Form Coding Instructions

Code for limitation that interfered with daily functions or placed resident at risk of injury

Source: Centers for Medicare & Medicaid Services

54754-7 Upper extremity (shoulder, elbow, wrist, hand)

Observation ID in Form

G0400A

Fully-Specified Name

Component
Range of motion
Property
Find
Time
Pt
System
Upper extremity
Scale
Ord
Method
CMS Assessment

Long Common Name

Deprecated Range of motion Upper extremity [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.77 (DEL)
Change Reason
Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments.
Order vs. Observation
Observation

Normative Answer List LL655-2

AnswerCodeScoreAnswer ID
No impairment0LA9606-0
Impairment on one side1LA11036-3
Impairment on both sides2LA11037-1

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0

54755-4 Lower extremity (hip, knee, ankle, foot)

Observation ID in Form

G0400B

Fully-Specified Name

Component
Range of motion
Property
Find
Time
Pt
System
Lower extremity
Scale
Ord
Method
CMS Assessment

Long Common Name

Deprecated Range of motion Lower extremity [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.77 (DEL)
Change Reason
Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments.
Order vs. Observation
Observation

Normative Answer List LL655-2

AnswerCodeScoreAnswer ID
No impairment0LA9606-0
Impairment on one side1LA11036-3
Impairment on both sides2LA11037-1

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0