Form Coding Instructions

Complete during the 2-day assessment period

Source: Centers for Medicare & Medicaid Services

52618-6 Does the patient have any signs or symptoms of a possible swallowing disorder?

Observation ID in Form

B1

Form Coding Instructions

Check all that apply

Source: Centers for Medicare & Medicaid Services

Form Coding Instructions

Check all that apply.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Swallowing disorder
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
CARE

Long Common Name

Swallowing disorder [CARE]

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64 (MIN)

Normative Answer List LL574-5

AnswerCodeScoreAnswer ID
Complaints of difficulty or pain with swallowingaLA9952-8
Coughing or choking during meals or when swallowing medicationsbLA9961-9
Holding food in mouth/cheeks or residual food in mouth after mealscLA9977-5
Loss of liquids/solids from mouth when eating or drinkingdLA10001-8
NPO: intake not by moutheLA10043-0
Other (specify)fLA6310-2
None Copyright http://snomed.info/sct ID:260413007 None (qualifier value)gLA137-2

Member of these Panels

LOINCLong Common Name
52745-7Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52619-4 Other (specify)

Observation ID in Form

B1f

Fully-Specified Name

Component
Swallowing disorder.other specified
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method
CARE

Long Common Name

Swallowing disorder.other specified [CARE]

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64 (MIN)

Member of these Panels

LOINCLong Common Name
52745-7Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52620-2 Describe the patient's usual ability with swallowing.

Observation ID in Form

B2

Form Coding Instructions

Check one option only

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Swallowing usual ability
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
CARE

Long Common Name

Swallowing usual ability [CARE]

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64 (MIN)

Normative Answer List LL575-2

AnswerCodeScoreAnswer ID
Regular food: solids and liquids swallowed safely without supervision and without modified food or liquid consistency.ALA10070-3
Modified food consistency/supervision: Patient requires modified food or liquid consistency and/or needs supervision during eating for safety.BLA10013-3
Tube/parenteral feeding: Tube/parenteral feeding used wholly or partially as a means of sustenance.CLA10103-2

Member of these Panels

LOINCLong Common Name
52745-7Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission