83252-7 Special Treatments, Procedures, and Programs - On Admission

Observation ID in Form

O0110_a

Form Coding Instructions

Check all of the following treatments, procedures, and programs that were performed.

Source: Centers for Medicare & Medicaid Services

Form Coding Instructions

Assessment period is days 1 through 3 of the SNF PPS Stay starting with A2400B. Check all that apply.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Special treatments, procedures, and programs at admission
Property
Find
Time
RptPeriod
System
^Patient
Scale
Nom
Method
CMS Assessment

Long Common Name

Special treatments, procedures, and programs at admission [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.69 (MAJ)
Change Reason
Release 2.69: TIME_ASPCT: Updated Timing since this item is recorded at admission but assessed over a period of time according to the CMS manuals.;
Order vs. Observation
Observation

Normative Answer List LL5385-1

AnswerCodeScoreAnswer ID
ChemotherapyA1LA6172-6
Chemotherapy - IVA2LA30275-4
Chemotherapy - OralA3LA30276-2
Chemotherapy - OtherA10LA30277-0
RadiationB1LA4351-8
Oxygen therapyC1LA27962-2
Oxygen therapy - ContinuousC2LA30278-8
Oxygen therapy - IntermittentC3LA30279-6
Oxygen therapy - High-concentrationC4LA30280-4
SuctioningD1LA27963-0
Suctioning - ScheduledD2LA30359-6
Suctioning - As neededD3LA30360-4
Tracheostomy careE1LA27964-8
Invasive mechanical ventilator (ventilator or respirator)F1LA28889-6
Non-invasive mechanical ventilatorG1LA30281-2
Non-invasive mechanical ventilator - BiPAPG2LA30282-0
Non-invasive mechanical ventilator - CPAPG3LA30283-8
IV medicationsH1LA27972-1
IV medications - Vasoactive medicationsH2LA30284-6
IV medications - AntibioticsH3LA30285-3
IV medications - AnticoagulantH4LA30286-1
IV medications - OtherH10LA30287-9
TransfusionsI1LA27966-3
DialysisJ1LA7216-0
Dialysis - HemodialysisJ2LA30288-7
Dialysis - Peritoneal dialysisJ3LA30289-5
IV accessO1LA30290-3
IV access - PeripheralO2LA30291-1
IV access - MidlineO3LA30292-9
IV access - Central (e.g., PICC, tunneled, port)O4LA30293-7
None of the aboveZ1LA9-3

Member of these Panels

LOINCLong Common Name
103991-6CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment]
83265-9Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]
87414-9Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment]
88329-8Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
89963-3Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 during assessment period [CMS Assessment]
85645-0Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
87509-6Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 4.00 during assessment period [CMS Assessment]
113114-3Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 4.4 during assessment period [CMS Assessment]
93128-7Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment]
93222-8Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.00 during assessment period [CMS Assessment]
103949-4Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.1 during assessment period [CMS Assessment]
113119-2Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.3 during assessment period [CMS Assessment]
103564-1MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
104552-5MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
104554-1MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
104609-3MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
108256-9Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment]
99160-4Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment]
99131-5Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment]
106525-9Outcome and assessment information set (OASIS) form - version E1 - Resumption of Care during assessment period [CMS Assessment]
106523-4Outcome and assessment information set (OASIS) form - version E1 - Start of Care during assessment period [CMS Assessment]
108292-4Outcome and assessment information set (OASIS) form - version E2 - Resumption of Care during assessment period [CMS Assessment]
108291-6Outcome and assessment information set (OASIS) form - version E2 - Start of Care during assessment period [CMS Assessment]
100997-6Respiratory Allergen Panel, Area 5 - Serum

86761-4 Special Treatments, Procedures, and Programs - While a Resident

Observation ID in Form

O0110_b

Form Coding Instructions

Check all of the following treatments, procedures, and programs that were performed.

Source: Centers for Medicare & Medicaid Services

Form Coding Instructions

Check all that apply.

Source: Centers for Medicare & Medicaid Services

Form Coding Instructions

Performed while a resident of this facility and within the last 14 days.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Procedures performed during last 14D - while a resident
Property
Find
Time
14D
System
^Patient
Scale
Nom
Method
CMS Assessment

Long Common Name

Procedures performed during last 14 days - while a resident [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.63
Last Updated
Version 2.63 (ADD)
Order vs. Observation
Observation

Normative Answer List LL6301-7

AnswerCodeScoreAnswer ID
ChemotherapyA1LA6172-6
RadiationB1LA4351-8
Oxygen therapyC1LA27962-2
SuctioningD1LA27963-0
Tracheostomy careE1LA27964-8
Invasive mechanical ventilator (ventilator or respirator)F1LA28889-6
Non-invasive mechanical ventilatorG1LA30281-2
IV medicationsH1LA27972-1
TransfusionsI1LA27966-3
DialysisJ1LA7216-0
Hospice careK1LA6217-9
Isolation or quarantine for active infectious disease (does not include standard body/fluid precautions)M1LA27970-5
IV accessO1LA30290-3
None of the aboveZ1LA9-3

Member of these Panels

LOINCLong Common Name
86870-3Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA (NO/SO) item set [CMS Assessment]
86874-5Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA start of therapy (NS/SS) item set [CMS Assessment]
86522-0Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
86872-9Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
86871-1Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
86873-7Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
86856-2Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home PPS (NP) and Nursing home quarterly (NQ) item set [CMS Assessment]
86876-0Deprecated MDS v3.0 - RAI v1.14.1 - Swing bed PPS (SP) item set [CMS Assessment]
88279-5Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
88280-3Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
88282-9Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
88283-7Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
88284-5Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
88285-2Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
88287-8Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home PPS (NP) item set [CMS Assessment]
88292-8Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
88288-6Deprecated MDS v3.0 - RAI v1.15.1 - Swing bed PPS (SP) item set [CMS Assessment]
88951-9Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA (NO and SO) item set [CMS Assessment]
88952-7Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home and Swing bed OMRA start of therapy (NS and SS) item set [CMS Assessment]
88954-3Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment]
88945-1Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home discharge (ND) and Swing bed discharge (SD) item set [CMS Assessment]
88946-9Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home OMRA start of therapy and discharge (NSD) and Swing bed OMRA start of therapy and discharge (SSD) item set [CMS Assessment]
88947-7Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
88949-3Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment]
88955-0Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment]
88950-1Deprecated MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment]
90480-5Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
90473-0Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
90477-1Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
90474-8Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
90475-5Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
90481-3Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Optional State Assessment (OSA) item set during assessment period [CMS Assessment]
91552-0Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed discharge (SD) item set during assessment period [CMS Assessment]
90476-3Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
104608-5MDS v3.0 - RAI v1.19.1 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
103564-1MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
104606-9MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
104552-5MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
104554-1MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
104609-3MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
108256-9Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment]
100997-6Respiratory Allergen Panel, Area 5 - Serum

93185-7 Special Treatments, Procedures, and Programs - At Discharge

Observation ID in Form

O0110_c

Form Coding Instructions

Check all of the following treatments, procedures, and programs that were performed.

Source: Centers for Medicare & Medicaid Services

Form Coding Instructions

Assessment period is the last 3 days of the SNF PPS Stay ending on A2400C. Check all that apply.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Special treatments, procedures, and programs at discharge
Property
Find
Time
RptPeriod
System
^Patient
Scale
Nom
Method
CMS Assessment

Long Common Name

Special treatments, procedures, and programs at discharge [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.67
Last Updated
Version 2.69 (MAJ)
Change Reason
Release 2.69: TIME_ASPCT: Updated Timing since this item is recorded at admission but assessed over a period of time according to the CMS manuals.;
Order vs. Observation
Observation

Normative Answer List LL5385-1

AnswerCodeScoreAnswer ID
ChemotherapyA1LA6172-6
Chemotherapy - IVA2LA30275-4
Chemotherapy - OralA3LA30276-2
Chemotherapy - OtherA10LA30277-0
RadiationB1LA4351-8
Oxygen therapyC1LA27962-2
Oxygen therapy - ContinuousC2LA30278-8
Oxygen therapy - IntermittentC3LA30279-6
Oxygen therapy - High-concentrationC4LA30280-4
SuctioningD1LA27963-0
Suctioning - ScheduledD2LA30359-6
Suctioning - As neededD3LA30360-4
Tracheostomy careE1LA27964-8
Invasive mechanical ventilator (ventilator or respirator)F1LA28889-6
Non-invasive mechanical ventilatorG1LA30281-2
Non-invasive mechanical ventilator - BiPAPG2LA30282-0
Non-invasive mechanical ventilator - CPAPG3LA30283-8
IV medicationsH1LA27972-1
IV medications - Vasoactive medicationsH2LA30284-6
IV medications - AntibioticsH3LA30285-3
IV medications - AnticoagulantH4LA30286-1
IV medications - OtherH10LA30287-9
TransfusionsI1LA27966-3
DialysisJ1LA7216-0
Dialysis - HemodialysisJ2LA30288-7
Dialysis - Peritoneal dialysisJ3LA30289-5
IV accessO1LA30290-3
IV access - PeripheralO2LA30291-1
IV access - MidlineO3LA30292-9
IV access - Central (e.g., PICC, tunneled, port)O4LA30293-7
None of the aboveZ1LA9-3

Member of these Panels

LOINCLong Common Name
103991-6CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment]
113114-3Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 4.4 during assessment period [CMS Assessment]
93128-7Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment]
93221-0Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.00 during assessment period [CMS Assessment]
103946-0Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 during assessment period [CMS Assessment]
113166-3Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.3 during assessment period [CMS Assessment]
93220-2Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.00 during assessment period [CMS Assessment]
103947-8Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.1 during assessment period [CMS Assessment]
113165-5Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.3 during assessment period [CMS Assessment]
103564-1MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
104606-9MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
105201-8MDS v3.0 - RAI v1.19.1 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment]
104552-5MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
104554-1MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
104607-7MDS v3.0 - RAI v1.19.1 - Swing Bed discharge (SD) item set during assessment period [CMS Assessment]
104609-3MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
108256-9Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment]
108293-2OASIS E2 - DC during assessment period [CMS Assessment]
99178-6Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment]
106529-1Outcome and assessment information set (OASIS) form - version E1 - Discharge from Agency during assessment period [CMS Assessment]
100997-6Respiratory Allergen Panel, Area 5 - Serum