45394-4 Patient Last (Family) name

Observation ID in Form

CMS-2746_01

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Last name

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Patient Last name

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.70

Change Reason

Release 2.70: LONG_COMMON_NAME: Added "Patient" to distinguish from the general "Last name" term that does not distinguish between various subjects (patient, provider, contact, etc.).; SHORTNAME: Added "Patient" to distinguish from the general "Last name" term that does not distinguish between various subjects (patient, provider, contact, etc.).;

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.1

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Nominal
• Past
• Person name
• Point in time
• Random

Related Codes

45392-8 Patient First (Given) name

Observation ID in Form

CMS-2746_01

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

First name

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Patient First name

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.70

Change Reason

Release 2.70: LONG_COMMON_NAME: Added "Patient" to distinguish from the general "First name" term that does not distinguish between various subjects (patient, provider, contact, etc.).; SHORTNAME: Added "Patient" to distinguish from the general "First name" term that does not distinguish between various subjects (patient, provider, contact, etc.).;

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.2

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Given name
• Nominal
• Person name
• Point in time
• Random

Related Codes

45393-6 Middle initial

Observation ID in Form

CMS-2746_01

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Middle initial

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Middle initial

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.66

Change Reason

Change PROPERTY from ID to Pn to match convention for other name terms

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.3

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Nominal
• Person name
• Point in time
• Random

Related Codes

45397-7 Medicare or comparable number

Observation ID in Form

CMS-2746_02

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Medicare or comparable number

Property

ID

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Medicare or comparable #

Basic Attributes

Class

ADMIN.PATIENT.ID

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.66

Change Reason

Changed CLASS to ADMIN

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-3

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PATIENT.ID
• Ident
• Identifier
• Intradermal
• Medicare or comparable #
• No
• Nominal
• Num
• Point in time
• Random

Related Codes

46098-0 Sex

Part Descriptions

LP101395-4   Sex
In LOINC, sex refers to the biological sex of an organism, which is most commonly determined based on anatomy and physiology or genetic (chromosome) analysis. Our definition is based on the World Health Organization's definition of sex and gender: sex (male, female) refers to biological and physiological characteristics, and gender (masculine, feminine) refers to socially constructed roles, behaviors, activities, and attributes. (http://www.who.int/gender/whatisgender/en) Source: Regenstrief LOINC, WHO: gender

Observation ID in Form

CMS-2746_03

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Sex

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Sex

Basic Attributes

Class

ADMIN.PATIENT.DEMOG

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.73

Change Reason

Changed Component from 'Gender' to 'Sex' to align with the World Health Organization (WHO) definition of this concept.

Order vs. Observation

Both

Common Test Rank Get Info

2086

HL7^® Attributes

HL7^® Field ID

PID-8

Example Answer List LL1-9

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PT.DEMOG
• AOEObservation
• Gender
• Nominal
• Point in time
• Random
• Typ

Related Codes

21112-8 Birth date

Observation ID in Form

CMS-2746_04

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Birth date

Property

TmStp

Time

Pt

System

^Patient

Scale

Qn

Method

Additional Names

Short Name

Birth date

Display Name

Birth date [Date/time]

Consumer Name Alpha Get Info

Birth date

Basic Attributes

Class

MISC

Type

Laboratory

First Released

Version 1.0m

Last Updated

Version 2.73

Order vs. Observation

Observation

Common Test Rank Get Info

1746

HL7^® Attributes

HL7^® Field ID

PID-7.1

Member of these Panels

Language Variants Get Info

Related Names

• Birthdate
• Date and time
• Date of birth
• DOB
• MISC
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Time stamp
• Timestamp

Example Units

Related Codes

45396-9 Social Security number [Identifier]

Observation ID in Form

CMS-2746_05

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Social Security number

Property

ID

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Social Security #

Basic Attributes

Class

ADMIN.PATIENT.ID

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.73

Change Reason

Updated Class from SURVEY.MDS to ADMIN; Capitalized Security in Component

Order vs. Observation

Both

Common Test Rank Get Info

6170

HL7^® Attributes

HL7^® Field ID

PID-19

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PATIENT.ID
• Ident
• Identifier
• Intradermal
• No
• Nominal
• Num
• Point in time
• Random
• Social Security #

Related Codes

46499-0 State of residence

Term Description

The state in which the patient is currently residing while receiving care.
Source: Regenstrief LOINC

Observation ID in Form

CMS-2746_06

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

State of residence

Property

Loc

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

State of residence

Basic Attributes

Class

ADMIN.PATIENT.DEMOG

Type

Clinical

First Released

Version 2.19

Last Updated

Version 2.73

Order vs. Observation

Both

Common Test Rank Get Info

7483

HL7^® Attributes

HL7^® Field ID

PID-11.4

Example Answer List LL3661-7

Externally Defined

Yes

Code System

CDC-PHIN

Code System OID

1.3.6.1.4.1.12009.10.1.2296

Link to External List

https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.830

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PT.DEMOG
• Housing
• Living Arrangement
• Living Arrangements
• Location
• Nominal
• Point in time
• Random

Related Codes

71480-8 Location of death [ESRD]

Observation ID in Form

CMS-2746_07

Observation Required in Panel

Required

Fully-Specified Name

Component

Location of death

Property

Loc

Time

Pt

System

^Patient

Scale

Nom

Method

ESRD

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.40

Last Updated

Version 2.67

Order vs. Observation

Observation

Survey Question

Source

ESRD.RQMT_164

Normative Answer List LL1910-0

Member of these Panels

Related Names

• End Stage Renal Disease
• ESRD survey
• Location
• Nominal
• Point in time
• Random
• Survey

31211-6 Date of death

Observation ID in Form

CMS-2746_08

Observation Required in Panel

Required

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Date of death

Property

TmStp

Time

Pt

System

^Patient

Scale

Qn

Method

Additional Names

Short Name

Date of death

Basic Attributes

Class

TUMRRGT

Type

Clinical

First Released

Version 2.07

Last Updated

Version 2.56

HL7^® Attributes

HL7^® Field ID

PID-29

Member of these Panels

Language Variants Get Info

Related Names

• Date and time
• DOD
• Expired date
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Time stamp
• Timestamp
• TUMOR REGISTRY(NAACCR)

68341-7 Modality at time of death

Observation ID in Form

CMS-2746_09

Observation Required in Panel

Required

Fully-Specified Name

Component

Dialysis at time of death

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.44

Survey Question

Text

Modality at time of death

Source

ESRD.RQMT_166

Normative Answer List LL1889-6

Member of these Panels

Related Names

• Dialy
• ESRD
• ESRD survey
• Nominal
• Point in time
• Random
• Survey
• Typ

67878-9 Dialysis facility name

Observation ID in Form

CMS-2746_10a

Observation Required in Panel

Required

Fully-Specified Name

Component

Facility name

Property

ID

Time

Pt

System

Dialysis facility

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.40

Survey Question

Text

Dialysis facility name

Source

ESRD.RQMT_249

Member of these Panels

Related Names

• Dialy
• ESRD
• ESRD survey
• Ident
• Identifier
• Nominal
• Point in time
• Random
• Survey

65833-6 Facility Address

Observation ID in Form

CMS-2746_10b

Observation Required in Panel

Required

Fully-Specified Name

Component

Address

Property

Addr

Time

Pt

System

Facility

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.36

Last Updated

Version 2.64

Change Reason

Changed Long Commmon Name from "Address Facility" to "Facility Address" for clarity

Order vs. Observation

Order

Member of these Panels

Related Names

• Address
• Admin
• ESRD
• ESRD survey
• Nominal
• Point in time
• Random
• Survey

65833-6 Facility Address

Observation ID in Form

CMS-2746_10b

Fully-Specified Name

Component

Address

Property

Addr

Time

Pt

System

Facility

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.36

Last Updated

Version 2.64

Change Reason

Changed Long Commmon Name from "Address Facility" to "Facility Address" for clarity

Order vs. Observation

Order

Member of these Panels

Related Names

• Address
• Admin
• ESRD
• ESRD survey
• Nominal
• Point in time
• Random
• Survey

65647-0 City

Observation ID in Form

CMS-2746_10b

Observation Required in Panel

Required

Fully-Specified Name

Component

City

Property

Loc

Time

Pt

System

Facility

Scale

Nom

Method

Additional Names

Short Name

City Facility

Basic Attributes

Class

ADMIN.FACILITY

Type

Clinical

First Released

Version 2.36

Last Updated

Version 2.66

Change Reason

Updated the PhenX ID from "PhenX.<ID>" to "PX<ID>" in Survey Question Source field to align with the variable identifier used in the PhenX Toolkit.

Survey Question

Text

City

Source

PX091601230000

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• Location
• Nominal
• Point in time
• Random

Related Codes

68488-6 State location of Facility

Observation ID in Form

CMS-2746_10b

Observation Required in Panel

Required

Fully-Specified Name

Component

State

Property

Loc

Time

Pt

System

Facility

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.73

Common Test Rank Get Info

12290

Member of these Panels

Related Names

• Admin
• ESRD
• ESRD survey
• Location
• Nominal
• Point in time
• Random
• Survey

68330-0 Dialysis facility's CMS Certification Number (CCN) where the patient is receiving care

Observation ID in Form

CMS-2746_11

Observation Required in Panel

Required

Fully-Specified Name

Component

CMS certification number - CCN

Property

ID

Time

Pt

System

Dialysis facility

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.40

Survey Question

Text

Dialysis facility's CMS Certification Number (CCN) where the patient is receiving care

Source

ESRD.RQMT_250

Member of these Panels

Related Names

• CCN
• CMS certification #
• Dialy
• ESRD
• ESRD survey
• Ident
• Identifier
• No
• Nominal
• Num
• Point in time
• Random
• Survey

68343-3 Primary cause?

Observation ID in Form

CMS-2746_12a

Observation Required in Panel

Required

Fully-Specified Name

Component

Cause of death.primary

Property

Find

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.40

Survey Question

Text

Primary cause?

Source

ESRD.RQMT_173

Normative Answer List LL1892-0

Externally Defined

Yes

Code System

Code System OID

1.3.6.1.4.1.12009.10.1.1069

Link to External List

http://www.cdc.gov/nchs/icd.htm

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Nominal
• Point in time
• Primary cause of death
• Random
• Survey

68344-1 Were there secondary causes?

Observation ID in Form

CMS-2746_12b

Observation Required in Panel

Required

Fully-Specified Name

Component

Were there secondary causes of death

Property

Find

Time

Pt

System

^Patient

Scale

Ord

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.44

Survey Question

Text

Were there secondary causes?

Source

ESRD.RQMT_174

Normative Answer List LL361-7

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Ordinal
• Point in time
• QL
• Qual
• Qualitative
• Random
• Screen
• Secondary causes death present
• Survey

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

68345-8 If yes, secondary cause of death

Observation ID in Form

CMS-2746_12b1

Observation Required in Panel

Optional

Fully-Specified Name

Component

Cause of death.secondary

Property

Find

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.40

Survey Question

Text

If yes, secondary cause of death

Source

ESRD.RQMT_175

Normative Answer List LL1892-0

Externally Defined

Yes

Code System

Code System OID

1.3.6.1.4.1.12009.10.1.1069

Link to External List

http://www.cdc.gov/nchs/icd.htm

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Nominal
• Point in time
• Random
• Secondary cause of death
• Survey

68346-6 If cause is other, please specify

Observation ID in Form

CMS-2746_12c

Observation Required in Panel

Optional

Fully-Specified Name

Component

Cause of death.other

Property

Find

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.40

Survey Question

Text

If cause is other, please specify

Source

ESRD.RQMT_176

Normative Answer List LL1892-0

Externally Defined

Yes

Code System

Code System OID

1.3.6.1.4.1.12009.10.1.1069

Link to External List

http://www.cdc.gov/nchs/icd.htm

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Nominal
• Other cause of death
• Othr
• Point in time
• Random
• Survey

68347-4 Renal replacement therapy discontinued prior to death?

Observation ID in Form

CMS-2746_13a

Observation Required in Panel

Required

Fully-Specified Name

Component

Renal replacement therapy discontinued prior to death

Property

Find

Time

Pt

System

^Patient

Scale

Ord

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.44

Survey Question

Text

Renal replacement therapy discontinued prior to death?

Source

ESRD.RQMT_177

Normative Answer List LL361-7

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Kidney
• Ordinal
• Point in time
• QL
• Qual
• Qualitative
• Random
• RRT stopped
• Screen
• Survey

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

68348-2 If yes, check one of the following

Observation ID in Form

CMS-2746_13b

Observation Required in Panel

Required

Fully-Specified Name

Component

Reason renal replacement therapy discontinued

Property

Find

Time

Pt

System

^Patient

Scale

Nom

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.44

Survey Question

Text

If yes, check one of the following

Source

ESRD.RQMT_178

Normative Answer List LL1890-4

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Kidney
• Nominal
• Point in time
• Random
• Reason RRT discontinued
• Survey

68349-0 Date last dialysis treatment

Observation ID in Form

CMS-2746_13f

Observation Required in Panel

Required

Fully-Specified Name

Component

Date last dialysis treatment

Property

Date

Time

Pt

System

^Patient

Scale

Qn

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.50

Survey Question

Text

Date last dialysis treatment

Source

ESRD.RQMT_179

Member of these Panels

Related Names

• Dialy
• ESRD
• ESRD survey
• Past
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Survey
• Tx

68350-8 Was discontinuation renal replacement therapy after patient/family request to stop dialysis?

Observation ID in Form

CMS-2746_14

Observation Required in Panel

Required

Fully-Specified Name

Component

Discontinuation renal replacement therapy request of patient or family

Property

Find

Time

Pt

System

^Patient

Scale

Ord

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.44

Survey Question

Text

Was discontinuation renal replacement therapy after patient/family request to stop dialysis?

Source

ESRD.RQMT_180

Normative Answer List LL1362-4

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Finding
• Findings
• Kidney
• Ordinal
• Point in time
• QL
• Qual
• Qualitative
• Random
• RRT stop request pt-family
• Screen
• Survey

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

68351-6 Date of most recent transplant

Term Description

If deceased ever received a transplant
Source: Regenstrief LOINC

Observation ID in Form

CMS-2746_15a

Observation Required in Panel

Optional

Fully-Specified Name

Component

Date most recent transplant

Property

Date

Time

Pt

System

^Patient

Scale

Qn

Method

Basic Attributes

Class

SURVEY.ESRD

Type

Surveys

First Released

Version 2.38

Last Updated

Version 2.50

Survey Question

Text

Date of most recent transplant

Source

ESRD.RQMT_181

Member of these Panels

Related Names

• ESRD
• ESRD survey
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Survey

68332-6 Type of donor

Observation ID in Form

CMS-2746_15b

Observation Required in Panel

Optional

Fully-Specified Name

Component

Donor

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method