88329-8
Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment]
Deprecated
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 v2.0 assessments performed between October 1, 2018 and September 30, 2019.
Source: Regenstrief LOINC
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
---|---|---|---|---|
88329-8 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment] | |||
Indent85395-2 | Identification Information | |||
Indent Indent85396-0 | Facility Information | |||
Indent Indent Indent76696-4 | Facility Name | |||
Indent Indent Indent69417-4 | Facility Medicare Provider Number | |||
Indent Indent45397-7 | Patient Medicare Number | |||
Indent Indent45400-9 | Patient Medicaid Number | |||
Indent Indent45392-8 | Patient First Name | |||
Indent Indent45394-4 | Patient Last Name | |||
Indent Indent52463-7 | Patient Identification Number | |||
Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
Indent Indent45396-9 | Social Security Number | |||
Indent Indent46098-0 | Gender | |||
Indent Indent59362-4 | Race/Ethnicity | 0..6 | ||
Indent Indent45404-1 | Marital Status | |||
Indent Indent52539-4 | Zip Code of Patient's Pre-Hospital Residence | |||
Indent Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
Indent Indent54593-9 | Assessment reference date - observation end date during assessment period [CMS Assessment] | {mm/dd/yyyy} | ||
Indent Indent85397-8 | Admission Class | |||
Indent Indent85398-6 | Admit From | |||
Indent Indent85399-4 | Pre-hospital Living Setting | |||
Indent Indent85400-0 | Pre-hospital Living With | |||
Indent85401-8 | Payer information | |||
Indent Indent85813-4 | Payment Source | |||
Indent Indent Indent85402-6 | Primary Source | |||
Indent Indent Indent85403-4 | Secondary Source | |||
Indent87415-6 | Medical Information | |||
Indent Indent85405-9 | Impairment Group - Admission | |||
Indent Indent Indent85845-6 | Impairment Group | |||
Indent Indent85406-7 | Impairment Group - Discharge | |||
Indent Indent Indent85845-6 | Impairment Group | |||
Indent Indent52797-8 | Etiologic Diagnosis | 1..3 | ||
Indent Indent85585-8 | Date of Onset of Impairment | {mm/dd/yyyy} | ||
Indent Indent75618-9 | Comorbid Conditions | 0..25 | ||
Indent Indent85407-5 | Are 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))? | |||
Indent Indent54567-3 | Height and Weight | |||
Indent Indent Indent3137-7 | Height on admission (in inches) | [in_us];cm;m | ||
Indent Indent Indent3141-9 | Weight on admission (in pounds) | [lb_av];kg | ||
Indent85410-9 | Discharge Information | |||
Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
Indent Indent85411-7 | Patient discharged against medical advice? | |||
Indent Indent85412-5 | Program Interruption(s) | |||
Indent Indent85483-6 | Program Interruption Dates | 0..3 | ||
Indent Indent Indent85413-3 | Program Interruption Date | 1..1 | {mm/dd/yyyy} | |
Indent Indent Indent85414-1 | Program Return Date | 1..1 | {mm/dd/yyyy} | |
Indent Indent85415-8 | Was the patient discharged alive? | |||
Indent Indent55128-3 | Patient's discharge destination/living setting | |||
Indent Indent85417-4 | Discharge to Living With | |||
Indent Indent85418-2 | Diagnosis for Interruption or Death | |||
Indent Indent85419-0 | Complications during rehabilitation stay | 0..6 | ||
Indent85420-8 | Therapy Information | |||
Indent Indent85494-3 | Week 1: Total Number of Minutes Provided | |||
Indent Indent Indent85566-8 | Physical Therapy | |||
Indent Indent Indent Indent85557-7 | Total minutes of individual therapy | min | ||
Indent Indent Indent Indent85558-5 | Total minutes of concurrent therapy | min | ||
Indent Indent Indent Indent85559-3 | Total minutes of group therapy | min | ||
Indent Indent Indent Indent85560-1 | Total minutes of co-treatment therapy | min | ||
Indent Indent Indent85561-9 | Occupational Therapy | |||
Indent Indent Indent Indent85562-7 | Total minutes of individual therapy | min | ||
Indent Indent Indent Indent85563-5 | Total minutes of concurrent therapy | min | ||
Indent Indent Indent Indent85564-3 | Total minutes of group therapy | min | ||
Indent Indent Indent Indent85565-0 | Total minutes of co-treatment therapy | min | ||
Indent Indent Indent85493-5 | Speech-Language Pathology | |||
Indent Indent Indent Indent85492-7 | Total minutes of individual therapy | min | ||
Indent Indent Indent Indent85491-9 | Total minutes of concurrent therapy | min | ||
Indent Indent Indent Indent85490-1 | Total minutes of group therapy | min | ||
Indent Indent Indent Indent85489-3 | Total minutes of co-treatment therapy | min | ||
Indent Indent85495-0 | Week 2: Total Number of Minutes Provided | |||
Indent Indent Indent85589-0 | Physical Therapy | |||
Indent Indent Indent Indent85567-6 | Total minutes of individual therapy | min | ||
Indent Indent Indent Indent85568-4 | Total minutes of concurrent therapy | min | ||
Indent Indent Indent Indent85569-2 | Total minutes of group therapy | min | ||
Indent Indent Indent Indent85570-0 | Total minutes of co-treatment therapy | min | ||
Indent Indent Indent85590-8 | Occupational Therapy | |||
Indent Indent Indent Indent85571-8 | Total minutes of individual therapy | min | ||
Indent Indent Indent Indent85572-6 | Total minutes of concurrent therapy | min | ||
Indent Indent Indent Indent85573-4 | Total minutes of group therapy | min | ||
Indent Indent Indent Indent85574-2 | Total minutes of co-treatment therapy | min | ||
Indent Indent Indent85591-6 | Speech-Language Pathology | |||
Indent Indent Indent Indent85575-9 | Total minutes of individual therapy | min | ||
Indent Indent Indent Indent85576-7 | Total minutes of concurrent therapy | min | ||
Indent Indent Indent Indent85577-5 | Total minutes of group therapy | min | ||
Indent Indent Indent Indent85578-3 | Total minutes of co-treatment therapy | min | ||
Indent88523-6 | Quality Indicators - Admission | |||
Indent Indent88522-8 | Hearing, Speech, and Vision | |||
Indent Indent Indent83250-1 | Expression of Ideas and Wants | |||
Indent Indent Indent87503-9 | Understanding Verbal and Non-Verbal Content | |||
Indent Indent88524-4 | Cognitive Patterns | |||
Indent Indent Indent83248-5 | Should Brief Interview for Mental Status (C0200-C0500) be Conducted? | |||
Indent Indent Indent52491-8 | Brief Interview for Mental Status | |||
Indent Indent Indent Indent52731-7 | Repetition of Three Words. Number of words repeated after first attempt | |||
Indent Indent Indent Indent54510-3 | Temporal Orientation (orientation to year, month, and day) | |||
Indent Indent Indent Indent Indent52732-5 | Able to report correct year | |||
Indent Indent Indent Indent Indent52733-3 | Able to report correct month | |||
Indent Indent Indent Indent Indent54609-3 | Able to report correct day of the week | |||
Indent Indent Indent Indent52493-4 | Recall | |||
Indent Indent Indent Indent Indent52735-8 | Able to recall "sock" | |||
Indent Indent Indent Indent Indent52736-6 | Able to recall "blue" | |||
Indent Indent Indent Indent Indent52737-4 | Able to recall "bed" | |||
Indent Indent Indent Indent54614-3 | BIMS Summary Score | {score} | ||
Indent Indent Indent54615-0 | Should the Staff Assessment for Mental Status (C0900) be Conducted? | |||
Indent Indent Indent88521-0 | Staff Assessment for Mental Status | |||
Indent Indent Indent Indent88333-0 | Memory/Recall Ability | 1..4 | ||
Indent Indent88482-5 | Functional Abilities and Goals - Admission | |||
Indent Indent Indent83239-4 | Prior Functioning: Everyday Activities | |||
Indent Indent Indent Indent85070-1 | Self-Care | |||
Indent Indent Indent Indent85071-9 | Indoor Mobility (Ambulation) | |||
Indent Indent Indent Indent85072-7 | Stairs | |||
Indent Indent Indent Indent85073-5 | Functional Cognition | |||
Indent Indent Indent83234-5 | Prior Device Use | 1..5 | ||
Indent Indent Indent83233-7 | Self-Care - Admission Performance | |||
Indent Indent Indent Indent83232-9 | Eating | |||
Indent Indent Indent Indent83230-3 | Oral hygiene | |||
Indent Indent Indent Indent83228-7 | Toileting hygiene | |||
Indent Indent Indent Indent83226-1 | Shower/bathe self | |||
Indent Indent Indent Indent83224-6 | Upper body dressing | |||
Indent Indent Indent Indent83222-0 | Lower body dressing | |||
Indent Indent Indent Indent83220-4 | Putting on/taking off footwear | |||
Indent Indent Indent85054-5 | Self-Care - Discharge Goal | |||
Indent Indent Indent Indent83231-1 | Eating | |||
Indent Indent Indent Indent83229-5 | Oral hygiene | |||
Indent Indent Indent Indent83227-9 | Toileting hygiene | |||
Indent Indent Indent Indent83225-3 | Shower/bathe self | |||
Indent Indent Indent Indent83223-8 | Upper body dressing | |||
Indent Indent Indent Indent83221-2 | Lower body dressing | |||
Indent Indent Indent Indent83219-6 | Putting on/taking off footwear | |||
Indent Indent Indent88330-6 | Mobility - Admission Performance | |||
Indent Indent Indent Indent83218-8 | Roll left and right | |||
Indent Indent Indent Indent83216-2 | Sit to lying | |||
Indent Indent Indent Indent83214-7 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent83212-1 | Sit to stand | |||
Indent Indent Indent Indent83210-5 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent83208-9 | Toilet transfer | |||
Indent Indent Indent Indent83206-3 | Car transfer | |||
Indent Indent Indent Indent83204-8 | Walk 10 feet | |||
Indent Indent Indent Indent83202-2 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent83200-6 | Walk 150 feet | |||
Indent Indent Indent Indent83198-2 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent83196-6 | 1 step (curb) | |||
Indent Indent Indent Indent83194-1 | 4 steps | |||
Indent Indent Indent Indent83192-5 | 12 steps | |||
Indent Indent Indent Indent83190-9 | Picking up object | |||
Indent Indent Indent Indent83271-7 | Does the patient use a wheelchair and/or scooter? | |||
Indent Indent Indent Indent83188-3 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent Indent83235-2 | Wheel 150 feet | |||
Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent85056-0 | Mobility - Discharge Goal | |||
Indent Indent Indent Indent83217-0 | Roll left and right | |||
Indent Indent Indent Indent83215-4 | Sit to lying | |||
Indent Indent Indent Indent83213-9 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent83211-3 | Sit to stand | |||
Indent Indent Indent Indent83209-7 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent83207-1 | Toilet transfer | |||
Indent Indent Indent Indent83205-5 | Car transfer | |||
Indent Indent Indent Indent83203-0 | Walk 10 feet | |||
Indent Indent Indent Indent83201-4 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent83199-0 | Walk 150 feet | |||
Indent Indent Indent Indent83197-4 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent83195-8 | 1 step (curb) | |||
Indent Indent Indent Indent83193-3 | 4 steps | |||
Indent Indent Indent Indent83191-7 | 12 steps | |||
Indent Indent Indent Indent83189-1 | Picking up object | |||
Indent Indent Indent Indent83187-5 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent83236-0 | Wheel 150 feet | |||
Indent Indent83237-8 | Bladder and Bowel | |||
Indent Indent Indent83238-6 | Bladder Continence | |||
Indent Indent Indent83242-8 | Bowel Continence | |||
Indent Indent83264-2 | Active Diagnoses | |||
Indent Indent Indent83243-6 | Comorbidities and Co-existing Conditions | 1..2 | ||
Indent Indent83273-3 | Health Conditions - Admission | |||
Indent Indent Indent52552-7 | History of Falls. Has the patient had two or more falls in the past year or any fall with injury in the past year? | |||
Indent Indent Indent83274-1 | Prior Surgery. Did the resident have major surgery during the 100 days prior to admission? | |||
Indent Indent83244-4 | Swallowing/Nutritional Status | |||
Indent Indent Indent83245-1 | Swallowing/Nutritional Status | 1..3 | ||
Indent Indent85055-2 | Skin Conditions - Admission | |||
Indent Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this patient have one or more unhealed pressure ulcers/injuries? | |||
Indent Indent Indent83246-9 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage - Admission | |||
Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure injuries | {#} | ||
Indent Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
Indent Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
Indent Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
Indent Indent Indent Indent54893-3 | Number of unstageable pressure ulcers/injuries due to non-removable dressing/device | {#} | ||
Indent Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
Indent Indent Indent Indent54950-1 | Number of unstageable pressure injuries presenting as deep tissue injury | {#} | ||
Indent Indent88872-7 | Medications | |||
Indent Indent Indent88870-1 | Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues? | |||
Indent Indent Indent88871-9 | Medication Follow-up: Did the facility 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? | |||
Indent Indent83261-8 | Special Treatments, Procedures, and Programs - Admission | |||
Indent Indent Indent83252-7 | Special Treatments, Procedures, and Programs | 0..1 | ||
Indent88525-1 | Quality Indicators - Discharge | |||
Indent Indent88483-3 | Functional Abilities and Goals - Discharge | |||
Indent Indent Indent83254-3 | Self-Care - Discharge Performance | |||
Indent Indent Indent Indent83232-9 | Eating | |||
Indent Indent Indent Indent83230-3 | Oral hygiene | |||
Indent Indent Indent Indent83228-7 | Toileting hygiene | |||
Indent Indent Indent Indent83226-1 | Shower/bathe self | |||
Indent Indent Indent Indent83224-6 | Upper body dressing | |||
Indent Indent Indent Indent83222-0 | Lower body dressing | |||
Indent Indent Indent Indent83220-4 | Putting on/taking off footwear | |||
Indent Indent Indent88331-4 | Mobility - Discharge Performance | |||
Indent Indent Indent Indent83218-8 | Roll left and right | |||
Indent Indent Indent Indent83216-2 | Sit to lying | |||
Indent Indent Indent Indent83214-7 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent83212-1 | Sit to stand | |||
Indent Indent Indent Indent83210-5 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent83208-9 | Toilet transfer | |||
Indent Indent Indent Indent83206-3 | Car transfer | |||
Indent Indent Indent Indent83204-8 | Walk 10 feet | |||
Indent Indent Indent Indent83202-2 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent83200-6 | Walk 150 feet | |||
Indent Indent Indent Indent83198-2 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent83196-6 | 1 step (curb) | |||
Indent Indent Indent Indent83194-1 | 4 steps | |||
Indent Indent Indent Indent83192-5 | 12 steps | |||
Indent Indent Indent Indent83190-9 | Picking up object | |||
Indent Indent Indent Indent83271-7 | Does the patient use a wheelchair and/or scooter? | |||
Indent Indent Indent Indent83188-3 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent Indent83235-2 | Wheel 150 feet | |||
Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair or scooter used | |||
Indent Indent83279-0 | Health Conditions - Discharge | |||
Indent Indent Indent83280-8 | Any Falls Since Admission. Has the patient had any falls since admission? | |||
Indent Indent Indent54854-5 | Number of Falls Since Admission | |||
Indent Indent Indent Indent54855-2 | No injury | |||
Indent Indent Indent Indent54856-0 | Injury (except major) | |||
Indent Indent Indent Indent54857-8 | Major injury | |||
Indent Indent88332-2 | Skin Conditions - Discharge | |||
Indent Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this patient have one or more unhealed pressure ulcers/injuries? | |||
Indent Indent Indent83256-8 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage - Discharge | |||
Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure injuries | {#} | ||
Indent Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
Indent Indent Indent Indent54886-7 | Number of these Stage 2 pressure ulcers that were present upon admission | {#} | ||
Indent Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
Indent Indent Indent Indent54887-5 | Number of these Stage 3 pressure ulcers that were present upon admission | {#} | ||
Indent Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
Indent Indent Indent Indent54890-9 | Number of these Stage 4 pressure ulcers that were present upon admission | {#} | ||
Indent Indent Indent Indent54893-3 | Number of unstageable pressure ulcers/injuries due to non-removable dressing/device | {#} | ||
Indent Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers/injuries that were present upon admission | {#} | ||
Indent Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
Indent Indent Indent Indent54947-7 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
Indent Indent Indent Indent54950-1 | Number of unstageable pressure injuries presenting as deep tissue injury | {#} | ||
Indent Indent Indent Indent54951-9 | Number of these unstageable pressure injuries that were present upon admission | {#} | ||
Indent Indent87522-9 | Medications | |||
Indent Indent Indent57256-0 | Did the facility contact and complete physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the admission? | |||
Indent Indent83247-7 | Special Treatments, Procedures, and Programs - Discharge | |||
Indent Indent Indent69339-0 | Influenza Vaccine | |||
Indent Indent Indent Indent55019-4 | Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
Indent Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
Indent Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | C |
Fully-Specified Name
- Component
- Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 2.0
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.64
- Last Updated
- Version 2.73
- 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.; Previous Releases: Removed "(IRF-PAI)" in the Component formal name to align with current LOINC model. The Component part in the Long Common Name will continue to include the acronym in parentheses.
- 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.
- CodeSystem lookup
- https:
//fhir.loinc.org/CodeSystem/$lookup?system=http: //loinc.org&code=88329-8 - Questionnaire definition
- https:
//fhir.loinc.org/Questionnaire/?url=http: //loinc.org/q/88329-8
LOINC Copyright
Copyright © 2024 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright