| 88238-1 |
Functional Abilities and Goals |
|
|
|
| Indent85642-7 |
Prior Functioning: Everyday Activities |
|
|
|
| Indent Indent85071-9 |
Indoor Mobility (Ambulation) |
|
|
|
| Indent83234-5 |
Prior Device Use |
|
1..4 |
|
| Indent85667-4 |
Self-Care - Admission Performance |
|
|
|
| Indent Indent83232-9 |
Eating |
|
|
|
| Indent Indent83230-3 |
Oral hygiene |
|
|
|
| Indent Indent83228-7 |
Toileting hygiene |
|
|
|
| Indent Indent85652-6 |
Wash upper body |
|
|
|
| Indent85661-7 |
Self-Care - Discharge Goal |
|
|
|
| Indent Indent83231-1 |
Eating |
|
|
|
| Indent Indent83229-5 |
Oral hygiene |
|
|
|
| Indent Indent83227-9 |
Toileting hygiene |
|
|
|
| Indent Indent85653-4 |
Wash upper body |
|
|
|
| Indent87502-1 |
Mobility - Admission Performance |
|
|
|
| Indent Indent83218-8 |
Roll left and right |
|
|
|
| Indent Indent83216-2 |
Sit to lying |
|
|
|
| Indent Indent83214-7 |
Lying to sitting on side of bed |
|
|
|
| Indent Indent83212-1 |
Sit to stand |
|
|
|
| Indent Indent83210-5 |
Chair/bed-to-chair transfer |
|
|
|
| Indent Indent83208-9 |
Toilet transfer |
|
|
|
| Indent Indent83204-8 |
Walk 10 feet |
|
|
|
| Indent Indent83202-2 |
Walk 50 feet with two turns |
|
|
|
| Indent Indent83200-6 |
Walk 150 feet |
|
|
|
| Indent Indent83271-7 |
Does the patient use a wheelchair and/or scooter? |
|
|
|
| Indent Indent83188-3 |
Wheel 50 feet with two turns |
|
|
|
| Indent Indent83272-5 |
Indicate the type of wheelchair or scooter used |
|
|
|
| Indent Indent83235-2 |
Wheel 150 feet |
|
|
|
| Indent Indent83272-5 |
Indicate the type of wheelchair or scooter used |
|
|
|
| Indent85660-9 |
Mobility - Discharge Goal |
|
|
|
| Indent Indent83217-0 |
Roll left and right |
|
|
|
| Indent Indent83215-4 |
Sit to lying |
|
|
|
| Indent Indent83213-9 |
Lying to sitting on side of bed |
|
|
|
| Indent Indent83211-3 |
Sit to stand |
|
|
|
| Indent Indent83209-7 |
Chair/Bed-to-chair transfer |
|
|
|
| Indent Indent83207-1 |
Toilet transfer |
|
|
|
| Indent Indent83203-0 |
Walk 10 feet |
|
|
|
| Indent Indent83201-4 |
Walk 50 feet with two turns |
|
|
|
| Indent Indent83199-0 |
Walk 150 feet |
|
|
|
| Indent Indent83187-5 |
Wheel 50 feet with two turns |
|
|
|
| Indent Indent83236-0 |
Wheel 150 feet |
|
|
|
