85907-4

Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]

Deprecated

Status Information

Status: DEPRECATED

Term Description

This panel should be used for CMS OASIS-C2 Start of Care assessments performed between January 1, 2017 and December 31, 2018.

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC	Name	Cardinality	Example UCUM Units
85907-4	Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
Indent85908-2	Home Health Patient Tracking Sheet
IndentIndent69417-4	CMS Certification Number
IndentIndent46494-1	Branch State
IndentIndent46495-8	Branch ID Number
IndentIndent68468-8	National Provider Identifier (NPI) for the attending physician who has signed the plan of care
IndentIndent46496-6	Patient ID Number
IndentIndent46497-4	Start of Care Date		{mm/dd/yyyy}
IndentIndent54503-8	Patient Name
IndentIndentIndent45392-8	(First)
IndentIndentIndent45393-6	(MI)
IndentIndentIndent45394-4	(Last)
IndentIndentIndent45395-1	(Suffix)
IndentIndent46499-0	Patient State of Residence
IndentIndent45401-7	Patient ZIP Code
IndentIndent45397-7	Medicare Number
IndentIndent45396-9	Social Security Number
IndentIndent45400-9	Medicaid Number
IndentIndent21112-8	Birth Date		{mm/dd/yyyy}
IndentIndent46098-0	Gender
IndentIndent59362-4	Race/Ethnicity	1..6
IndentIndent57199-2	Current Payment Sources for Home Care	1..11
Indent57040-8	CLINICAL RECORD ITEMS
IndentIndent46500-5	Discipline of Person Completing Assessment
IndentIndent46501-3	Date Assessment Completed		{mm/dd/yyyy}
IndentIndent57200-8	This Assessment is Currently Being Completed for the Following Reason
IndentIndent57201-6	Date of Physician-ordered Start of Care (Resumption of Care)		{mm/dd/yyyy}
IndentIndent57202-4	Date of Referral		{mm/dd/yyyy}
IndentIndent57203-2	Episode Timing: Is the Medicare home health payment episode for which this assessment will define a case mix group an "early" episode or a "later" episode in the patient's current sequence of adjacent Medicare home health payment episodes?
Indent85909-0	PATIENT HISTORY AND DIAGNOSES
IndentIndent57204-0	From which of the following Inpatient Facilities was the patient discharged within the past 14 days?	1..7
IndentIndent86470-2	Inpatient Discharge Date (most recent)		{mm/dd/yyyy}
IndentIndent46504-7	Inpatient Facility Diagnosis: ICD-10-CM Code	1..6
IndentIndent46507-0	Diagnosis Requiring Medical or Treatment Regimen Change Within Past 14 Days	1..6
IndentIndent86469-4	Conditions Prior to Medical or Treatment Regimen Change or Inpatient Stay Within Past 14 Days	1..6
IndentIndent85911-6	Diagnoses, Symptom Control, and Optional Diagnoses
IndentIndentIndent85912-4	Primary Diagnosis
IndentIndentIndentIndent86255-7	Primary Diagnosis: ICD-10-code
IndentIndentIndentIndent85920-7	Primary Diagnosis Symptom Control Rating
IndentIndentIndentIndent85914-0	Optional Diagnosis: ICD-10-CM
IndentIndentIndentIndent86254-0	Optional Diagnosis: ICD-10-CM - multiple coding
IndentIndentIndent85913-2	Other Diagnoses	0..5
IndentIndentIndentIndent81885-6	Other Diagnoses: ICD-10-CM
IndentIndentIndentIndent85920-7	Other Diagnoses Symptom Control Rating
IndentIndentIndentIndent85914-0	Optional Diagnosis: ICD-10-CM
IndentIndentIndentIndent86254-0	Optional Diagnosis: ICD-10-CM - multiple coding
IndentIndent83243-6	Active Diagnoses-Comorbidities and Co-existing Conditions	0..2
IndentIndent46466-9	Therapies the patient receives at home	1..3
IndentIndent57319-6	Risk for Hospitalization: Which of the following signs or symptoms characterize this patient as at risk for hospitalization?	1..9
IndentIndent57206-5	Overall Status: Which description best fits the patient's overall status?
IndentIndent57207-3	Risk factors, either present or past, likely to affect health status and/or outcome	1..4
IndentIndent54567-3	Height and weight
IndentIndentIndent3137-7	Height (in inches)		[in_us];cm;m
IndentIndentIndent3141-9	Weight (in pounds)		[lb_av];kg
Indent85951-2	Living Arrangements
IndentIndent85950-4	Patient Living Situation: Which of the following best describes the patient's residential circumstance and availability of assistance?
Indent57042-4	SENSORY STATUS
IndentIndent57215-6	Vision (with corrective lenses if the patient usually wears them)
IndentIndent57216-4	Ability to Hear (with hearing aid or hearing appliance if normally used)
IndentIndent57217-2	Understanding of Verbal Content in patient's own language (with hearing aid or device if used)
IndentIndent57218-0	Speech and Oral (Verbal) Expression of Language (in patient's own language)
IndentIndent57219-8	Has this patient had a formal Pain Assessment using a standardized, validated pain assessment tool (appropriate to the patient's ability to communicate the severity of pain)?
IndentIndent57220-6	Frequency of pain interfering with patient's activity or movement
Indent85917-3	INTEGUMENTARY STATUS
IndentIndent57221-4	Pressure Ulcer Assessment: Was this patient assessed for Risk of Developing Pressure Ulcers?
IndentIndent57280-0	Does this patient have a Risk of Developing Pressure Ulcers?
IndentIndent85918-1	Does this patient have at least one Unhealed Pressure Ulcer at Stage 2 or Higher or designated as Unstageable?
IndentIndent85919-9	Current Number of Unhealed Pressure Ulcers at Each Stage
IndentIndentIndent55124-2	Number of Stage 2 pressure ulcers		{#}
IndentIndentIndent55125-9	Number of Stage 3 pressure ulcers		{#}
IndentIndentIndent55126-7	Number of Stage 4 pressure ulcers		{#}
IndentIndentIndent54893-3	Number of unstageable pressure ulcers due to non-removable dressing/device		{#}
IndentIndentIndent54946-9	Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar		{#}
IndentIndentIndent54950-1	Number of unstageable pressure ulcers with suspected deep tissue injury in evolution		{#}
IndentIndent57229-7	Status of Most Problematic Pressure Ulcer that is Observable
IndentIndent46536-9	Current Number of Stage 1 Pressure Ulcers		{#}
IndentIndent57231-3	Stage of Most Problematic Unhealed Pressure Ulcer that is Stageable
IndentIndent57232-1	Does this patient have a Stasis Ulcer?
IndentIndent57233-9	Current Number of Stasis Ulcer(s) that are Observable		{#}
IndentIndent57234-7	Status of Most Problematic Stasis Ulcer that is Observable
IndentIndent57235-4	Does this patient have a Surgical Wound?
IndentIndent57236-2	Status of Most Problematic Surgical Wound that is Observable
IndentIndent46534-4	Does this patient have a Skin Lesion or Open Wound (excluding bowel ostomy), other than those described above, that is receiving intervention by the home health agency?
Indent85921-5	RESPIRATORY STATUS
IndentIndent57237-0	When is the patient dyspneic or noticeably Short of Breath?
IndentIndent57238-8	Respiratory Treatments utilized at home	1..3
Indent85922-3	ELIMINATION STATUS
IndentIndent46552-6	Has this patient been treated for a Urinary Tract Infection in the past 14 days?
IndentIndent46553-4	Urinary Incontinence or Urinary Catheter Presence
IndentIndent57241-2	When does Urinary Incontinence occur?
IndentIndent46587-2	Bowel Incontinence Frequency
IndentIndent86471-0	Ostomy for Bowel Elimination: Does this patient have an ostomy for bowel elimination that (within the last 14 days): a) was related to an inpatient facility stay; or b) necessitated a change in medical or treatment regimen?
Indent57047-3	NEURO/EMOTIONAL/BEHAVIORAL STATUS
IndentIndent46589-8	Cognitive Functioning: Patient's current (day of assessment) level of alertness, orientation, comprehension, concentration, and immediate memory for simple commands.
IndentIndent58104-1	When Confused (Reported or Observed Within the Last 14 Days)
IndentIndent86495-9	When Anxious (Reported or Observed Within the Last 14 Days)
IndentIndent57242-0	Depression Screening: Has the patient been screened for depression, using a standardized, validated depression screening tool?
IndentIndentIndent58120-7	PHQ-2©
IndentIndentIndentIndent44250-9	Little interest or pleasure in doing things
IndentIndentIndentIndent44255-8	Feeling down, depressed, or hopeless?
IndentIndent46473-5	Cognitive, behavorial, and psychiatric symptoms that are demonstrated at least once a week (Reported or Observed)
IndentIndent46592-2	Frequency of Disruptive Behavior Symptoms (Reported or Observed): Any physical, verbal, or other disruptive/dangerous symptoms that are injurious to self or others or jeopardize personal safety.
IndentIndent46593-0	Is this patient receiving Psychiatric Nursing Services at home provided by a qualified psychiatric nurse?
Indent85923-1	ADL & IADLs
IndentIndent46595-5	Grooming: Current ability to tend safely to personal hygiene needs (specifically: washing face and hands, hair care, shaving or make up, teeth or denture care, or fingernail care).
IndentIndent46597-1	Current Ability to Dress Upper Body safely (with or without dressing aids) including undergarments, pullovers, front-opening shirts and blouses, managing zippers, buttons, and snaps.
IndentIndent46599-7	Current Ability to Dress Lower Body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes.
IndentIndent57243-8	Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair).
IndentIndent57244-6	Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode.
IndentIndent57245-3	Toileting Hygiene: Current ability to maintain perineal hygiene safely, adjust clothes and/or incontinence pads before and after using toilet, commode, bedpan, urinal. If managing ostomy, includes cleaning area around stoma, but not managing equipment.
IndentIndent57246-1	Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast.
IndentIndent85924-9	FUNCTIONAL ABILITIES and GOALS - SOC/ROC
IndentIndentIndent85925-6	Mobility
IndentIndentIndentIndent85926-4	Lying to Sitting on Side of Bed - SOC Performance
IndentIndentIndentIndent85927-2	Lying to Sitting on Side of Bed - Discharge Goal
IndentIndent57247-9	Ambulation/Locomotion: Current ability to walk safely, once in a standing position, or use a wheelchair, once in a seated position, on a variety of surfaces.
IndentIndent57248-7	Feeding or Eating: Current ability to feed self meals and snacks safely
IndentIndent57249-5	Current Ability to Plan and Prepare Light Meals (for example, cereal, sandwich) or reheat delivered meals safely.
IndentIndent46569-0	Ability to Use Telephone: Current ability to answer the phone safely, including dialing numbers, and effectively using the telephone to communicate.
IndentIndent58121-5	Prior Functioning ADL/IADL
IndentIndentIndent85070-1	Self-Care (specifically: grooming, dressing, bathing, and toileting hygiene)
IndentIndentIndent86185-6	Ambulation
IndentIndentIndent86186-4	Transfer
IndentIndentIndent86187-2	Household tasks (specifically: light meal preparation, laundry, shopping, and phone use.)
IndentIndent57254-5	Has this patient had a multi-factor Falls Risk Assessment using a standardized, validated assessment tool?
Indent85928-0	MEDICATIONS
IndentIndent57255-2	Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues?
IndentIndent57281-8	Medication Follow-up: Did the agency contact a physician (or physician-designee) by midnight of the next calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues?
IndentIndent57257-8	Patient/Caregiver High-Risk Drug Education: Has the patient/caregiver received instruction on special precautions for all high-risk medications (such as hypoglycemics, anticoagulants, etc.) and how and when to report problems that may occur?
IndentIndent57285-9	Management of Oral Medications: Patient's current ability to prepare and take all oral medications reliably and safely, including administration of the correct dosage at the appropriate times/intervals
IndentIndent57284-2	Management of Injectable Medications: Patient's current ability to prepare and take all prescribed injectable medications reliably and safely, including administration of correct dosage at the appropriate times/intervals
IndentIndent57196-8	Prior Medication Management: Indicate the patient's usual ability with managing oral and injectable medications prior to his/her most recent illness, exacerbation or injury.
IndentIndentIndent57258-6	Oral medications
IndentIndentIndent57259-4	Injectable medications
Indent57049-9	CARE MANAGEMENT
IndentIndent57306-3	Types and Sources of Assistance
IndentIndentIndent57260-2	ADL assistance (for example, transfer/ ambulation, bathing, dressing, toileting, eating/feeding)
IndentIndentIndent57261-0	IADL assistance (for example, meals, housekeeping, laundry, telephone, shopping, finances)
IndentIndentIndent57262-8	Medication administration (for example, oral, inhaled or injectable)
IndentIndentIndent57263-6	Medical procedures/treatments (for example, changing wound dressing, home exercise program)
IndentIndentIndent57264-4	Management of equipment (for example, oxygen, IV/infusion equipment, enteral/parenteral nutrition, ventilator therapy equipment or supplies)
IndentIndentIndent57265-1	Supervision and safety (for example, due to cognitive impairment)
IndentIndentIndent57266-9	Advocacy or facilitation of patient's participation in appropriate medical care (for example, transportation to or from appointments)
IndentIndent57267-7	How Often does the patient receive ADL or IADL assistance from any caregiver(s) (other than home health agency staff)?
Indent57050-7	THERAPY NEED AND PLAN OF CARE
IndentIndent57268-5	Therapy need: Number of therapy visits indicated (total of physical, occupational and speech-language pathology combined)		{#}
IndentIndent57197-6	Plan of Care Synopsis
IndentIndentIndent57269-3	Patient-specific parameters for notifying physician of changes in vital signs or other clinical findings
IndentIndentIndent57270-1	Diabetic foot care including monitoring for the presence of skin lesions on the lower extremities and patient/caregiver education on proper foot care
IndentIndentIndent57271-9	Fall prevention interventions
IndentIndentIndent57272-7	Depression intervention(s) such as medication, referral for other treatment, or a monitoring plan for current treatment and/or physician notified that patient screened positive for depression
IndentIndentIndent57273-5	Intervention(s) to monitor and mitigate pain
IndentIndentIndent57274-3	Intervention(s) to prevent pressure ulcers
IndentIndentIndent57275-0	Pressure ulcer treatment based on principles of moist wound healing OR order for treatment based on moist wound healing has been requested from physician

LOINC Names Get Info

Fully-Specified Name: Outcome and assessment information set (OASIS) form - version C2 - Start of care:-:Pt:^Patient:-:CMS Assessment
Long Common Name: Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]

Part Model Get Info

Component
Outcome and assessment information set (OASIS) form - version C2 - Start of care
LP249858-4
- Analyte
  Outcome and assessment information set (OASIS) form - version C2 - Start of care
  LP249858-4
  - Component Numerator
    Outcome and assessment information set (OASIS) form - version C2 - Start of care
    LP249858-4
    - Component Numerator Core
      Outcome and assessment information set (OASIS) form - version C2 - Start of care
      LP249858-4
    - 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
- Time Core
  Pt
  LP6960-1
- Time Modifier
  NULL
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 2.63
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=85907-4

LOINC Copyright

Copyright © Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. See https://loinc.org/license for the full LOINC copyright and license.