58121-5
Prior Functioning ADL and IADL
Active
Form Coding Instructions
Indicate the patient's usual ability with everyday activities prior to this current illness, exacerbation, or injury. Check only one box in each row
Source: Centers for Medicare & Medicaid Services85070-1 Self-care (specifically: grooming, dressing, bathing, and toileting hygiene)
Term Description
Need for assistance with bathing, dressing, using the toilet, and eating prior to the current illness, exacerbation, or injury.
Observation ID in Form
M1900A
Fully-Specified Name
- Component
- Prior functioning.self care
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
Prior functioning.self care during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.61
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Change Component display to match Component, like similar terms
- Order vs. Observation
- Observation
Normative Answer List LL812-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Independent | 0 | LA12302-8 | |
| Needed some help | 1 | LA12303-6 | |
| Dependent | 2 | LA12304-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 103991-6 | CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment] |
| 83265-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment] |
| 87414-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment] |
| 88329-8 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment] |
| 89963-3 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 during assessment period [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88949-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home PPS (NP) item set [CMS Assessment] |
| 88955-0 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home quarterly (NQ) item set [CMS Assessment] |
| 88950-1 | Deprecated MDS v3.0 - RAI v1.16.1 - Swing bed PPS (SP) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 90474-8 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 90475-5 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 90476-3 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 57039-0 | Deprecated Outcome and assessment information set (OASIS) form - version C |
| 57191-9 | Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care |
| 57190-1 | Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care |
| 86189-8 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment] |
| 85907-4 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment] |
| 113114-3 | Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 4.4 during assessment period [CMS Assessment] |
| 93128-7 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment] |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 104552-5 | MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 104554-1 | MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 104609-3 | MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 88368-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Resumption of care during assessment period [CMS Assessment] |
| 88373-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Start of care during assessment period [CMS Assessment] |
| 99160-4 | Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment] |
| 99131-5 | Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment] |
| 106525-9 | Outcome and assessment information set (OASIS) form - version E1 - Resumption of Care during assessment period [CMS Assessment] |
| 106523-4 | Outcome and assessment information set (OASIS) form - version E1 - Start of Care during assessment period [CMS Assessment] |
| 108292-4 | Outcome and assessment information set (OASIS) form - version E2 - Resumption of Care during assessment period [CMS Assessment] |
| 108291-6 | Outcome and assessment information set (OASIS) form - version E2 - Start of Care during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
86185-6 Ambulation
Term Description
Indicates the patient's usual ability to walk (with or without assistive devices) prior to the most recent illness, exacerbation, or injury.
Observation ID in Form
M1900B
Fully-Specified Name
- Component
- Prior functioning.ambulation
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
Prior functioning.ambulation during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.63
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL812-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Independent | 0 | LA12302-8 | |
| Needed some help | 1 | LA12303-6 | |
| Dependent | 2 | LA12304-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 57039-0 | Deprecated Outcome and assessment information set (OASIS) form - version C |
| 57191-9 | Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care |
| 57190-1 | Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care |
| 86189-8 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment] |
| 85907-4 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment] |
86186-4 Transfer
Term Description
Indicate the patient's usual ability to transfer to tub, shower, commode, and bed to chair prior to the most recent illness, exacerbation, or injury
Observation ID in Form
M1900C
Fully-Specified Name
- Component
- Prior functioning.transfer
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
Prior functioning.transfer during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.63
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL812-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Independent | 0 | LA12302-8 | |
| Needed some help | 1 | LA12303-6 | |
| Dependent | 2 | LA12304-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 57039-0 | Deprecated Outcome and assessment information set (OASIS) form - version C |
| 57191-9 | Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care |
| 57190-1 | Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care |
| 86189-8 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment] |
| 85907-4 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment] |
86187-2 Household tasks (specifically: light meal preparation, laundry, shopping, and phone use.)
Term Description
Indicate the patient's usual ability to prepare light meal, do laundry, go shopping, and use the phone prior to the most recent illness, exacerbation, or injury
Observation ID in Form
M1900D
Fully-Specified Name
- Component
- Prior functioning.household tasks
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
Prior functioning.household tasks during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.63
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL812-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Independent | 0 | LA12302-8 | |
| Needed some help | 1 | LA12303-6 | |
| Dependent | 2 | LA12304-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 57039-0 | Deprecated Outcome and assessment information set (OASIS) form - version C |
| 57191-9 | Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care |
| 57190-1 | Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care |
| 86189-8 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment] |
| 85907-4 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment] |