86264-9
Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
Deprecated
Status Information
- Status
- DEPRECATED
Term Description
This information is collected at discharge from home health agency other than Death at Home or Transfer to Inpatient Facility. This panel should be used for CMS OASIS-C2 Discharged from agency assessments performed between January 1, 2017 and December 31, 2018.
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 86264-9 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment] | |||
| Indent86257-3 | CLINICAL RECORD ITEMS | |||
| Indent Indent46500-5 | Discipline of Person Completing Assessment | |||
| Indent Indent46501-3 | Date Assessment Completed | {mm/dd/yyyy} | ||
| Indent Indent57200-8 | This Assessment is Currently Being Completed for the Following Reason | |||
| Indent86256-5 | PATIENT HISTORY AND DIAGNOSES | |||
| Indent Indent85915-7 | InfluenzaVaccine Data Collection Period: Does this episode of care (SOC/ROC to Transfer/Discharge) include any dates on or between October 1 and March 31? | |||
| Indent Indent57208-1 | Influenza Vaccine Received: Did the patient receive the influenza vaccine for this year's flu season | |||
| Indent Indent72057-3 | Pneumococcal vaccination been received | |||
| Indent Indent45956-0 | Reason Pneumococcal Vaccine not received: If patient has never received the pneumococcal vaccination (for example, pneumovax), state reason | |||
| Indent86266-4 | SENSORY STATUS | |||
| Indent Indent57218-0 | Speech and Oral (Verbal) Expression of Language (in patient's own language) | |||
| Indent Indent57220-6 | Frequency of pain interfering with patient's activity or movement | |||
| Indent86267-2 | INTEGUMENTARY STATUS | |||
| Indent Indent85918-1 | Does this patient have at least one Unhealed Pressure Ulcer at Stage 2 or Higher or designated as Unstageable? | |||
| Indent Indent57222-2 | The Oldest Stage 2 pressure ulcer that is present at discharge | |||
| Indent Indent58052-2 | Record date pressure ulcer first identified | {mm/dd/yyyy} | ||
| Indent Indent86270-6 | Current Number of Unhealed Pressure Ulcers at Each Stage | |||
| Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
| Indent Indent Indent54886-7 | Number of these Stage 2 pressure ulcers that were present at most recent SOC/ROC | {#} | ||
| Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
| Indent Indent Indent54887-5 | Number of these Stage 3 pressure ulcers that were present at most recent SOC/ROC | {#} | ||
| Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
| Indent Indent Indent54890-9 | Number of these Stage 4 pressure ulcers that were present at most recent SOC/ROC | {#} | ||
| Indent Indent Indent54893-3 | Number of unstageable pressure ulcers due to non-removable dressing/device | {#} | ||
| Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers that were present at most recent SOC/ROC | {#} | ||
| Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent Indent54947-7 | Number of these unstageable pressure ulcers that were present at most recent SOC/ROC | {#} | ||
| Indent Indent Indent54950-1 | Number of unstageable pressure ulcers with suspected deep tissue injury in evolution | {#} | ||
| Indent Indent Indent54951-9 | Number of these unstageable pressure ulcers that were present at most recent SOC/ROC | {#} | ||
| Indent Indent86268-0 | Worsening in Pressure Ulcer Status since SOC/ROC | |||
| Indent Indent Indent83283-2 | Stage 2 | {#} | ||
| Indent Indent Indent83284-0 | Stage 3 | {#} | ||
| Indent Indent Indent83285-7 | Stage 4 | {#} | ||
| Indent Indent Indent83286-5 | Unstageable - Known or likely but Unstageable due to non-removable dressing. | {#} | ||
| Indent Indent Indent83287-3 | Unstageable - Known or likely but Unstageable due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent Indent83288-1 | Unstageable - Suspected deep tissue injury in evolution. | {#} | ||
| Indent Indent57229-7 | Status of Most Problematic Pressure Ulcer that is Observable | |||
| Indent Indent46536-9 | Current Number of Stage 1 Pressure Ulcers | {#} | ||
| Indent Indent57231-3 | Stage of Most Problematic Unhealed Pressure Ulcer that is Stageable | |||
| Indent Indent57232-1 | Does this patient have a Stasis Ulcer? | |||
| Indent Indent57233-9 | Current Number of Stasis Ulcer(s) that are Observable | {#} | ||
| Indent Indent57234-7 | Status of Most Problematic Stasis Ulcer that is Observable | |||
| Indent Indent57235-4 | Does this patient have a Surgical Wound? | |||
| Indent Indent57236-2 | Status of Most Problematic Surgical Wound that is Observable | |||
| Indent86249-0 | RESPIRATORY STATUS | |||
| Indent Indent57237-0 | When is the patient dyspneic or noticeably Short of Breath? | |||
| Indent57045-7 | CARDIAC STATUS | |||
| Indent Indent57239-6 | Symptoms in Heart Failure Patients | |||
| Indent Indent57240-4 | Heart Failure Follow-up: If patient has been diagnosed with heart failure and has exhibited symptoms indicative of heart failure at the time of or at any time since the most recent SOC/ROC assessment, what action(s) has (have) been taken to respond? | 1..5 | ||
| Indent86269-8 | ELIMINATION STATUS | |||
| Indent Indent46552-6 | Has this patient been treated for a Urinary Tract Infection in the past 14 days? | |||
| Indent Indent46553-4 | Urinary Incontinence or Urinary Catheter Presence | |||
| Indent Indent57241-2 | When does Urinary Incontinence occur? | |||
| Indent Indent46587-2 | Bowel Incontinence Frequency | |||
| Indent69332-5 | NEURO/EMOTIONAL/BEHAVIORAL STATUS | |||
| Indent Indent46589-8 | Cognitive Functioning: Patient's current (day of assessment) level of alertness, orientation, comprehension, concentration, and immediate memory for simple commands. | |||
| Indent Indent58104-1 | When Confused (Reported or Observed Within the Last 14 Days) | |||
| Indent Indent86495-9 | When Anxious (Reported or Observed Within the Last 14 Days) | |||
| Indent Indent46473-5 | Cognitive, behavorial, and psychiatric symptoms that are demonstrated at least once a week (Reported or Observed): | 1..6 | ||
| Indent Indent46592-2 | 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. | |||
| Indent69337-4 | ADL/IADLs | |||
| Indent Indent46595-5 | 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). | |||
| Indent Indent46597-1 | 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. | |||
| Indent Indent46599-7 | Current Ability to Dress Lower Body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes. | |||
| Indent Indent57243-8 | Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair). | |||
| Indent Indent57244-6 | Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode. | |||
| Indent Indent57245-3 | 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. | |||
| Indent Indent57246-1 | Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast. | |||
| Indent Indent57247-9 | 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. | |||
| Indent Indent57248-7 | Feeding or Eating: Current ability to feed self meals and snacks safely | |||
| Indent Indent57249-5 | Current Ability to Plan and Prepare Light Meals (for example, cereal, sandwich) or reheat delivered meals safely. | |||
| Indent Indent46569-0 | Ability to Use Telephone: Current ability to answer the phone safely, including dialing numbers, and effectively using the telephone to communicate. | |||
| Indent86265-6 | MEDICATIONS | |||
| Indent Indent57256-0 | Medication Intervention | |||
| Indent Indent57195-0 | Patient/Caregiver Drug Education Intervention | |||
| Indent Indent57285-9 | 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 | |||
| Indent Indent57284-2 | 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 | |||
| Indent57049-9 | CARE MANAGEMENT | |||
| Indent Indent57306-3 | Types and Sources of Assistance | |||
| Indent Indent Indent57260-2 | ADL assistance (for example, transfer/ ambulation, bathing, dressing, toileting, eating/feeding) | |||
| Indent Indent Indent57261-0 | IADL assistance (for example, meals, housekeeping, laundry, telephone, shopping, finances) | |||
| Indent Indent Indent57262-8 | Medication administration (for example, oral, inhaled or injectable) | |||
| Indent Indent Indent57263-6 | Medical procedures/treatments (for example, changing wound dressing, home exercise program) | |||
| Indent Indent Indent57264-4 | Management of equipment (for example, oxygen, IV/infusion equipment, enteral/parenteral nutrition, ventilator therapy equipment or supplies) | |||
| Indent Indent Indent57265-1 | Supervision and safety (for example, due to cognitive impairment) | |||
| Indent Indent Indent57266-9 | Advocacy or facilitation of patient's participation in appropriate medical care (for example, transportation to or from appointments) | |||
| Indent Indent57267-7 | How Often does the patient receive ADL or IADL assistance from any caregiver(s) (other than home health agency staff)? | |||
| Indent57052-3 | EMERGENT CARE | |||
| Indent Indent57276-8 | Emergent Care: At the time of or at any time since the most recent SOC/ROC assessment has the patient utilized a hospital emergency department (includes holding/observation status)? | |||
| Indent Indent57277-6 | Reason For Emergent Care: For what reason(s) did the patient receive emergent care (with or without hospitalization)? | 1..19 | ||
| Indent69331-7 | DATA ITEMS COLLECTED AT INPATIENT FACILITY ADMISSION OR AGENCY ONLY | |||
| Indent Indent57198-4 | Intervention Synopsis: At the time of or at any time since the most recent SOC/ROC assessment, were the following interventions BOTH included in the physician-ordered plan or care AND implemented? | |||
| Indent Indent Indent57270-1 | Diabetic foot care including monitoring for the presence of skin lesions on the lower extremities and patient/caregiver education on proper foot care | |||
| Indent Indent Indent57271-9 | Falls prevention interventions | |||
| Indent Indent Indent57272-7 | Depression intervention(s) such as medication, referral for other treatment, or a monitoring plan for current treatment | |||
| Indent Indent Indent57273-5 | Intervention(s) to monitor and mitigate pain | |||
| Indent Indent Indent57274-3 | Intervention(s) to prevent pressure ulcers | |||
| Indent Indent Indent57275-0 | Pressure ulcer treatment based on principles of moist wound healing | |||
| Indent Indent46578-1 | To which Inpatient Facility has the patient been admitted? | |||
| Indent Indent55128-3 | Discharge disposition: Where is the patient after discharge from your agency? | 1..1 | ||
| Indent Indent46581-5 | Date of Last (Most Recent) Home Visit | {mm/dd/yyyy} | ||
| Indent Indent46582-3 | Discharge/Transfer/Death Date | {mm/dd/yyyy} |
LOINC Names Get Info
- Fully-Specified Name
- Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency:
-: Pt: ^Patient: -: CMS Assessment - Long Common Name
- Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
Part Model Get Info
- Component
- Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency
LP250706-1
- Analyte
- Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency
LP250706-1
- Component Numerator
- Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency
LP250706-1
- Component Numerator Core
- Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency
LP250706-1
- 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
Requests to this service require a free LOINC username and password. Below is a sample of the possible capabilities. See the LOINC Terminology Service documentation for more information.
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://