Form Coding Instructions

Complete Examination Procedure (attachment d.) before making ratings. MOVEMENT RATINGS: Rate highest severity observed. Rate movements that occur upon activation one less than those observed spontaneously. Circle movement as well as code number that applies. CODE: 0 = None 1 = Minimal, may be extreme normal 2 = Mild 3 = Moderate 4 - Severe

Source: Six Aims for Behavioral Health

111793-6 Facial and Oral Movements

Observation ID in Form

H1

Fully-Specified Name

Component
Facial and Oral Movements
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Basic Attributes

Class
PANEL.SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111792-8 Muscles of Facial Expression e.g. movements of forehead, eyebrows

Observation ID in Form

1

Fully-Specified Name

Component
Muscles of facial expression
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Muscles of facial expression

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111791-0 Lips and Perioral Area e.g., puckering, pouting, smacking

Observation ID in Form

2

Fully-Specified Name

Component
Lips and perioral area
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Lips and perioral area

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111790-2 Jaw e.g., biting, clenching, chewing, mouth opening, lateral movement

Observation ID in Form

3

Fully-Specified Name

Component
Jaw movement
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Jaw movement

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111789-4 Tongue Rate only increase in movement both in and out of mouth, NOT inability to sustain movement

Observation ID in Form

4

Fully-Specified Name

Component
Tongue movement
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Tongue movement

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111788-6 Extremity Movements

Observation ID in Form

H2

Fully-Specified Name

Component
Extremity Movements
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Basic Attributes

Class
PANEL.SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111787-8 Upper (arms, wrists,, hands, fingers)

Observation ID in Form

5

Form Context

Include choreic movements (i.e., rapid, objectively purposeless, irregular, spontaneous) athetoid movements (i.e., slow, irregular, complex, serpentine). DO NOT INCLUDE TREMOR (i.e., repetitive, regular, rhythmic)

Source: Six Aims for Behavioral Health

Fully-Specified Name

Component
Upper extremity movement
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Upper extremity movement

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111786-0 Lower (legs, knees, ankles, toes)

Observation ID in Form

6

Form Context

e.g., lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot.

Source: Six Aims for Behavioral Health

Fully-Specified Name

Component
Lower extremity movement
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Lower extremity movement

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111785-2 Trunk Movements

Observation ID in Form

H3

Fully-Specified Name

Component
Trunk Movements
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Basic Attributes

Class
PANEL.SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111784-5 Neck, shoulders, hips e.g., rocking,twisting, squirming, pelvic gyrations

Observation ID in Form

7

Fully-Specified Name

Component
Neck, shoulders, hips movement
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Neck, shoulders, hips movement

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111774-6 Abnormal movement score

Observation ID in Form

7a

Form Coding Instructions

Add together the individual scores for the first seven items (questions 1-7). The total score should be between 0 and 28

Source: Six Aims for Behavioral Health

Fully-Specified Name

Component
Abnormal movement score
Property
Score
Time
Pt
System
^Patient
Scale
Nom
Method
AIMS

Long Common Name

Abnormal movement score [AIMS]

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7478-2

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

Example Units

UnitSource
{score}Example UCUM Units

111783-7 Global Judgments

Observation ID in Form

H4

Fully-Specified Name

Component
Global Judgments
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Basic Attributes

Class
PANEL.SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111782-9 Severity of abnormal movements overall

Observation ID in Form

8

Fully-Specified Name

Component
Severity of abnormal movement
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111781-1 Incapacitation due to abnormal movements

Observation ID in Form

9

Fully-Specified Name

Component
Incapacitation due to abnormal movements
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7290-1

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111780-3 Patient’s awareness of abnormal movements. Rate only patient’s report

Observation ID in Form

10

Form Coding Instructions

No awareness 0 Aware, no distress 1 Aware, mild distress 2 Aware, moderate distress 3 Aware, severe distress 4

Source: Six Aims for Behavioral Health

Fully-Specified Name

Component
Patients awareness of abnormal movements
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Long Common Name

Patients awareness of abnormal movements

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7478-2

AnswerCodeScoreAnswer ID
no awareness0LA35425-0
aware, no distress1LA35426-8
aware, mild distress2LA35428-4
aware, moderate distress3LA35429-2
aware, severe distress4LA35430-0

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111779-5 Dental Status

Observation ID in Form

H5

Fully-Specified Name

Component
Dental status
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Long Common Name

Dental status

Basic Attributes

Class
PANEL.SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111778-7 Current problems with teeth and/or dentures

Observation ID in Form

11

Fully-Specified Name

Component
Current problems with teeth &or dentures
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL4256-5

AnswerCodeScoreAnswer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)0LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)1LA33-6

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111777-9 Are dentures usually worn?

Observation ID in Form

12

Fully-Specified Name

Component
Are dentures usually worn
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Long Common Name

Are dentures usually worn

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7289-3

AnswerCodeScoreAnswer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)LA32-8

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111776-1 Edentia?

Observation ID in Form

13

Fully-Specified Name

Component
Edentia
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Long Common Name

Edentia

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7289-3

AnswerCodeScoreAnswer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)LA32-8

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111775-3 Do movements disappear in sleep?

Observation ID in Form

14

Fully-Specified Name

Component
Do movements disappear in sleep
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Long Common Name

Do movements disappear in sleep

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7289-3

AnswerCodeScoreAnswer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)LA32-8

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

111770-4 Total score

Term Description

Scoring Procedure
Complete the examination procedure before making ratings.
For the movement ratings (the first three categories below), rate the
highest severity observed. 0 = none, 1 = minimal (may be extreme
normal), 2 = mild, 3 = moderate, and 4 = severe. According to the
original AIMS instructions, one point is subtracted if movements are
seen only on activation, but not all investigators follow that
convention.
The total AIMS score is calculated as the sum of items 1-7; dental items are not included in this total.
This implementation subtracts 1 point for movements seen only on activation before summing the total score

Fully-Specified Name

Component
Total score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
AIMS

Long Common Name

Total score [AIMS]

Basic Attributes

Class
SURVEY.NEURO
Type
Surveys
First Released
Version 2.82
Last Updated
Version 2.82 (ADD)
Order vs. Observation
Observation

Example Answer List LL7479-0

AnswerCodeScoreAnswer ID
None Copyright http://snomed.info/sct ID:260413007 None (qualifier value)0LA137-2
Minimal, may be extreme normal1LA37002-5
Mild2LA6752-5
Moderate3LA6751-7
Severe4LA6750-9

Member of these Panels

LOINCLong Common Name
111794-4Abnormal Involuntary Movement Scale Original 14-Item Version [AIMS]

Example Units

UnitSource
{score}Example UCUM Units