication|981|1|| | | | |x|x| |x| |||||
OASIS|3.00      |7900|M2310_ECR_HYPOGLYC|Emergent care reason: hypoglycemia/hyperglycemia|990|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8000|M2310_ECR_OTHER|Emergent care reason: other than above|999|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8100|M2310_ECR_UNKNOWN|Emergent care reason: unknown|1000|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8200|M2410_INPAT_FACILITY|Inpatient facility|1013|2|| | | | |x|x| |x| |||||
OASIS|3.00      |8300|M2420_DSCHRG_DISP|Discharge disposition|1015|2|| | | | | | | |x| |||||
OASIS|3.00      |3830|M0906_DC_TRAN_DTH_DT|Discharge, transfer, death date|1053|8|| | | | |x|x|x|x|x|||||
OASIS|3.00      |100|TRANS_TYPE_CD|Transaction type code|11|1||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |25600|M1033_HOSP_RISK_HSTRY_FALLS|Hosp risk: 2+ falls or injury fall in past year|1515|1||x|x|x|x| | | | | |||||
OASIS|3.00      |25700|M1033_HOSP_RISK_WEIGHT_LOSS|Hosp risk: unintentional weight loss|1516|1||x|x|x|x| | | | | |||||
OASIS|3.00      |25800|M1033_HOSP_RISK_MLTPL_HOSPZTN|Hosp risk: 2+ hospitalizations in past 6 months|1517|1||x|x|x|x| | | | | |||||
OASIS|3.00      |25900|M1033_HOSP_RISK_MLTPL_ED_VISIT|Hosp risk: 2+ emergcy dept visits in past 6 months|1518|1||x|x|x|x| | | | | |||||
OASIS|3.00      |26000|M1033_HOSP_RISK_MNTL_BHV_DCLN|Hosp risk: decline mental/emotional/behav status|1519|1||x|x|x|x| | | | | |||||
OASIS|3.00      |26100|M1033_HOSP_RISK_COMPLIANCE|Hosp risk: difficulty with medical instructions|1520|1||x|x|x|x| | | | | |||||
OASIS|3.00      |26200|M1033_HOSP_RISK_5PLUS_MDCTN|Hosp risk: taking five or more medications|1521|1||x|x|x|x| | | | | |||||
OASIS|3.00      |26300|M1033_HOSP_RISK_CRNT_EXHSTN|Hosp risk: current exhaustion|1522|1||x|x|x|x| | | | | |||||
OASIS|3.00      |26400|M1033_HOSP_RISK_OTHR_RISK|Hosp risk: other risk(s) not listed|1523|1||x|x|x|x| | | | | |||||
OASIS|3.00      |26500|M1033_HOSP_RISK_NONE_ABOVE|Hosp risk: none of the above|1524|1||x|x|x|x| | | | | |||||
OASIS|3.00      |33500|M1041_IN_INFLNZ_SEASON|Does episode include Oct 1 thru Mar 31|1525|1|| | | | |x|x| |x| |||||
OASIS|3.00      |33600|M1046_INFLNZ_RECD_CRNT_SEASON|Did patient receive influenza vaccine|1526|2|| | | | |x|x| |x| |||||
OASIS|3.00      |13700|M2102_CARE_TYPE_SRC_ADL|Care mgmt, types/sources: ADL|1537|2|| | | | | | | |x| |||||
OASIS|3.00      |13800|M2102_CARE_TYPE_SRC_MDCTN|Care mgmt, types/sources: med admin|1541|2|| | | | | | | |x| |||||
OASIS|3.00      |13900|M2102_CARE_TYPE_SRC_PRCDR|Care mgmt, types/sources: med procs tx|1543|2|| | | | | | | |x| |||||
OASIS|3.00      |14000|M2102_CARE_TYPE_SRC_SPRVSN|Care mgmt, types/sources: supervision and safety|1547|2||x|x| | | | | |x| |||||
OASIS|3.00      |23900|M1021_PRIMARY_DIAG_ICD|Primary diagnosis ICD code|1359|8||x|x| | | | | | | |||||
OASIS|3.00      |24000|M1021_PRIMARY_DIAG_SEVERITY|Primary diagnosis severity rating|1367|2||x|x| | | | | | | |||||
OASIS|3.00      |24100|M1023_OTH_DIAG1_ICD|Other diagnosis 1: ICD code|1369|8||x|x| | | | | | | |||||
OASIS|3.00      |24200|M1023_OTH_DIAG1_SEVERITY|Other diagnosis 1: severity rating|1377|2||x|x| | | | | | | |||||
OASIS|3.00      |24300|M1023_OTH_DIAG2_ICD|Other diagnosis 2: ICD code|1379|8||x|x| | | | | | | |||||
OASIS|3.00      |24400|M1023_OTH_DIAG2_SEVERITY|Other diagnosis 2: severity rating|1387|2||x|x| | | | | | | |||||
OASIS|3.00      |24500|M1023_OTH_DIAG3_ICD|Other diagnosis 3: ICD code|1389|8||x|x| | | | | | | |||||
OASIS|3.00      |24600|M1023_OTH_DIAG3_SEVERITY|Other diagnosis 3: severity rating|1397|2||x|x| | | | | | | |||||
OASIS|3.00      |24700|M1023_OTH_DIAG4_ICD|Other diagnosis 4: ICD code|1399|8||x|x| | | | | | | |||||
OASIS|3.00      |24800|M1023_OTH_DIAG4_SEVERITY|Other diagnosis 4: severity rating|1407|2||x|x| | | | | | | |||||
OASIS|3.00      |24900|M1023_OTH_DIAG5_ICD|Other diagnosis 5: ICD code|1409|8||x|x| | | | | | | |||||
OASIS|3.00      |25000|M1023_OTH_DIAG5_SEVERITY|Other diagnosis 5: severity rating|1417|2||x|x| | | | | | | |||||
OASIS|3.00      |23800|M1028_ACTV_DIAG_PVD_PAD|Active Diagnoses - PVD or PAD|1553|1||x|x| | | | | | | |||||
OASIS|3.00      |23810|M1028_ACTV_DIAG_DM|Active Diagnoses - Diabetes Mellitus|1554|1||x|x| | | | | | | |||||
OASIS|3.00      |27900|M1060_HEIGHT_A|Height (in inches)|1555|2||x|x| | | | | | | |||||
OASIS|3.00      |28000|M1060_WEIGHT_B|Weight (in pounds)|1557|3||x|x| | | | | | | |||||
OASIS|3.00      |29930|M1311_NBR_PRSULC_STG2_A1|Number of Stage 2 Pressure Ulcers|1560|2||x|x| | | | | |x| |||||
OASIS|3.00      |29940|M1311_NBR_ULC_SOCROC_STG2_A2|Number of Stage 2 pressure ulcers at SOC/ROC|1562|2|| | | | | | | |x| |||||
OASIS|3.00      |29950|M1311_NBR_PRSULC_STG3_B1|Number of Stage 3 Pressure Ulcers|1564|2||x|x| | | | | |x| |||||
OASIS|3.00      |29960|M1311_NBR_ULC_SOCROC_STG3_B2|Number of Stage 3 pressure ulcers at SOC/ROC|1566|2|| | | | | | | |x| |||||
OASIS|3.00      |29970|M1311_NBR_PRSULC_STG4_C1|Number of Stage 4 Pressure Ulcers|1568|2||x|x| | | | | |x| |||||
OASIS|3.00      |29980|M1311_NBR_ULC_SOCROC_STG4_C2|Number of Stage 4 pressure ulcers at SOC/ROC|1570|2|| | | | | | | |x| |||||
OASIS|3.00      |29990|M1311_NSTG_DRSG_D1|Num unstage pressure ulcer non-remov dress|1572|2||x|x| | | | | |x| |||||
OASIS|3.00      |30000|M1311_NSTG_DRSG_SOCROC_D2|Num unstage pressure ulcer non-remov dress SOC/ROC|1574|2|| | | | | | | |x| |||||
OASIS|3.00      |30010|M1311_NSTG_CVRG_E1|Unstageable: coverage by slough or eschar|1576|2||x|x| | | | | |x| |||||
OASIS|3.00      |30020|M1311_NSTG_CVRG_SOCROC_E2|Unstageable: coverage by slough or eschar SOC/ROC|1578|2|| | | | | | | |x| |||||
OASIS|3.00      |30030|M1311_NSTG_DEEP_TSUE_F1|Unstageable: deep tissue injury|1580|2||x|x| | | | | |x| |||||
OASIS|3.00      |30040|M1311_NSTG_DEEP_TSUE_SOCROC_F2|Unstageable: deep tissue injury SOC/ROC|1582|2|| | | | | | | |x| |||||
OASIS|3.00      |21720|GG0170C_MOBILITY_SOCROC_PERF|Lying to sitting on bed side (SOC/ROC Perf)|1604|2||x|x| | | | | | | |||||
OASIS|3.00      |21730|GG0170C_MOBILITY_DSCHG_GOAL|Lying to sitting on bed side (Dschrg Goal)|1606|2||x|x| | | | | | | |||||
OASIS|3.00      |31600|M2001_DRUG_RGMN_RVW|Drug regimen review|1608|1||x|x| | | | | | | |||||
OASIS|3.00      |31700|M2003_MDCTN_FLWP|Medication follow-up|1609|1||x|x| | | | | | | |||||
OASIS|3.00      |31800|M2005_MDCTN_INTRVTN|Medication intervention|1610|1|| | | | |x|x|x|x| |||||
OASIS|3.00      |7700|M2301_EMER_USE_AFTR_LAST_ASMT|Emergent care: use since most recent SOC/ROC|1613|2|| | | | |x|x| |x| |||||
OASIS|3.00      |34400|M2401_INTRVTN_SMRY_FALL_PRVNT|Intervention synopsis: falls prevention|1617|2|| | | | |x|x| |x| |||||
OASIS|3.00      |34500|M2401_INTRVTN_SMRY_DPRSN|Intervention synopsis: depression intervention|1619|2|| | | | |x|x| |x| |||||
OASIS|3.00      |34600|M2401_INTRVTN_SMRY_PAIN_MNTR|Intervention synopsis: monitor and mitigate pain|1621|2|| | | | |x|x| |x| |||||
OASIS|3.00      |34700|M2401_INTRVTN_SMRY_PRSULC_PRVN|Intervention synopsis: prevent pressure ulcers|1623|2|| | | | |x|x| |x| |||||
OASIS|3.00      |34800|M2401_INTRVTN_SMRY_PRSULC_WET|Intervention synopsis: PU moist wound treatment|1625|2|| | | | |x|x| |x| |||||
OASIS|3.00      |23820|M1028_ACTV_DIAG_NOA|Active Diagnoses - None of the above|1627|1||x|x| | | | | | | |||||
OASIS|3.00      |21300|GG0100A|Prior Function - Self Care|1628|1||x|x| | | | | | | |||||
OASIS|3.00      |21310|GG0100B|Prior Function - Indoor Mobility (Ambulation)|1629|1||x|x| | | | | | | |||||
OASIS|3.00      |21320|GG0100C|Prior Function - Stairs|1630|1||x|x| | | | | | | |||||
OASIS|3.00      |21330|GG0100D|Prior Function - Functional Cognition|1631|1||x|x| | | | | | | |||||
OASIS|3.00      |21340|GG0110A|Prior Device - Manual wheelchair|1632|1||x|x| | | | | | | |||||
OASIS|3.00      |21350|GG0110B|Prior Device - Motorized wheelchair and/or scooter|1633|1||x|x| | | | | | | |||||
OASIS|3.00      |21360|GG0110C|Prior Device - Mechanical lift|1634|1||x|x| | | | | | | |||||
OASIS|3.00      |21370|GG0110D|Prior Device - Walker|1635|1||x|x| | | | | | | |||||
OASIS|3.00      |21380|GG0110E|Prior Device - Orthotics/Prosthetics|1636|1||x|x| | | | | | | |||||
OASIS|3.00      |21390|GG0110Z|Prior Device - None of the above|1637|1||x|x| | | | | | | |||||
OASIS|3.00      |21400|GG0130A1|Eating (SOC/ROC Perf)|1638|2||x|x| | | | | | | |||||
OASIS|3.00      |21410|GG0130A2|Eating (Dschg Goal)|1640|2||x|x| | | | | | | |||||
OASIS|3.00      |21420|GG0130A3|Eating (Dischg Perf)|1642|2|| | | | | | | |x| |||||
OASIS|3.00      |21430|GG0130A4|Eating (Follow-Up Perf)|1644|2|| | |x|x| | | | | |||||
OASIS|3.00      |21440|GG0130B1|Oral Hygiene (SOC/ROC Perf)|1646|2||x|x| | | | | | | |||||
OASIS|3.00      |21450|GG0130B2|Oral Hygiene (Dschrg Goal)|1648|2||x|x| | | | | | | |||||
OASIS|3.00      |21460|GG0130B3|Oral Hygiene (Dschrg Perf)|1650|2|| | | | | | | |x| |||||
OASIS|3.00      |21470|GG0130B4|Oral Hygiene (Follow-Up Perf)|1652|2|| | |x|x| | | | | |||||
OASIS|3.00      |21480|GG0130C1|Toileting hygiene (SOC/ROC Perf)|1654|2||x|x| | | | | | | |||||
OASIS|3.00      |21490|GG0130C2|Toileting hygiene (Dschrg Goal)|1656|2||x|x| | | | | | | |||||
OASIS|3.00      |21500|GG0130C3|Toileting hygiene (Dschrg Perf)|1658|2|| | | | | | | |x| |||||
OASIS|3.00      |21510|GG0130C4|Toileting hygiene (Follow-Up Perf)|1660|2|| | |x|x| | | | | |||||
OASIS|3.00      |21520|GG0130E1|Shower/bathe self (SOC/ROC Perf)|1662|2||x|x| | | | | | | |||||
OASIS|3.00      |21530|GG0130E2|Shower/bathe self (Dschrg Goal)|1664|2||x|x| | | | | | | |||||
OASIS|3.00      |21540|GG0130E3|Shower/bathe self (Dschrg Perf)|1666|2|| | | | | | | |x| |||||
OASIS|3.00      |21550|GG0130F1|Upper body dressing (SOC/ROC Perf)|1668|2||x|x| | | | | | | |||||
OASIS|3.00      |21560|GG0130F2|Upper body dressing (Dschrg Goal)|1670|2||x|x| | | | | | | |||||
OASIS|3.00      |21570|GG0130F3|Upper body dressing (Dschrg Perf)|1672|2|| | | | | | | |x| |||||
OASIS|3.00      |21580|GG0130G1|Lower body dressing (SOC/ROC Perf)|1674|2||x|x| | | | | | | |||||
OASIS|3.00      |21590|GG0130G2|Lower body dressing (Dschrg Goal)|1676|2||x|x| | | | | | | |||||
OASIS|3.00      |21600|GG0130G3|Lower body dressing (Dschrg Perf)|1678|2|| | | | | | | |x| |||||
OASIS|3.00      |21610|GG0130H1|Put on/take off footwear (SOC/ROC Perf)|1680|2||x|x| | | | | | | |||||
OASIS|3.00      |21620|GG0130H2|Put on/take off footwear (Dschrg Goal)|1682|2||x|x| | | | | | | |||||
OASIS|3.00      |21630|GG0130H3|Put on/take off footwear (Dschrg Perf)|1684|2|| | | | | | | |x| |||||
OASIS|3.00      |21640|GG0170A1|Roll left and right (SOC/ROC Perf)|1686|2||x|x| | | | | | | |||||
OASIS|3.00      |50|ASMT_SYS_CD|Assessment system code|1|10||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |150|ITM_SBST_CD|Item subset code|12|3||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |200|ITM_SET_VRSN_CD|Item set version code|15|10||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |250|SPEC_VRSN_CD|Specifications version code|25|10||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |300|CORRECTION_NUM|Correction number|35|2||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |350|STATE_CD|Agency's state postal code|37|2||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |400|HHA_AGENCY_ID|Assigned agency submission ID|39|16||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |500|SFW_ID|Software vendor federal employer tax ID|65|9||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |550|SFW_NAME|Software vendor company name|74|30||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |600|SFW_EMAIL_ADR|Software vendor email address|104|50||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |650|SFW_PROD_NAME|Software product name|154|50||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |700|SFW_PROD_VRSN_CD|Software product version code|204|20||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |450|NATL_PRVDR_ID|Agency National Provider ID (NPI)|55|10||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |750|ACY_DOC_CD|Document ID code (agency use)|224|20||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |1700|M0010_CCN|Facility CMS certification number (CCN)|254|6||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |1800|M0014_BRANCH_STATE|Branch state|260|2||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |1900|M0016_BRANCH_ID|Branch ID|262|10||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |1500|M0018_PHYSICIAN_ID|Attending physician National Provider ID (NPI)|272|10||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |1600|M0018_PHYSICIAN_UK|Attending physician NPI: Unknown|282|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |2000|M0020_PAT_ID|Patient ID number|283|20||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |2100|M0030_START_CARE_DT|Start of care date|303|8||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |2200|M0032_ROC_DT|Resumption of care date|311|8||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |2300|M0032_ROC_DT_NA|No resumption of care date|319|1||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |2400|M0040_PAT_FNAME|Patient's first name|320|12||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |2500|M0040_PAT_MI|Patient's middle initial|332|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |2600|M0040_PAT_LNAME|Patient's last name|333|18||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |2700|M0040_PAT_SUFFIX|Patient's suffix|351|3||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |2800|M0050_PAT_ST|Patient state of residence|354|2||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |2900|M0060_PAT_ZIP|Patient zip code|356|11||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3200|M0063_MEDICARE_NUM|Medicare number, including suffix|367|12||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3300|M0063_MEDICARE_NA|No Medicare number|379|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3000|M0064_SSN|Patient's Social Security number|380|9||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |3100|M0064_SSN_UK|No Social Security number|389|1||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |3400|M0065_MEDICAID_NUM|Medicaid number|390|14||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3500|M0065_MEDICAID_NA|No Medicaid number|404|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3520|M0066_PAT_BIRTH_DT|Date of birth|405|8||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |3510|M0069_PAT_GENDER|Gender|413|1||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |3530|M0150_CPAY_NONE|Payment sources: no charge for current services|420|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3540|M0150_CPAY_MCARE_FFS|Payment sources: Medicare fee-for-service|421|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3550|M0150_CPAY_MCARE_HMO|Payment sources: Medicare HMO/managed care|422|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3560|M0150_CPAY_MCAID_FFS|Payment sources: Medicaid fee-for-service|423|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3570|M0150_CPAY_MCAID_HMO|Payment sources: Medicaid HMO/managed care|424|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3580|M0150_CPAY_WRKCOMP|Payment sources: worker's compensation|425|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3590|M0150_CPAY_TITLEPGMS|Payment sources: title programs|426|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3600|M0150_CPAY_OTH_GOVT|Payment sources: other government|427|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3610|M0150_CPAY_PRIV_INS|Payment sources: private insurance|428|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3620|M0150_CPAY_PRIV_HMO|Payment sources: private HMO/managed care|429|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3630|M0150_CPAY_SELFPAY|Payment sources: self-pay|430|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3640|M0150_CPAY_OTHER|Payment sources: other|431|1||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3650|M0150_CPAY_UK|Payment sources: unknown|432|1||x|x| | | | | | | |||||
OASIS|3.00      |3660|M0080_ASSESSOR_DISCIPLINE|Discipline of person completing assessment|433|2||x|x|x|x|x|x|x|x| |||||
OASIS|3.00      |3670|M0090_INFO_COMPLETED_DT|Date assessment completed|435|8||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |3680|M0100_ASSMT_REASON|Reason for assessment|443|2||x|x|x|x|x|x|x|x|x|||||
OASIS|3.00      |3690|M0102_PHYSN_ORDRD_SOCROC_DT|Physician ordered SOC/ROC date|445|8||x|x| | | | | | | |||||
OASIS|3.00      |3700|M0102_PHYSN_ORDRD_SOCROC_DT_NA|Physician ordered SOC/ROC date - NA|453|1||x|x| | | | | | | |||||
OASIS|3.00      |3710|M0104_PHYSN_RFRL_DT|Physician date of referral|454|8||x|x| | | | | | | |||||
OASIS|3.00      |3720|M0110_EPISODE_TIMING|Episode timing|462|2||x|x|x|x| | | | | |||||
OASIS|3.00      |3730|M1000_DC_LTC_14_DA|Past 14 days: disch from LTC NH|464|1||x|x| | | | | | | |||||
OASIS|3.00      |3740|M1000_DC_SNF_14_DA|Past 14 days: disch from skilled nursing facility|465|1||x|x| | | | | | | |||||
OASIS|3.00      |3750|M1000_DC_IPPS_14_DA|Past 14 days: disch from short stay acute hospital|466|1||x|x| | | | | | | |||||
OASIS|3.00      |3760|M1000_DC_LTCH_14_DA|Past 14 days: disch from long term care hospital|467|1||x|x| | | | | | | |||||
OASIS|3.00      |3770|M1000_DC_IRF_14_DA|Past 14 days: disch from inpatient rehab facility|468|1||x|x| | | | | | | |||||
OASIS|3.00      |3780|M1000_DC_PSYCH_14_DA|Past 14 days: disch from psych hospital or unit|469|1||x|x| | | | | | | |||||
OASIS|3.00      |3790|M1000_DC_OTH_14_DA|Past 14 days: disch from other|470|1||x|x| | | | | | | |||||
OASIS|3.00      |3800|M1000_DC_NONE_14_DA|Past 14 days: not disch from inpatient facility|471|1||x|x| | | | | | | |||||
OASIS|3.00      |3810|M1005_INP_DISCHARGE_DT|Most recent inpatient discharge date|472|8||x|x| | | | | | | |||||
OASIS|3.00      |3820|M1005_INP_DSCHG_UNKNOWN|Inpatient discharge date unknown|480|1||x|x| | | | | | | |||||
OASIS|3.00      |13600|M1100_PTNT_LVG_STUTN|Patient living situation|769|2||x|x| | | | | | | |||||
OASIS|3.00      |29900|M1306_UNHLD_STG2_PRSR_ULCR|Patient has 1+ unhealed PU/injury at stage 2+|786|1||x|x|x|x| | | |x| |||||
OASIS|3.00      |29920|M1307_OLDST_STG2_ONST_DT|Date of onset of oldest stage 2 pressure ulcer|789|8|| | | | | | | |x| |||||
OASIS|3.00      |29910|M1307_OLDST_STG2_AT_DSCHRG|Status of oldest stage 2 pressure ulcer at disch|787|2|| | | | | | | |x| |||||
OASIS|3.00      |21650|GG0170A2|Roll left and right (Dschrg Goal)|1688|2||x|x| | | | | | | |||||
OASIS|3.00      |21660|GG0170A3|Roll left and right (Dschrg Perf)|1690|2|| | | | | | | |x| |||||
OASIS|3.00      |21670|GG0170A4|Roll left and right (Follow-Up Perf)|1692|2|| | |x|x| | | | | |||||
OASIS|3.00      |21680|GG0170B1|Sit to lying (SOC/ROC Perf)|1694|2||x|x| | | | | | | |||||
OASIS|3.00      |21690|GG0170B2|Sit to lying (Dschrg Goal)|1696|2||x|x| | | | | | | |||||
OASIS|3.00      |21700|GG0170B3|Sit to lying (Dschrg Perf)|1698|2|| | | | | | | |x| |||||
OASIS|3.00      |21710|GG0170B4|Sit to lying (Follow-Up Perf)|1700|2|| | |x|x| | | | | |||||
OASIS|3.00      |21740|GG0170C3|Lying to sitting on bed side (Dschrg Perf)|1702|2|| | | | | | | |x| |||||
OASIS|3.00      |21750|GG0170C4|Lying to sitting on bed side (Follow-Up Perf)|1704|2|| | |x|x| | | | | |||||
OASIS|3.00      |21760|GG0170D1|Sit to stand (SOC/ROC Perf)|1706|2||x|x| | | | | | | |||||
OASIS|3.00      |21770|GG0170D2|Sit to stand (Dschrg Goal)|1708|2||x|x| | | | | | | |||||
OASIS|3.00      |21780|GG0170D3|Sit to stand (Dschrg Perf)|1710|2|| | | | | | | |x| |||||
OASIS|3.00      |21790|GG0170D4|Sit to stand (Follow-Up Perf)|1712|2|| | |x|x| | | | | |||||
OASIS|3.00      |21800|GG0170E1|Chair/bed-to-chair transfer (SOC/ROC Perf)|1714|2||x|x| | | | | | | |||||
OASIS|3.00      |21810|GG0170E2|Chair/bed-to-chair transfer (Dschrg Goal)|1716|2||x|x| | | | | | | |||||
OASIS|3.00      |21820|GG0170E3|Chair/bed-to-chair transfer (Dschrg Perf)|1718|2|| | | | | | | |x| |||||
OASIS|3.00      |21830|GG0170E4|Chair/bed-to-chair transfer (Follow-Up Perf)|1720|2|| | |x|x| | | | | |||||
OASIS|3.00      |21840|GG0170F1|Toilet transfer (SOC/ROC Perf)|1722|2||x|x| | | | | | | |||||
OASIS|3.00      |21850|GG0170F2|Toilet transfer (Dschrg Goal)|1724|2||x|x| | | | | | | |||||
OASIS|3.00      |21860|GG0170F3|Toilet transfer (Dschrg Perf)|1726|2|| | | | | | | |x| |||||
OASIS|3.00      |21870|GG0170F4|Toilet transfer (Follow-Up Perf)|1728|2|| | |x|x| | | | | |||||
OASIS|3.00      |21880|GG0170G1|Car transfer (SOC/ROC Perf)|1730|2||x|x| | | | | | | |||||
OASIS|3.00      |21890|GG0170G2|Car transfer (Dschrg Goal)|1732|2||x|x| | | | | | | |||||
OASIS|3.00      |21900|GG0170G3|Car transfer (Dschrg Perf)|1734|2|| | | | | | | |x| |||||
OASIS|3.00      |21910|GG0170I1|Walk 10 feet (SOC/ROC Perf)|1736|2||x|x| | | | | | | |||||
OASIS|3.00      |21920|GG0170I2|Walk 10 feet (Dschrg Goal)|1738|2||x|x| | | | | | | |||||
OASIS|3.00      |21930|GG0170I3|Walk 10 feet (Dschrg Perf)|1740|2|| | | | | | | |x| |||||
OASIS|3.00      |21940|GG0170I4|Walk 10 feet (Follow-Up Perf)|1742|2|| | |x|x| | | | | |||||
OASIS|3.00      |21950|GG0170J1|Walk 50 feet with two turns (SOC/ROC Perf)|1744|2||x|x| | | | | | | |||||
OASIS|3.00      |21960|GG0170J2|Walk 50 feet with two turns (Dschrg Goal)|1746|2||x|x| | | | | | | |||||
OASIS|3.00      |21970|GG0170J3|Walk 50 feet with two turns (Dschrg Perf)|1748|2|| | | | | | | |x| |||||
OASIS|3.00      |21980|GG0170J4|Walk 50 feet with two turns (Follow-Up Perf)|1750|2|| | |x|x| | | | | |||||
OASIS|3.00      |21990|GG0170K1|Walk 150 feet (SOC/ROC Perf)|1752|2||x|x| | | | | | | |||||
OASIS|3.00      |22000|GG0170K2|Walk 150 feet (Dschrg Goal)|1754|2||x|x| | | | | | | |||||
OASIS|3.00      |22010|GG0170K3|Walk 150 feet (Dschrg Perf)|1756|2|| | | | | | | |x| |||||
OASIS|3.00      |22020|GG0170L1|Walking 10 feet uneven surf (SOC/ROC Perf)|1758|2||x|x| | | | | | | |||||
OASIS|3.00      |22030|GG0170L2|Walking 10 feet uneven surf (Dschrg Goal)|1760|2||x|x| | | | | | | |||||
OASIS|3.00      |22040|GG0170L3|Walking 10 feet uneven surf (Dschrg Perf)|1762|2|| | | | | | | |x| |||||
OASIS|3.00      |22050|GG0170L4|Walking 10 feet uneven surf (Follow-Up Perf)|1764|2|| | |x|x| | | | | |||||
OASIS|3.00      |22060|GG0170M1|1 step (curb) (SOC/ROC Perf)|1766|2||x|x| | | | | | | |||||
OASIS|3.00      |22070|GG0170M2|1 step (curb) (Dschrg Goal)|1768|2||x|x| | | | | | | |||||
OASIS|3.00      |22080|GG0170M3|1 step (curb) (Dschrg Perf)|1770|2|| | | | | | | |x| |||||
OASIS|3.00      |22090|GG0170M4|1 step (curb) (Follow-Up Perf)|1772|2|| | |x|x| | | | | |||||
OASIS|3.00      |22100|GG0170N1|4 steps (SOC/ROC Perf)|1774|2||x|x| | | | | | | |||||
OASIS|3.00      |22110|GG0170N2|4 steps (Dschrg Goal)|1776|2||x|x| | | | | | | |||||
OASIS|3.00      |22120|GG0170N3|4 steps (Dschrg Perf)|1778|2|| | | | | | | |x| |||||
OASIS|3.00      |22130|GG0170N4|4 steps (Follow-Up Perf)|1780|2|| | |x|x| | | | | |||||
OASIS|3.00      |22140|GG0170O1|12 steps (SOC/ROC Perf)|1782|2||x|x| | | | | | | |||||
OASIS|3.00      |22150|GG0170O2|12 steps (Dschrg Goal)|1784|2||x|x| | | | | | | |||||
OASIS|3.00      |22160|GG0170O3|12 steps (Dschrg Perf)|1786|2|| | | | | | | |x| |||||
OASIS|3.00      |22170|GG0170P1|Picking up object (SOC/ROC Perf)|1788|2||x|x| | | | | | | |||||
OASIS|3.00      |22180|GG0170P2|Picking up object (Dschrg Goal)|1790|2||x|x| | | | | | | |||||
OASIS|3.00      |22190|GG0170P3|Picking up object (Dschrg Perf)|1792|2|| | | | | | | |x| |||||
OASIS|3.00      |22200|GG0170Q1|Use wheelchair and/or scooter (SOC/ROC Perf)|1794|1||x|x| | | | | | | |||||
OASIS|3.00      |22210|GG0170Q3|Use wheelchair and/or scooter (Dschrg Perf)|1795|1|| | | | | | | |x| |||||
OASIS|3.00      |22220|GG0170Q4|Use wheelchair and/or scooter (Follow-Up Perf)|1796|1|| | |x|x| | | | | |||||
OASIS|3.00      |22230|GG0170R1|Wheel 50 feet with two turns (SOC/ROC Perf)|1797|2||x|x| | | | | | | |||||
OASIS|3.00      |22240|GG0170R2|Wheel 50 feet with two turns (Dschrg Goal)|1799|2||x|x| | | | | | | |||||
OASIS|3.00      |22250|GG0170R3|Wheel 50 feet with two turns (Dschrg Perf)|1801|2|| | | | | | | |x| |||||
OASIS|3.00      |22260|GG0170R4|Wheel 50 feet with two turns (Follow-Up Perf)|1803|2|| | |x|x| | | | | |||||
OASIS|3.00      |22270|GG0170RR1|Type of wheelchair or scooter (SOC/ROC Perf)|1805|1||x|x| | | | | | | |||||
OASIS|3.00      |22280|GG0170RR3|Type of wheelchair or scooter (Dschg Perf)|1806|1|| | | | | | | |x| |||||
OASIS|3.00      |22290|GG0170S1|Wheel 150 feet (SOC/ROC Perf)|1807|2||x|x| | | | | | | |||||
OASIS|3.00      |22300|GG0170S2|Wheel 150 feet (Dschrg Goal)|1809|2||x|x| | | | | | | |||||
OASIS|3.00      |22310|GG0170S3|Wheel 150 feet (Dschrg Perf)|1811|2|| | | | | | | |x| |||||
OASIS|3.00      |22320|GG0170SS1|Type of wheelchair or scooter (SOC/ROC Perf)|1813|1||x|x| | | | | | | |||||
OASIS|3.00      |22330|GG0170SS3|Type of wheelchair or scooter (Dschrg Perf)|1814|1|| | | | | | | |x| |||||
OASIS|3.00      |26900|J1800|Falls since SOC/ROC: any falls|1815|1|| | | | |x|x|x|x| |||||
OASIS|3.00      |27000|J1900A|Num falls since SOC/ROC: no injury|1816|1|| | | | |x|x|x|x| |||||
OASIS|3.00      |27100|J1900B|Num falls since SOC/ROC: injury (except major)|1817|1|| | | | |x|x|x|x| |||||
OASIS|3.00      |27200|J1900C|Num falls since SOC/ROC: major injury|1818|1|| | | | |x|x|x|x| |||||
OASIS|3.00      |3840|A1005A|Ethnicity: No, Not Hispanic, Latino/a, Spanish|1819|1||x| | | | | | | | |||||
OASIS|3.00      |3850|A1005B|Ethnicity: Yes, Mex, Mex Amer, Chicano/a|1820|1||x| | | | | | | | |||||
OASIS|3.00      |3860|A1005C|Ethnicity: Yes, Puerto Rican|1821|1||x| | | | | | | | |||||
OASIS|3.00      |3870|A1005D|Ethnicity: Yes, Cuban|1822|1||x| | | | | | | | |||||
OASIS|3.00      |3880|A1005E|Ethnicity: Yes, Another Hispanic/Latino/Spanish|1823|1||x| | | | | | | | |||||
OASIS|3.00      |3890|A1005X|Ethnicity: Patient unable to respond|1824|1||x| | | | | | | | |||||
OASIS|3.00      |3900|A1010A|Race: White|1826|1||x| | | | | | | | |||||
OASIS|3.00      |3910|A1010B|Race: Black or African American|1827|1||x| | | | | | | | |||||
OASIS|3.00      |3920|A1010C|Race: American Indian or Alaska Native|1828|1||x| | | | | | | | |||||
OASIS|3.00      |3930|A1010D|Race: Asian Indian|1829|1||x| | | | | | | | |||||
OASIS|3.00      |3940|A1010E|Race: Chinese|1830|1||x| | | | | | | | |||||
OASIS|3.00      |3950|A1010F|Race: Filipino|1831|1||x| | | | | | | | |||||
OASIS|3.00      |3960|A1010G|Race: Japanese|1832|1||x| | | | | | | | |||||
OASIS|3.00      |3970|A1010H|Race: Korean|1833|1||x| | | | | | | | |||||
OASIS|3.00      |3980|A1010I|Race: Vietnamese|1834|1||x| | | | | | | | |||||
OASIS|3.00      |3990|A1010J|Race: Other Asian|1835|1||x| | | | | | | | |||||
OASIS|3.00      |4000|A1010K|Race: Native Hawaiian|1836|1||x| | | | | | | | |||||
OASIS|3.00      |4010|A1010L|Race: Guamanian or Chamorro|1837|1||x| | | | | | | | |||||
OASIS|3.00      |4020|A1010M|Race: Samoan|1838|1||x| | | | | | | | |||||
OASIS|3.00      |4030|A1010N|Race: Other Pacific Islander|1839|1||x| | | | | | | | |||||
OASIS|3.00      |4040|A1010X|Race: Patient unable to respond|1840|1||x| | | | | | | | |||||
OASIS|3.00      |9100|B0200|Hearing|1877|1||x| | | | | | | | |||||
OASIS|3.00      |9200|B1000|Vision|1878|1||x| | | | | | | | |||||
OASIS|3.00      |4050|A1110A|Preferred language|1843|15||x| | | | | | | | |||||
OASIS|3.00      |4060|A1110B|Do you need or want an interpreter|1858|1||x| | | | | | | | |||||
OASIS|3.00      |6600|A1250A|Transportation: Yes, medical|1859|1||x|x| | | | | |x| |||||
OASIS|3.00      |6610|A1250B|Transportation: Yes, non-medical|1860|1||x|x| | | | | |x| |||||
OASIS|3.00      |6620|A1250C|Transportation: No|1861|1||x|x| | | | | |x| |||||
OASIS|3.00      |6650|A1250X|Transportation: Patient unable to respond|1862|1||x|x| | | | | |x| |||||
OASIS|3.00      |8350|A2121|Current Reconciled Medication List - Prvdr (Dis)|1864|1|| | | | | | | |x| |||||
OASIS|3.00      |8400|A2120|Current Reconciled Medication List - Prvdr (Tra)|1865|1|| | | | |x|x| | | |||||
OASIS|3.00      |8500|A2122A|Provider Trans - Electronic Health Record|1866|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8510|A2122B|Provider Trans - Health Info Exchange|1867|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8520|A2122C|Provider Trans - Verbal|1868|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8530|A2122D|Provider Trans - Paper-based|1869|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8540|A2122E|Provider Trans - Other Methods|1870|1|| | | | |x|x| |x| |||||
OASIS|3.00      |8600|A2123|Current Reconciled Medication List - Ptnt (Dis)|1871|1|| | | | | | | |x| |||||
OASIS|3.00      |8700|A2124A|Patient Trans - Electronic Health Record|1872|1|| | | | | | | |x| |||||
OASIS|3.00      |8710|A2124B|Patient Trans - Health Info Exchange|1873|1|| | | | | | | |x| |||||
OASIS|3.00      |8720|A2124C|Patient Trans - Verbal|1874|1|| | | | | | | |x| |||||
OASIS|3.00      |8730|A2124D|Patient Trans - Paper-based|1875|1|| | | | | | | |x| |||||
OASIS|3.00      |8740|A2124E|Patient Trans - Other Methods|1876|1|| | | | | | | |x| |||||
OASIS|3.00      |9300|B1300|Health Literacy|1879|1||x|x| | | | | |x| |||||
OASIS|3.00      |10200|C0100|Brief Interview for Mental Status|1880|1||x|x| | | | | |x| |||||
OASIS|3.00      |10300|C0200|Repetition of three words|1881|1||x|x| | | | | |x| |||||
OASIS|3.00      |10400|C0300A|Temporal Orientation: Able to report correct year|1882|1||x|x| | | | | |x| |||||
OASIS|3.00      |10410|C0300B|Temporal Orientation: Able to report correct month|1883|1||x|x| | | | | |x| |||||
OASIS|3.00      |10420|C0300C|Temporal Orientation: Able to report correct day|1884|1||x|x| | | | | |x| |||||
OASIS|3.00      |10500|C0400A|Recall: Able to recall "sock"|1885|1||x|x| | | | | |x| |||||
OASIS|3.00      |10510|C0400B|Recall: Able to recall "blue"|1886|1||x|x| | | | | |x| |||||
OASIS|3.00      |10520|C0400C|Recall: Able to recall "bed"|1887|1||x|x| | | | | |x| |||||
OASIS|3.00      |10600|C0500|BIMS Summary Score|1888|2||x|x| | | | | |x| |||||
OASIS|3.00      |10700|C1310A|Delirium: Acute Onset Mental Status Change|1890|1||x|x| | | | | |x| |||||
OASIS|3.00      |10710|C1310B|Delirium: Inattention|1891|1||x|x| | | | | |x| |||||
OASIS|3.00      |10720|C1310C|Delirium: Disorganized thinking|1892|1||x|x| | | | | |x| |||||
OASIS|3.00      |10730|C1310D|Delirium: Altered level of consciousness|1893|1||x|x| | | | | |x| |||||
OASIS|3.00      |11400|D0150A1|Mood: Little interest/pleasure doing things: Pres|1894|1||x|x| | | | | |x| |||||
OASIS|3.00      |11410|D0150A2|Mood: Little interest/pleasure doing things: Freq|1895|1||x|x| | | | | |x| |||||
OASIS|3.00      |11420|D0150B1|Mood: Feeling down, depressed, or hopeless: Pres|1896|1||x|x| | | | | |x| |||||
OASIS|3.00      |11430|D0150B2|Mood: Feeling down, depressed, or hopeless: Freq|1897|1||x|x| | | | | |x| |||||
OASIS|3.00      |11440|D0150C1|Mood: Trouble falling or staying asleep: Pres|1898|1||x|x| | | | | |x| |||||
OASIS|3.00      |11450|D0150C2|Mood: Trouble falling or staying asleep: Freq|1899|1||x|x| | | | | |x| |||||
OASIS|3.00      |11460|D0150D1|Mood: Feeling tired or having little energy: Pres|1900|1||x|x| | | | | |x| |||||
OASIS|3.00      |11470|D0150D2|Mood: Feeling tired or having little energy: Freq|1901|1||x|x| | | | | |x| |||||
OASIS|3.00      |11480|D0150E1|Mood: Poor appetite or overeating: Pres|1902|1||x|x| | | | | |x| |||||
OASIS|3.00      |11490|D0150E2|Mood: Poor appetite or overeating: Freq|1903|1||x|x| | | | | |x| |||||
OASIS|3.00      |11500|D0150F1|Mood: Feeling bad about yourself: Pres|1904|1||x|x| | | | | |x| |||||
OASIS|3.00      |11510|D0150F2|Mood: Feeling bad about yourself: Freq|1905|1||x|x| | | | | |x| |||||
OASIS|3.00      |11520|D0150G1|Mood: Trouble concentrating on things: Pres|1906|1||x|x| | | | | |x| |||||
OASIS|3.00      |11530|D0150G2|Mood: Trouble concentrating on things: Freq|1907|1||x|x| | | | | |x| |||||
OASIS|3.00      |11540|D0150H1|Mood: Moving or speaking so slowly: Pres|1908|1||x|x| | | | | |x| |||||
OASIS|3.00      |11550|D0150H2|Mood: Moving or speaking so slowly: Freq|1909|1||x|x| | | | | |x| |||||
OASIS|3.00      |11560|D0150I1|Mood: Thoughts of better off dead: Pres|1910|1||x|x| | | | | |x| |||||
OASIS|3.00      |11570|D0150I2|Mood: Thoughts of better off dead: Freq|1911|1||x|x| | | | | |x| |||||
OASIS|3.00      |11600|D0160|Total severity score|1912|2||x|x| | | | | |x| |||||
OASIS|3.00      |11700|D0700|Social Isolation|1914|1||x|x| | | | | |x| |||||
OASIS|3.00      |26600|J0510|Pain effect on sleep|1915|1||x|x| | | | | |x| |||||
OASIS|3.00      |26700|J0520|Pain interference with therapy activities|1916|1||x|x| | | | | |x| |||||
OASIS|3.00      |26800|J0530|Pain interference with day-to-day activities|1917|1||x|x| | | | | |x| |||||
OASIS|3.00      |29000|K0520A1|Nutritional Approaches (Admission): Parenteral|1918|1||x|x| | | | | | | |||||
OASIS|3.00      |29030|K0520B1|Nutritional Approaches (Admission): Feeding tube|1921|1||x|x| | | | | | | |||||
OASIS|3.00      |29060|K0520C1|Nutritional Approaches (Admission) : Mech Alt Diet|1924|1||x|x| | | | | | | |||||
OASIS|3.00      |29090|K0520D1|Nutritional Approaches (Admission) : Therapeutic|1927|1||x|x| | | | | | | |||||
OASIS|3.00      |29200|K0520Z1|Nutritional Approaches (Admission) : None|1930|1||x|x| | | | | | | |||||
OASIS|3.00      |29010|K0520A4|Nutritional Approaches (7 days): Parenteral|1919|1|| | | | | | | |x| |||||
OASIS|3.00      |29020|K0520A5|Nutritional Approaches (Discharge): Parenteral|1920|1|| | | | | | | |x| |||||
OASIS|3.00      |29040|K0520B4|Nutritional Approaches (7 days): Feeding tube|1922|1|| | | | | | | |x| |||||
OASIS|3.00      |29050|K0520B5|Nutritional Approaches (Discharge): Feeding Tube|1923|1|| | | | | | | |x| |||||
OASIS|3.00      |29070|K0520C4|Nutritional Approaches (7 days): Mech Alt Diet|1925|1|| | | | | | | |x| |||||
OASIS|3.00      |29080|K0520C5|Nutritional Approaches (Discharge): Mech Alt Diet|1926|1|| | | | | | | |x| |||||
OASIS|3.00      |29100|K0520D4|Nutritional Approaches (7 day): Therapeutic|1928|1|| | | | | | | |x| |||||
OASIS|3.00      |29110|K0520D5|Nutritional Approaches (Discharge): Therapeutic|1929|1|| | | | | | | |x| |||||
OASIS|3.00      |29210|K0520Z4|Nutritional Approaches (7 days): None|1931|1|| | | | | | | |x| |||||
OASIS|3.00      |29220|K0520Z5|Nutritional Approaches (Discharge): None|1932|1|| | | | | | | |x| |||||
OASIS|3.00      |31300|N0415A1|High-Risk Drug (Is Taking): Antipsychotic|1933|1||x|x| | | | | |x| |||||
OASIS|3.00      |31310|N0415A2|High-Risk Drug (Indication) : Antipsychotic|1934|1||x|x| | | | | |x| |||||
OASIS|3.00      |31320|N0415E1|High-Risk Drug (Is taking): Anticoagulant|1935|1||x|x| | | | | |x| |||||
OASIS|3.00      |31330|N0415E2|High-Risk Drug (Indication): Anticoagulant|1936|1||x|x| | | | | |x| |||||
OASIS|3.00      |31340|N0415F1|High-Risk Drug (Is taking): Antibiotic|1937|1||x|x| | | | | |x| |||||
OASIS|3.00      |31350|N0415F2|High-Risk Drug (Indication): Antibiotic|1938|1||x|x| | | | | |x| |||||
OASIS|3.00      |31360|N0415H1|High-Risk Drug (Is taking): Opioid|1939|1||x|x| | | | | |x| |||||
OASIS|3.00      |31370|N0415H2|High-Drug Risk (Indication): Opioid|1940|1||x|x| | | | | |x| |||||
OASIS|3.00      |31380|N0415I1|High-Risk Drug (Is taking): Antiplatelet|1941|1||x|x| | | | | |x| |||||
OASIS|3.00      |31390|N0415I2|High-Risk Drug (Indication): Antiplatelet|1942|1||x|x| | | | | |x| |||||
OASIS|3.00      |31400|N0415J1|High-Risk Drug (Is taking): Hypoglycemic|1943|1||x|x| | | | | |x| |||||
OASIS|3.00      |31410|N0415J2|High-Risk Drug (Indication): Hypoglycemic|1944|1||x|x| | | | | |x| |||||
OASIS|3.00      |31500|N0415Z1|High-Risk Drug (Is taking): None of the above|1945|1||x|x| | | | | |x| |||||
OASIS|3.00      |32800|O0110A1A|Treatment: Chemotherapy (Admission)|1946|1||x|x| | | | | | | |||||
OASIS|3.00      |32820|O0110A2A|Treatment: Chemo - IV (Admission)|1948|1||x|x| | | | | | | |||||
OASIS|3.00      |32840|O0110A3A|Treatment: Chemo - Oral (Admission)|1950|1||x|x| | | | | | | |||||
OASIS|3.00      |32860|O0110A10A|Treatment: Chemo - Other (Admission)|1952|1||x|x| | | | | | | |||||
OASIS|3.00      |32880|O0110B1A|Treatment: Radiation (Admission)|1954|1||x|x| | | | | | | |||||
OASIS|3.00      |32900|O0110C1A|Therapies: Oxygen Therapy (Admission)|1956|1||x|x| | | | | | | |||||
OASIS|3.00      |32920|O0110C2A|Therapies: Oxygen - Continuous (Admission)|1958|1||x|x| | | | | | | |||||
OASIS|3.00      |32940|O0110C3A|Therapies: Oxygen - Intermittent (Admission)|1960|1||x|x| | | | | | | |||||
OASIS|3.00      |32960|O0110C4A|Therapies: Oxygen - High-concentration (Admission)|1962|1||x|x| | | | | | | |||||
OASIS|3.00      |32980|O0110D1A|Therapies: Suctioning (Admission)|1964|1||x|x| | | | | | | |||||
OASIS|3.00      |33000|O0110D2A|Therapies: Suctioning - Scheduled (Admission)|1966|1||x|x| | | | | | | |||||
OASIS|3.00      |33020|O0110D3A|Therapies: Suctioning - As Needed (Admission)|1968|1||x|x| | | | | | | |||||
OASIS|3.00      |33040|O0110E1A|Therapies: Tracheostomy Care (Admission)|1970|1||x|x| | | | | | | |||||
OASIS|3.00      |33060|O0110F1A|Therapies: Invasive Mechanical Ventilator (Admis)|1972|1||x|x| | | | | | | |||||
OASIS|3.00      |33080|O0110G1A|Therapies: Non-Invas Mechanical Ventilator (Admis)|1974|1||x|x| | | | | | | |||||
OASIS|3.00      |33100|O0110G2A|Therapies: BiPAP (Admission)|1976|1||x|x| | | | | | | |||||
OASIS|3.00      |33120|O0110G3A|Therapies: CPAP (Admission)|1978|1||x|x| | | | | | | |||||
OASIS|3.00      |33140|O0110H1A|Other: IV Medications (Admission)|1980|1||x|x| | | | | | | |||||
OASIS|3.00      |33160|O0110H2A|Other: IV - Vasoactive medications (Admission)|1982|1||x|x| | | | | | | |||||
OASIS|3.00      |33180|O0110H3A|Other: IV - Antibiotics (Admission)|1984|1||x|x| | | | | | | |||||
OASIS|3.00      |33200|O0110H4A|Other: IV - Anticoagulation (Admission)|1986|1||x|x| | | | | | | |||||
OASIS|3.00      |33220|O0110H10A|Other: IV - Other (Admission)|1988|1||x|x| | | | | | | |||||
OASIS|3.00      |33240|O0110I1A|Other: Transfusions (Admission)|1990|1||x|x| | | | | | | |||||
OASIS|3.00      |33260|O0110J1A|Other: Dialysis (Admission)|1992|1||x|x| | | | | | | |||||
OASIS|3.00      |33280|O0110J2A|Other: Hemodialysis (Admission)|1994|1||x|x| | | | | | | |||||
OASIS|3.00      |33300|O0110J3A|Other: Peritoneal dialysis (Admission)|1996|1||x|x| | | | | | | |||||
OASIS|3.00      |33320|O0110O1A|Other: IV Access (Admission)|1998|1||x|x| | | | | | | |||||
OASIS|3.00      |33340|O0110O2A|Other: IV Access - Peripheral (Admission)|2000|1||x|x| | | | | | | |||||
OASIS|3.00      |33360|O0110O3A|Other: IV Access - Mid-line (Admission)|2002|1||x|x| | | | | | | |||||
OASIS|3.00      |33380|O0110O4A|Other: IV Access - Central (Admission)|2004|1||x|x| | | | | | | |||||
OASIS|3.00      |33400|O0110Z1A|Other: None of the above (Admission)|2006|1||x|x| | | | | | | |||||
OASIS|3.00      |32810|O0110A1C|Treatment: Chemotherapy (Discharge)|1947|1|| | | | | | | |x| |||||
OASIS|3.00      |32830|O0110A2C|Treatment: Chemo - IV (Discharge)|1949|1|| | | | | | | |x| |||||
OASIS|3.00      |32850|O0110A3C|Treatment: Chemo - Oral (Discharge)|1951|1|| | | | | | | |x| |||||
OASIS|3.00      |32870|O0110A10C|Treatment: Chemo - Other (Discharge)|1953|1|| | | | | | | |x| |||||
OASIS|3.00      |32890|O0110B1C|Treatment: Radiation (Discharge)|1955|1|| | | | | | | |x| |||||
OASIS|3.00      |32910|O0110C1C|Therapies: Oxygen Therapy (Discharge)|1957|1|| | | | | | | |x| |||||
OASIS|3.00      |32930|O0110C2C|Therapies: Oxygen - Continuous (Discharge)|1959|1|| | | | | | | |x| |||||
OASIS|3.00      |32950|O0110C3C|Therapies: Oxygen - Intermittent (Discharge)|1961|1|| | | | | | | |x| |||||
OASIS|3.00      |32970|O0110C4C|Therapies: Oxygen - High-concentration (Discharge)|1963|1|| | | | | | | |x| |||||
OASIS|3.00      |32990|O0110D1C|Therapies: Suctioning (Discharge)|1965|1|| | | | | | | |x| |||||
OASIS|3.00      |33010|O0110D2C|Therapies: Suctioning - Scheduled (Discharge)|1967|1|| | | | | | | |x| |||||
OASIS|3.00      |33030|O0110D3C|Therapies: Suctioning - As Needed (Discharge)|1969|1|| | | | | | | |x| |||||
OASIS|3.00      |33050|O0110E1C|Therapies: Tracheostomy Care (Discharge)|1971|1|| | | | | | | |x| |||||
OASIS|3.00      |33090|O0110G1C|Therapies: Non-Invas Mechanical Ventilator (Disch)|1975|1|| | | | | | | |x| |||||
OASIS|3.00      |33110|O0110G2C|Therapies: BiPAP (Discharge)|1977|1|| | | | | | | |x| |||||
OASIS|3.00      |33130|O0110G3C|Therapies: CPAP (Discharge)|1979|1|| | | | | | | |x| |||||
OASIS|3.00      |33070|O0110F1C|Therapies: Invasive Mechanical Ventilator (Disch)|1973|1|| | | | | | | |x| |||||
OASIS|3.00      |33150|O0110H1C|Other: IV Medications (Discharge)|1981|1|| | | | | | | |x| |||||
OASIS|3.00      |33170|O0110H2C|Other: IV - Vasoactive medications (Discharge)|1983|1|| | | | | | | |x| |||||
OASIS|3.00      |33190|O0110H3C|Other: IV - Antibiotics (Discharge)|1985|1|| | | | | | | |x| |||||
OASIS|3.00      |33210|O0110H4C|Other: IV - Anticoagulation (Discharge)|1987|1|| | | | | | | |x| |||||
OASIS|3.00      |33230|O0110H10C|Other: IV - Other (Discharge)|1989|1|| | | | | | | |x| |||||
OASIS|3.00      |33250|O0110I1C|Other: Transfusions (Discharge)|1991|1|| | | | | | | |x| |||||
OASIS|3.00      |33270|O0110J1C|Other: Dialysis (Discharge)|1993|1|| | | | | | | |x| |||||
OASIS|3.00      |33290|O0110J2C|Other: Hemodialysis (Discharge)|1995|1|| | | | | | | |x| |||||
OASIS|3.00      |33310|O0110J3C|Other: Peritoneal dialysis (Discharge)|1997|1|| | | | | | | |x| |||||
OASIS|3.00      |33330|O0110O1C|Other: IV Access (Discharge)|1999|1|| | | | | | | |x| |||||
OASIS|3.00      |33350|O0110O2C|Other: IV Access - Peripheral (Discharge)|2001|1|| | | | | | | |x| |||||
OASIS|3.00      |33370|O0110O3C|Other: IV Access - Mid-line (Discharge)|2003|1|| | | | | | | |x| |||||
OASIS|3.00      |33390|O0110O4C|Other: IV Access - Central (Discharge)|2005|1|| | | | | | | |x| |||||
OASIS|3.00      |33410|O0110Z1C|Other: None of the above (Discharge)|2007|1|| | | | | | | |x| |||||
OASIS|3.00      |4041|A1010Y|Race: Patient declines to respond|1841|1||x| | | | | | | | |||||
OASIS|3.00      |4042|A1010Z|Race: None of the above|1842|1||x| | | | | | | | |||||
OASIS|3.00      |3891|A1005Y|Ethnicity: Patient declines to respond|1825|1||x| | | | | | | | |||||
OASIS|3.00      |6651|A1250Y|Transportation: Patient declines to respond|1863|1||x|x| | | | | |x| |||||
HOPE|1.00|50|ASMT_SYS_CD|Assessment system code|1|10|N|x|x||||||x|x|||||
HOPE|1.00|200|ITM_SBST_CD|Item subset code|21|3|N|x|x||||||x|x|||||
HOPE|1.00|300|ITM_SET_VRSN_CD|Item set version code|24|10|N|x|x||||||x|x|||||
HOPE|1.00|400|SPEC_VRSN_CD|Specifications version code|34|10|N|x|x||||||x|x|||||
HOPE|1.00|550|CRCTN_NUM|Correction number|44|2|N|x|x||||||x|x|||||
HOPE|1.00|600|STATE_CD|Provider's state postal code|46|2|N|x|x||||||x|x|||||
HOPE|1.00|700|FAC_ID|Assigned provider submission ID|48|16|N|x|x||||||x|x|||||
HOPE|1.00|800|SFTWR_VNDR_ID|Software vendor federal employer tax ID|64|9|N|x|x||||||x|x|||||
HOPE|1.00|900|SFTWR_VNDR_NAME|Software vendor company name|73|30|N|x|x||||||x|x|||||
HOPE|1.00|1000|SFTWR_VNDR_EMAIL_ADR|Software vendor email address|103|50|N|x|x||||||x|x|||||
HOPE|1.00|1100|SFTWR_PROD_NAME|Software product name|153|50|N|x|x||||||x|x|||||
HOPE|1.00|1200|SFTWR_PROD_VRSN_CD|Software product version code|203|20|N|x|x||||||x|x|||||
HOPE|1.00|1500|A0050|Type of record|413|1|N|x|x||||||x|x|||||
HOPE|1.00|1600|A0100A|Facility National Provider Identifier (NPI)|414|10|N|x|x||||||x| |||||
HOPE|1.00|1700|A0100B|Facility CMS Certification Number (CCN)|424|12|N|x|x||||||x| |||||
HOPE|1.00|1800|A0215|Site of service at admission|436|2|N|x| |||||| | |||||
HOPE|1.00|1900|A0220|Admission date|438|8|N|x|x||||||x|x|||||
HOPE|1.00|2100|A0250|Reason for record|454|1|N|x|x||||||x|x|||||
HOPE|1.00|2200|A0270|Discharge date|456|8|N| | ||||||x|x|||||
HOPE|1.00|2300|A0500A|Patient first name|464|12|N|x|x||||||x|x|||||
HOPE|1.00|2400|A0500B|Patient middle initial|476|1|N|x|x||||||x| |||||
HOPE|1.00|2500|A0500C|Patient last name|477|18|N|x|x||||||x|x|||||
HOPE|1.00|2600|A0500D|Patient name suffix|495|3|N|x|x||||||x| |||||
HOPE|1.00|2700|A0600A|Social Security Number|498|9|N|x|x||||||x|x|||||
HOPE|1.00|2800|A0600B|Patient Medicare number|507|12|N|x|x||||||x| |||||
HOPE|1.00|2900|A0700|Patient Medicaid number|519|14|N|x|x||||||x| |||||
HOPE|1.00|3000|A0810|Sex|533|1|N|x|x||||||x|x|||||
HOPE|1.00|3100|A0900|Birthdate|534|8|N|x|x||||||x|x|||||
HOPE|1.00|3900|A2115|Reason for discharge|548|1|N| | ||||||x| |||||
HOPE|1.00|4000|F2000A|Was ptnt/rsp prty asked about CPR|550|1|N|x| |||||| | |||||
HOPE|1.00|4100|F2000B|Date ptnt/rsp prty asked about CPR|551|8|N|x| |||||| | |||||
HOPE|1.00|4200|F2100A|Was ptnt/rsp prty asked treatments oth than CPR|559|1|N|x| |||||| | |||||
HOPE|1.00|4300|F2100B|Date ptnt/rsp prty asked treatments oth than CPR|560|8|N|x| |||||| | |||||
HOPE|1.00|4400|F2200A|Was ptnt/rsp prty asked hospitalization|568|1|N|x| |||||| | |||||
HOPE|1.00|4500|F2200B|Date ptnt/rsp prty asked hospitalization|569|8|N|x| |||||| | |||||
HOPE|1.00|4600|F3000A|Was ptnt/crgvr asked sprtual/exstntial cncrns|577|1|N|x| |||||| | |||||
HOPE|1.00|4700|F3000B|Date ptnt/crgvr asked sprtual/exstntial cncrns|578|8|N|x| |||||| | |||||
HOPE|1.00|4800|I0010|Principal diagnosis|586|2|N|x| |||||| | |||||
HOPE|1.00|4900|J0900A|Was patient screened for pain|588|1|N|x| |||||| | |||||
HOPE|1.00|5000|J0900B|Date of first screening for pain|589|8|N|x| |||||| | |||||
HOPE|1.00|5100|J0900C|Patient's pain severity was|597|1|N|x| |||||| | |||||
HOPE|1.00|5200|J0900D|Type of standardized pain tool used|598|1|N|x| |||||| | |||||
HOPE|1.00|5300|J0910A|Was comprehensive pain assessment done|599|1|N|x| |||||| | |||||
HOPE|1.00|5400|J0910B|Date of comprehensive pain assessment|600|8|N|x| |||||| | |||||
HOPE|1.00|5500|J0910C1|Pain asmt included: location|608|1|N|x| |||||| | |||||
HOPE|1.00|5600|J0910C2|Pain asmt included: severity|609|1|N|x| |||||| | |||||
HOPE|1.00|5700|J0910C3|Pain asmt included: character|610|1|N|x| |||||| | |||||
HOPE|1.00|5800|J0910C4|Pain asmt included: duration|611|1|N|x| |||||| | |||||
HOPE|1.00|5900|J0910C5|Pain asmt included: frequency|612|1|N|x| |||||| | |||||
HOPE|1.00|6000|J0910C6|Pain asmt included: what relieves/worsens|613|1|N|x| |||||| | |||||
HOPE|1.00|6100|J0910C7|Pain asmt included: effect function/quality life|614|1|N|x| |||||| | |||||
HOPE|1.00|6200|J0910C9|Pain asmt included: none of the above|615|1|N|x| |||||| | |||||
HOPE|1.00|6300|J2030A|Was patient screened for shortness of breath|616|1|N|x| |||||| | |||||
HOPE|1.00|6400|J2030B|Date of first screening for shortness of breath|617|8|N|x| |||||| | |||||
HOPE|1.00|6500|J2030C|Did screening indicate pt had shortness of breath|625|1|N|x| |||||| | |||||
HOPE|1.00|6600|J2040A|Was treatment for shortness of breath initiated|626|1|N|x| |||||| | |||||
HOPE|1.00|6700|J2040B|Date treatment for shortness of breath initiated|627|8|N|x| |||||| | |||||
HOPE|1.00|7200|N0500A|Was scheduled opioid initiated or continued|635|1|N|x|x|||||| | |||||
HOPE|1.00|7300|N0500B|Date scheduled opioid initiated or continued|636|8|N|x|x|||||| | |||||
HOPE|1.00|7400|N0510A|Was PRN opioid initiated or continued|644|1|N|x|x|||||| | |||||
HOPE|1.00|7500|N0510B|Date PRN opioid initiated or continued|645|8|N|x|x|||||| | |||||
HOPE|1.00|7600|N0520A|Was bowel regimen initiated or continued|653|1|N|x|x|||||| | |||||
HOPE|1.00|7700|N0520B|Date bowel regimen initiated or continued|654|8|N|x|x|||||| | |||||
HOPE|1.00|7800|Z0500B|Date of signature verifying record completion|662|8|N|x|x||||||x|x|||||
HOPE|1.00|7802|A0550|Patient zip code|670|11|N|x| |||||| | |||||
HOPE|1.00|7805|A1400A|Payer: Medicare (FFS)|681|1|N|x|x|||||| | |||||
HOPE|1.00|7810|A1400B|Payer: Medicare (managed care/Part C/Mcr Advant.)|682|1|N|x|x|||||| | |||||
HOPE|1.00|7815|A1400C|Payer: Medicaid (FFS)|683|1|N|x|x|||||| | |||||
HOPE|1.00|7820|A1400D|Payer: Medicaid (managed care)|684|1|N|x|x|||||| | |||||
HOPE|1.00|7825|A1400G|Payer: Other Government|685|1|N|x|x|||||| | |||||
HOPE|1.00|7830|A1400H|Payer: Private insurance/Medigap|686|1|N|x|x|||||| | |||||
HOPE|1.00|7835|A1400I|Payer: Private managed care|687|1|N|x|x|||||| | |||||
HOPE|1.00|7840|A1400J|Payer: Self-pay|688|1|N|x|x|||||| | |||||
HOPE|1.00|7845|A1400K|Payer: No payor source|689|1|N|x|x|||||| | |||||
HOPE|1.00|7850|A1400X|Payer: Unknown|690|1|N|x|x|||||| | |||||
HOPE|1.00|7855|A1400Y|Payer: Other|691|1|N|x|x|||||| | |||||
HOPE|1.00|7860|J0905|Is pain an active problem for the patient?|692|1|N|x| |||||| | |||||
HOPE|1.00|7872|A1005A|Ethnicity: No, not Hispanic, Latino/a, Spanish|737|1|N|x| |||||| | |||||
HOPE|1.00|7874|A1005B|Ethnicity: Yes, Mex, Mex Amer, Chicano/a|738|1|N|x| |||||| | |||||
HOPE|1.00|7876|A1005C|Ethnicity: Yes, Puerto Rican|739|1|N|x| |||||| | |||||
HOPE|1.00|7878|A1005D|Ethnicity: Yes, Cuban|740|1|N|x| |||||| | |||||
HOPE|1.00|7880|A1005E|Ethnicity: Yes, another Hispanic/Latino/Spanish|741|1|N|x| |||||| | |||||
HOPE|1.00|7882|A1005X|Ethnicity: Patient unable to respond|742|1|N|x| |||||| | |||||
HOPE|1.00|7884|A1005Y|Ethnicity: Patient declines to respond|743|1|N|x| |||||| | |||||
HOPE|1.00|7886|A1010A|Race: White|744|1|N|x| |||||| | |||||
HOPE|1.00|7888|A1010B|Race: Black or African American|745|1|N|x| |||||| | |||||
HOPE|1.00|7890|A1010C|Race: American Indian or Alaska Native|746|1|N|x| |||||| | |||||
HOPE|1.00|7892|A1010D|Race: Asian Indian|747|1|N|x| |||||| | |||||
HOPE|1.00|7894|A1010E|Race: Chinese|748|1|N|x| |||||| | |||||
HOPE|1.00|7896|A1010F|Race: Filipino|749|1|N|x| |||||| | |||||
HOPE|1.00|7898|A1010G|Race: Japanese|750|1|N|x| |||||| | |||||
HOPE|1.00|7900|A1010H|Race: Korean|751|1|N|x| |||||| | |||||
HOPE|1.00|7902|A1010I|Race: Vietnamese|752|1|N|x| |||||| | |||||
HOPE|1.00|7904|A1010J|Race: Other Asian|753|1|N|x| |||||| | |||||
HOPE|1.00|7906|A1010K|Race: Native Hawaiian|754|1|N|x| |||||| | |||||
HOPE|1.00|7908|A1010L|Race: Guamanian or Chamorro|755|1|N|x| |||||| | |||||
HOPE|1.00|7910|A1010M|Race: Samoan|756|1|N|x| |||||| | |||||
HOPE|1.00|7912|A1010N|Race: Other Pacific Islander|757|1|N|x| |||||| | |||||
HOPE|1.00|7914|A1010X|Race: Patient unable to respond|758|1|N|x| |||||| | |||||
HOPE|1.00|7916|A1010Y|Race: Patient declines to respond|759|1|N|x| |||||| | |||||
HOPE|1.00|7918|A1010Z|Race: None of the above|760|1|N|x| |||||| | |||||
HOPE|1.00|7920|A1110A|Preferred language|761|15|N|x| |||||| | |||||
HOPE|1.00|7922|A1110B|Does the patient need or want an interpreter|776|1|N|x| |||||| | |||||
HOPE|1.00|7924|A1805|Admitted from|777|2|N|x| |||||| | |||||
HOPE|1.00|7926|A1905|Living Arrangements|779|1|N|x| |||||| | |||||
HOPE|1.00|7928|A1910|Availability of Assistance|780|1|N|x| |||||| | |||||
HOPE|1.00|7930|I0100|Cancer|781|1|N|x| |||||| | |||||
HOPE|1.00|7932|I0600|Heart Failure|782|1|N|x| |||||| | |||||
HOPE|1.00|7934|I0900|Peripheral Disease (PVD or PAD)|783|1|N|x| |||||| | |||||
HOPE|1.00|7936|I0950|Cardiovascular (excluding heart failure)|784|1|N|x| |||||| | |||||
HOPE|1.00|7938|I1101|Liver disease (e.g., cirrhosis)|785|1|N|x| |||||| | |||||
HOPE|1.00|7940|I1510|Renal disease|786|1|N|x| |||||| | |||||
HOPE|1.00|7942|I2102|Sepsis|787|1|N|x| |||||| | |||||
HOPE|1.00|7944|I2900|Diabetes Mellitus (DM)|788|1|N|x| |||||| | |||||
HOPE|1.00|7946|I2910|Neuropathy|789|1|N|x| |||||| | |||||
HOPE|1.00|7948|I4501|Stroke|790|1|N|x| |||||| | |||||
HOPE|1.00|7950|I4801|Dementia (including Alzheimer's disease)|791|1|N|x| |||||| | |||||
HOPE|1.00|7952|I5150|Neurological Conditions|792|1|N|x| |||||| | |||||
HOPE|1.00|7954|I5401|Seizure Disorder|793|1|N|x| |||||| | |||||
HOPE|1.00|7956|I6202|Chronic Obstructive Pulmonary Disease (COPD)|794|1|N|x| |||||| | |||||
HOPE|1.00|7958|I8005|Other Medical Condition|795|1|N|x| |||||| | |||||
HOPE|1.00|7960|J0050|Death is Imminent|796|1|N|x|x|||||| | |||||
HOPE|1.00|7962|J0915|Neuropathic Pain|797|1|N|x| |||||| | |||||
HOPE|1.00|7964|J2050A|Was symptom impact screening completed|798|1|N|x|x|||||| | |||||
HOPE|1.00|7966|J2050B|Date of symptom impact screening|799|8|N|x|x|||||| | |||||
HOPE|1.00|7968|J2051A|Symptom Impact - Pain|807|1|N|x|x|||||| | |||||
HOPE|1.00|7970|J2051B|Symptom Impact - Shortness of breath|808|1|N|x|x|||||| | |||||
HOPE|1.00|7972|J2051C|Symptom Impact - Anxiety|809|1|N|x|x|||||| | |||||
HOPE|1.00|7974|J2051D|Symptom Impact - Nausea|810|1|N|x|x|||||| | |||||
HOPE|1.00|7976|J2051E|Symptom Impact - Vomiting|811|1|N|x|x|||||| | |||||
HOPE|1.00|7978|J2051F|Symptom Impact - Diarrhea|812|1|N|x|x|||||| | |||||
HOPE|1.00|7980|J2051G|Symptom Impact - Constipation|813|1|N|x|x|||||| | |||||
HOPE|1.00|7982|J2051H|Symptom Impact - Agitation|814|1|N|x|x|||||| | |||||
HOPE|1.00|7984|J2052A|Was in-person SFV completed|815|1|N|x|x|||||| | |||||
HOPE|1.00|7986|J2052B|Date of in-person SFV|816|8|N|x|x|||||| | |||||
HOPE|1.00|7988|J2052C|Reason SFV Not Completed|824|1|N|x|x|||||| | |||||
HOPE|1.00|7990|J2053A|SFV Symptom Impact Since Screen - Pain|825|1|N|x|x|||||| | |||||
HOPE|1.00|7992|J2053B|SFV Symptom Impact Since Screen - Shortness breath|826|1|N|x|x|||||| | |||||
HOPE|1.00|7994|J2053C|SFV Symptom Impact Since Screen - Anxiety|827|1|N|x|x|||||| | |||||
HOPE|1.00|7996|J2053D|SFV Symptom Impact Since Screen - Nausea|828|1|N|x|x|||||| | |||||
HOPE|1.00|7998|J2053E|SFV Symptom Impact Since Screen - Vomiting|829|1|N|x|x|||||| | |||||
HOPE|1.00|8000|J2053F|SFV Symptom Impact Since Screen - Diarrhea|830|1|N|x|x|||||| | |||||
HOPE|1.00|8002|J2053G|SFV Symptom Impact Since Screen - Constipation|831|1|N|x|x|||||| | |||||
HOPE|1.00|8004|J2053H|SFV Symptom Impact Since Screen - Agitation|832|1|N|x|x|||||| | |||||
HOPE|1.00|8006|M1190|Patient has one or more skin conditions|833|1|N|x|x|||||| | |||||
HOPE|1.00|8008|M1195A|Skin Condition - Diabetic foot ulcer(s)|834|1|N|x|x|||||| | |||||
HOPE|1.00|8010|M1195B|Skin Condition - Open lesion(s)|835|1|N|x|x|||||| | |||||
HOPE|1.00|8012|M1195C|Skin Condition - Pressure Ulcer(s)/Injuries|836|1|N|x|x|||||| | |||||
HOPE|1.00|8014|M1195D|Skin Condition - Rash(es)|837|1|N|x|x|||||| | |||||
HOPE|1.00|8016|M1195E|Skin Condition - Skin tear(s)|838|1|N|x|x|||||| | |||||
HOPE|1.00|8018|M1195F|Skin Condition - Surgical wound(s)|839|1|N|x|x|||||| | |||||
HOPE|1.00|8020|M1195G|Skin Condition - Ulcers (not diabetic or pressure)|840|1|N|x|x|||||| | |||||
HOPE|1.00|8022|M1195H|Skin Condition - Moisture Associated Skin Damage|841|1|N|x|x|||||| | |||||
HOPE|1.00|8024|M1195Z|Skin Condition - None of the above|842|1|N|x|x|||||| | |||||
HOPE|1.00|8026|M1200A|Treatments - Pressure reducing device for chair|843|1|N|x|x|||||| | |||||
HOPE|1.00|8028|M1200B|Treatments - Pressure reducing device for bed|844|1|N|x|x|||||| | |||||
HOPE|1.00|8030|M1200C|Treatments - Turning/repositioning program|845|1|N|x|x|||||| | |||||
HOPE|1.00|8032|M1200D|Treatments - Nutrition or hydration intervention|846|1|N|x|x|||||| | |||||
HOPE|1.00|8034|M1200E|Treatments - Pressure ulcer/injury care|847|1|N|x|x|||||| | |||||
HOPE|1.00|8036|M1200F|Treatments - Surgical wound care|848|1|N|x|x|||||| | |||||
HOPE|1.00|8038|M1200G|Treatments - Apply nonsurgical dressings-not feet|849|1|N|x|x|||||| | |||||
HOPE|1.00|8040|M1200H|Treatments - Apply ointments/meds (not feet)|850|1|N|x|x|||||| | |||||
HOPE|1.00|8042|M1200I|Treatments - Application of dressings to feet|851|1|N|x|x|||||| | |||||
HOPE|1.00|8044|M1200J|Treatments - Incontinence Management|852|1|N|x|x|||||| | |||||
HOPE|1.00|8046|M1200Z|Treatments - None of the above|853|1|N|x|x|||||| | |||||
HOPE|1.00|8048|Z0350|Date Assessment Was Completed|854|8|N| |x|||||| |x|||||
