Status Information

Status
DEPRECATED

Term Description

This panel only includes the IRF-PAI items that are not a part of the FIM Instrument (an instrument copyrighted by UBFA, Inc ©1993, 2001). This panel should be used for CMS IRF-PAI v1.4 assessments performed between October 1, 2016 and September 30, 2017.

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINCNameR/O/CCardinalityExample UCUM Units
83265-9Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 1.4
Indent85410-9Discharge Information
IndentIndent52525-3Discharge Date{mm/dd/yyyy}
IndentIndent85411-7Patient discharged against medical advice?
IndentIndent85412-5Program Interruption(s)
IndentIndent85483-6Program Interruption Dates0..3
IndentIndentIndent85413-3Program Interruption Date1..1{mm/dd/yyyy}
IndentIndentIndent85414-1Program Return Date1..1{mm/dd/yyyy}
IndentIndent85415-8Was the patient discharged alive?
IndentIndent55128-3Patient's discharge destination/living setting
IndentIndent85417-4Discharge to Living With
IndentIndent85418-2Diagnosis for Interruption or Death
IndentIndent85419-0Complications during rehabilitation stay0..6
Indent85395-2Identification Information
IndentIndent85396-0Facility Information
IndentIndentIndent76696-4Facility Name
IndentIndentIndent69417-4Facility Medicare Provider Number
IndentIndent45397-7Patient Medicare Number
IndentIndent45400-9Patient Medicaid Number
IndentIndent45392-8Patient First Name
IndentIndent45394-4Patient Last Name
IndentIndent52463-7Patient Identification Number
IndentIndent21112-8Birth Date{mm/dd/yyyy}
IndentIndent45396-9Social Security Number
IndentIndent46098-0Gender
IndentIndent59362-4Race/Ethnicity0..6
IndentIndent45404-1Marital status
IndentIndent52539-4Zip Code of Patient's Pre-Hospital Residence
IndentIndent52455-3Admission Date{mm/dd/yyyy}
IndentIndent54593-9Assessment reference date - observation end date{mm/dd/yyyy}
IndentIndent85397-8Admission Class
IndentIndent85398-6Admit From
IndentIndent85399-4Pre-hospital Living Setting
IndentIndent85400-0Pre-hospital Living With
Indent85404-2Medical Information
IndentIndent85405-9Impairment Group - Admission
IndentIndentIndent85845-6Impairment Group
IndentIndent85406-7Impairment Group - Discharge
IndentIndentIndent85845-6Impairment Group
IndentIndent52797-8Etiologic Diagnosis1..3
IndentIndent85585-8Date of Onset of Impairment{mm/dd/yyyy}
IndentIndent75618-9Comorbid Conditions0..25
IndentIndent85407-5Are there any arthritis conditions recorded in items #21, #22, or #24 that meet all of the regulatory requirements for IRF classification (in 42 CFR 412.29(b)(2)(x), (xi), and (xii))?
IndentIndent54567-3Height and Weight
IndentIndentIndent3137-7Height on admission (in inches)[in_us];cm;m
IndentIndentIndent3141-9Weight on admission (in pounds)[lb_av];kg
IndentIndent85408-3Swallowing Status - Admission
IndentIndentIndent85846-4Swallowing Status
IndentIndent85409-1Swallowing Status - Discharge
IndentIndentIndent85846-4Swallowing Status
Indent85401-8Payer information
IndentIndent85813-4Payment Source
IndentIndentIndent85402-6Primary Source
IndentIndentIndent85403-4Secondary Source
Indent83266-7Quality Indicators - Admission
IndentIndent83251-9Hearing, Speech, and Vision
IndentIndentIndent83250-1Expression of Ideas and Wants
IndentIndentIndent83249-3Understanding Verbal Content (with hearing aid or device, if used and excluding language barriers)
IndentIndent83267-5Cognitive Patterns
IndentIndentIndent83248-5Should Brief Interview for Mental Status (C0200-C0500) be conducted?
IndentIndentIndent52491-8Brief Interview for Mental Status
IndentIndentIndentIndent52731-7Repetition of Three Words. Number of words repeated by patient after first attempt
IndentIndentIndentIndent54510-3Temporal Orientation: Year, Month, and Day
IndentIndentIndentIndentIndent52732-5Please tell me what year it is right now
IndentIndentIndentIndentIndent52733-3What month are we in right now?
IndentIndentIndentIndentIndent54609-3What day of the week is today?
IndentIndentIndentIndent52493-4Recall
IndentIndentIndentIndentIndent52735-8Recalls "sock"?
IndentIndentIndentIndentIndent52736-6Recalls "blue"?
IndentIndentIndentIndentIndent52737-4Recalls "bed"?
IndentIndentIndentIndent54614-3BIMS Summary Score{score}
IndentIndentIndent54615-0Should the Staff Assessment for Mental Status (C0900) be Conducted?
IndentIndentIndent83241-0Staff Assessment for Mental Status
IndentIndentIndentIndent83240-2Memory/Recall Ability1..4
IndentIndent83268-3Functional Abilities and Goals - Admission
IndentIndentIndent83239-4Prior Functioning: Everyday Activities
IndentIndentIndentIndent85070-1Self-Care
IndentIndentIndentIndent85071-9Indoor Mobility (Ambulation)
IndentIndentIndentIndent85072-7Stairs
IndentIndentIndentIndent85073-5Functional Cognition
IndentIndentIndent83234-5Prior Device Use1..5
IndentIndentIndent83233-7Self-Care - Admission Performance
IndentIndentIndentIndent83232-9Eating
IndentIndentIndentIndent83230-3Oral hygiene
IndentIndentIndentIndent83228-7Toileting hygiene
IndentIndentIndentIndent83226-1Shower/bathe self
IndentIndentIndentIndent83224-6Upper body dressing
IndentIndentIndentIndent83222-0Lower body dressing
IndentIndentIndentIndent83220-4Putting on/taking off footwear
IndentIndentIndent85054-5Self-Care - Discharge Goal
IndentIndentIndentIndent83231-1Eating
IndentIndentIndentIndent83229-5Oral hygiene
IndentIndentIndentIndent83227-9Toileting hygiene
IndentIndentIndentIndent83225-3Shower/bathe self
IndentIndentIndentIndent83223-8Upper body dressing
IndentIndentIndentIndent83221-2Lower body dressing
IndentIndentIndentIndent83219-6Putting on/taking off footwear
IndentIndentIndent83269-1Mobility - Admission Performance
IndentIndentIndentIndent83218-8Roll left and right
IndentIndentIndentIndent83216-2Sit to lying
IndentIndentIndentIndent83214-7Lying to sitting on side of bed
IndentIndentIndentIndent83212-1Sit to stand
IndentIndentIndentIndent83210-5Chair/bed-to-chair transfer
IndentIndentIndentIndent83208-9Toilet transfer
IndentIndentIndentIndent83206-3Car transfer
IndentIndentIndentIndent83270-9Does the patient walk?
IndentIndentIndentIndent83204-8Walk 10 feet
IndentIndentIndentIndent83202-2Walk 50 feet with two turns
IndentIndentIndentIndent83200-6Walk 150 feet
IndentIndentIndentIndent83198-2Walking 10 feet on uneven surfaces
IndentIndentIndentIndent83196-61 step (curb)
IndentIndentIndentIndent83194-14 steps
IndentIndentIndentIndent83192-512 steps
IndentIndentIndentIndent83190-9Picking up object
IndentIndentIndentIndent83271-7Does the patient use a wheelchair/scooter?
IndentIndentIndentIndent83188-3Wheel 50 feet with two turns
IndentIndentIndentIndent83272-5Indicate the type of wheelchair/scooter used
IndentIndentIndentIndent83235-2Wheel 150 feet
IndentIndentIndentIndent83272-5Indicate the type of wheelchair/scooter used
IndentIndentIndent85056-0Mobility - Discharge Goal
IndentIndentIndentIndent83217-0Roll left and right
IndentIndentIndentIndent83215-4Sit to lying
IndentIndentIndentIndent83213-9Lying to sitting on side of bed
IndentIndentIndentIndent83211-3Sit to stand
IndentIndentIndentIndent83209-7Chair/Bed-to-chair transfer
IndentIndentIndentIndent83207-1Toilet transfer
IndentIndentIndentIndent83205-5Car transfer
IndentIndentIndentIndent83203-0Walk 10 feet
IndentIndentIndentIndent83201-4Walk 50 feet with two turns
IndentIndentIndentIndent83199-0Walk 150 feet
IndentIndentIndentIndent83197-4Walking 10 feet on uneven surfaces
IndentIndentIndentIndent83195-81 step (curb)
IndentIndentIndentIndent83193-34 steps
IndentIndentIndentIndent83191-712 steps
IndentIndentIndentIndent83189-1Picking up object
IndentIndentIndentIndent83187-5Wheel 50 feet with two turns
IndentIndentIndentIndent83236-0Wheel 150 feet
IndentIndent83237-8Bladder and Bowel
IndentIndentIndent83238-6Bladder continence
IndentIndentIndent83242-8Bowel continence
IndentIndent83264-2Active diagnoses
IndentIndentIndent83243-6Comorbidities and Co-existing Conditions1..2
IndentIndent83273-3Health Conditions - Admission
IndentIndentIndent52552-7History of Falls. Has the patient had two or more falls in the past year or any fall with injury in the past year?
IndentIndentIndent83274-1Prior Surgery. Did the resident have major surgery during the 100 days prior to admission?
IndentIndent83244-4Swallowing/Nutritional Status
IndentIndentIndent83245-1Swallowing/Nutritional Status1..3
IndentIndent85055-2Skin Conditions - Admission
IndentIndentIndent58214-8Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndentIndent83246-9Current Number of Unhealed Pressure Ulcers at Each Stage - Admission
IndentIndentIndentIndent54884-2Number of Stage 1 pressure ulcers{#}
IndentIndentIndentIndent55124-2Number of Stage 2 pressure ulcers{#}
IndentIndentIndentIndent55125-9Number of Stage 3 pressure ulcers{#}
IndentIndentIndentIndent55126-7Number of Stage 4 pressure ulcers{#}
IndentIndentIndentIndent54893-3Number of unstageable pressure ulcers due to non-removable dressing/device{#}
IndentIndentIndentIndent54946-9Number of pressure unstageable ulcers due to coverage of wound bed by slough and/or eschar{#}
IndentIndentIndentIndent54950-1Number of unstageable pressure ulcers with suspected deep tissue injury in evolution{#}
IndentIndent83261-8Special Treatments, Procedures, and Programs - Admission
IndentIndentIndent83252-7Special Treatments, Procedures, and Programs0..1
Indent83275-8Quality Indicators - Discharge
IndentIndent83276-6Functional Abilities and Goals - Discharge
IndentIndentIndent83254-3Self-Care - Discharge Performance
IndentIndentIndentIndent83232-9Eating
IndentIndentIndentIndent83230-3Oral hygiene
IndentIndentIndentIndent83228-7Toileting hygiene
IndentIndentIndentIndent83226-1Shower/bathe self
IndentIndentIndentIndent83224-6Upper body dressing
IndentIndentIndentIndent83222-0Lower body dressing
IndentIndentIndentIndent83220-4Putting on/taking off footwear
IndentIndentIndent83277-4Mobility - Discharge Performance
IndentIndentIndentIndent83218-8Roll left and right
IndentIndentIndentIndent83216-2Sit to lying
IndentIndentIndentIndent83214-7Lying to sitting on side of bed
IndentIndentIndentIndent83212-1Sit to stand
IndentIndentIndentIndent83210-5Chair/bed-to-chair transfer
IndentIndentIndentIndent83208-9Toilet transfer
IndentIndentIndentIndent83206-3Car transfer
IndentIndentIndentIndent83278-2Does the patient walk?
IndentIndentIndentIndent83204-8Walk 10 feet
IndentIndentIndentIndent83202-2Walk 50 feet with two turns
IndentIndentIndentIndent83200-6Walk 150 feet
IndentIndentIndentIndent83198-2Walking 10 feet on uneven surfaces
IndentIndentIndentIndent83196-61 step (curb)
IndentIndentIndentIndent83194-14 steps
IndentIndentIndentIndent83192-512 steps
IndentIndentIndentIndent83190-9Picking up object
IndentIndentIndentIndent83271-7Does the patient use a wheelchair/scooter?
IndentIndentIndentIndent83188-3Wheel 50 feet with two turns
IndentIndentIndentIndent83272-5Indicate the type of wheelchairscooter used
IndentIndentIndentIndent83235-2Wheel 150 feet
IndentIndentIndentIndent83272-5Indicate the type of wheelchair/scooter used
IndentIndent83279-0Health Conditions - Discharge
IndentIndentIndent83280-8Any falls since admission. Has the patient had any falls since admission?
IndentIndentIndent54854-5Number of Falls Since Admission
IndentIndentIndentIndent54855-2No injury
IndentIndentIndentIndent54856-0Injury (except major)
IndentIndentIndentIndent54857-8Major injury
IndentIndent83281-6Skin Conditions - Discharge
IndentIndentIndent58214-8Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndentIndent83256-8Current Number of Unhealed Pressure Ulcers at Each Stage - Discharge
IndentIndentIndentIndent54884-2Number of Stage 1 pressure ulcers{#}
IndentIndentIndentIndent55124-2Number of Stage 2 pressure ulcers{#}
IndentIndentIndentIndent54886-7Number of these Stage 2 pressure ulcers that were present upon admission{#}
IndentIndentIndentIndent55125-9Number of Stage 3 pressure ulcers{#}
IndentIndentIndentIndent54887-5Number of these Stage 3 pressure ulcers that were present upon admission{#}
IndentIndentIndentIndent55126-7Number of Stage 4 pressure ulcers{#}
IndentIndentIndentIndent54890-9Number of these Stage 4 pressure ulcers that were present upon admission{#}
IndentIndentIndentIndent54893-3Number of unstageable pressure ulcers due to non-removable dressing{#}
IndentIndentIndentIndent54894-1Number of these unstageable pressure ulcers that were present upon admission{#}
IndentIndentIndentIndent54946-9Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar{#}
IndentIndentIndentIndent54947-7Number of these unstageable pressure ulcers that were present upon admission{#}
IndentIndentIndentIndent54950-1Number of unstageable pressure ulcers with suspected deep tissue injury in evolution{#}
IndentIndentIndentIndent54951-9Number of these unstageable pressure ulcers that were present upon admission{#}
IndentIndentIndent83282-4Worsening in Pressure Ulcer Status Since Admission
IndentIndentIndentIndent83283-2Stage 2{#}
IndentIndentIndentIndent83284-0Stage 3{#}
IndentIndentIndentIndent83285-7Stage 4{#}
IndentIndentIndentIndent83286-5Unstageable - Non-removable dressing{#}
IndentIndentIndentIndent83287-3Unstageable - Slough and/or eschar{#}
IndentIndentIndentIndent83288-1Unstageable - Deep tissue injury{#}
IndentIndentIndent83258-4Healed Pressure Ulcers
IndentIndentIndentIndent83260-0Stage 1{#}
IndentIndentIndentIndent54958-4Stage 2{#}
IndentIndentIndentIndent54959-2Stage 3{#}
IndentIndentIndentIndent54960-0Stage 4{#}
IndentIndent83247-7Special Treatments, Procedures, and Programs - Discharge
IndentIndentIndent69339-0Influenza Vaccine
IndentIndentIndentIndent55019-4Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season?
IndentIndentIndentIndent58131-4Date influenza vaccine received{mm/dd/yyyy}
IndentIndentIndentIndent55020-2If influenza vaccine not received, state reason:C
Indent85814-2Signature of Persons Completing the Assessment
IndentIndent85647-6Signature
IndentIndent85650-0Title
IndentIndent70158-1Date Information is Provided and Time
Indent85420-8Therapy Information
IndentIndent85494-3Week 1: Total Number of Minutes Provided
IndentIndentIndent85566-8Physical Therapy
IndentIndentIndentIndent85557-7Total minutes of individual therapymin
IndentIndentIndentIndent85558-5Total minutes of concurrent therapymin
IndentIndentIndentIndent85559-3Total minutes of group therapymin
IndentIndentIndentIndent85560-1Total minutes of co-treatment therapymin
IndentIndentIndent85561-9Occupational Therapy
IndentIndentIndentIndent85562-7Total minutes of individual therapymin
IndentIndentIndentIndent85563-5Total minutes of concurrent therapymin
IndentIndentIndentIndent85564-3Total minutes of group therapymin
IndentIndentIndentIndent85565-0Total minutes of co-treatment therapymin
IndentIndentIndent85493-5Speech-language Pathology
IndentIndentIndentIndent85492-7Total minutes of individual therapymin
IndentIndentIndentIndent85491-9Total minutes of concurrent therapymin
IndentIndentIndentIndent85490-1Total minutes of group therapymin
IndentIndentIndentIndent85489-3Total minutes of co-treatment therapymin
IndentIndent85495-0Week 2: Total Number of Minutes Provided
IndentIndentIndent85589-0Physical Therapy
IndentIndentIndentIndent85567-6Total minutes of individual therapymin
IndentIndentIndentIndent85568-4Total minutes of concurrent therapymin
IndentIndentIndentIndent85569-2Total minutes of group therapymin
IndentIndentIndentIndent85570-0Total minutes of co-treatment therapymin
IndentIndentIndent85590-8Occupational Therapy
IndentIndentIndentIndent85571-8Total minutes of individual therapymin
IndentIndentIndentIndent85572-6Total minutes of concurrent therapymin
IndentIndentIndentIndent85573-4Total minutes of group therapymin
IndentIndentIndentIndent85574-2Total minutes of co-treatment therapymin
IndentIndentIndent85591-6Speech-language Pathology
IndentIndentIndentIndent85575-9Total minutes of individual therapymin
IndentIndentIndentIndent85576-7Total minutes of concurrent therapymin
IndentIndentIndentIndent85577-5Total minutes of group therapymin
IndentIndentIndentIndent85578-3Total minutes of co-treatment therapymin

LOINC Names Get Info

Fully-Specified Name
Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 1.4:-:Pt:^Patient:-:CMS Assessment
Long Common Name
Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment]

Part Model Get Info

  • Component
    Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 1.4
    LP231646-3
    • Analyte
      Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 1.4
      LP231646-3
      • Component Numerator
        Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 1.4
        LP231646-3
        • Component Numerator Core
          Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 1.4
          LP231646-3
        • Component Numerator Core Suffix
          NULL
           
      • Component Denominator
        NULL
         
        • Component Denominator Core
          NULL
           
        • Component Denominator Core Suffix
          NULL
           
    • Challenge
      NULL
       
    • Adjustment
      NULL
       
    • Count
      NULL
       
  • Property
    -
    LP6769-6
  • Time
    Pt
    LP6960-1
  • System
    ^Patient
    LP310005-6
    • System Core
      NULL
       
    • Super System
      Patient
      LP6985-8
  • Scale
    -
    LP7747-1
  • Method
    CMS Assessment
    LP230524-3

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.73 (DEL)
Change Reason
Release 2.73: Status: LOINC will keep most current version and one prior version of CMS assessments active and discourage all older versions.;
Order vs. Observation
Order
Panel Type
Panel

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=83265-9
Questionnaire definition
https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/83265-9