LOINC
Version 2.73

90480-5MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set [CMS Assessment]Active

Term Description

This panel should be used for CMS MDS 3.0 v1.17.1 IPA assessments performed between October 1, 2019 and September 30, 2020 and CMS MDS 3.0 v1.17.2 IPA assessments performed after October 1, 2020.
Source: Regenstrief LOINC

Panel Hierarchy
Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
90480-5 MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set [CMS Assessment]
Indent90503-4 Identification Information
IndentIndent58198-3 Type of Record
IndentIndent54581-4 Facility Provider Numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State Provider Number
IndentIndent85632-8 Type of Provider
IndentIndent90521-6 Optional State Assessment
IndentIndentIndent90522-4 Is this assessment for state payment purposes only?
IndentIndent90571-1 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent54587-1 Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry?
IndentIndentIndent58108-2 Entry/discharge reporting
IndentIndentIndent71440-2 Type of discharge
IndentIndent86526-1 Unit Certification or Licensure Designation
IndentIndent54503-8 Legal Name of Resident
IndentIndentIndent45392-8 First name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Last name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare Numbers
IndentIndentIndent45396-9 Social Security Number
IndentIndentIndent45397-7 Medicare number
IndentIndent45400-9 Medicaid Number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent59362-4 Race/Ethnicity 1..6
IndentIndent54505-3 Language
IndentIndentIndent54588-9 Does the resident need or want an interpreter to communicate with a doctor or health care staff?
IndentIndentIndent54899-0 Preferred language
IndentIndent45404-1 Marital Status
IndentIndent54506-1 Optional Resident Items
IndentIndentIndent46106-1 Medical record number
IndentIndentIndent45403-3 Room number
IndentIndentIndent52462-9 Name by which resident prefers to be addressed
IndentIndentIndent21843-8 Lifetime occupation(s)
IndentIndent54593-9 Assessment Reference Date. Observation end date {mm/dd/yyyy}
IndentIndent54507-9 Medicare Stay
IndentIndentIndent54594-7 Has the resident had a Medicare-covered stay since the most recent entry?
IndentIndentIndent54595-4 Start date of most recent Medicare stay {mm/dd/yyyy}
IndentIndentIndent54596-2 End date of most recent Medicare stay {mm/dd/yyyy}
Indent90505-9 Hearing, Speech, and Vision
IndentIndent54597-0 Comatose. Persistent vegetative state/no discernible consciousness
IndentIndent95737-3 Makes Self Understood. Ability to express ideas and wants, consider both verbal and non-verbal expression
Indent93050-3 Cognitive Patterns
IndentIndent54605-1 Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
IndentIndent52491-8 Brief Interview for Mental Status (BIMS)
IndentIndentIndent52731-7 Repetition of Three Words. Number of words repeated after first attempt
IndentIndentIndent54510-3 Temporal Orientation (orientation to year, month, and day)
IndentIndentIndentIndent52732-5 Able to report correct year
IndentIndentIndentIndent52733-3 Able to report correct month
IndentIndentIndentIndent54609-3 Able to report correct day of the week
IndentIndentIndent52493-4 Recall
IndentIndentIndentIndent52735-8 Able to recall "sock"
IndentIndentIndentIndent52736-6 Able to recall "blue"
IndentIndentIndentIndent52737-4 Able to recall "bed"
IndentIndentIndent54614-3 BIMS Summary Score {score}
IndentIndent54615-0 Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted?
IndentIndent86814-1 Staff Assessment for Mental Status
IndentIndentIndent54616-8 Short-term Memory OK. Seems or appears to recall after 5 minutes
IndentIndentIndent54624-2 Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life
Indent90482-1 Mood
IndentIndent54634-1 Should Resident Mood Interview be Conducted?
IndentIndent54635-8 Resident Mood Interview (PHQ-9)
IndentIndentIndent86843-0 Symptom Presence
IndentIndentIndentIndent54636-6 Little interest or pleasure in doing things
IndentIndentIndentIndent54638-2 Feeling down, depressed or hopeless
IndentIndentIndentIndent54640-8 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54642-4 Feeling tired or having little energy
IndentIndentIndentIndent54644-0 Poor appetite or overeating
IndentIndentIndentIndent54646-5 Feeling bad about yourself - or that you are a failure or have let yourself or your family down
IndentIndentIndentIndent54648-1 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54650-7 Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual
IndentIndentIndentIndent54652-3 Thoughts that you would be better off dead, or of hurting yourself in some way
IndentIndentIndent86844-8 Symptom Frequency
IndentIndentIndentIndent54637-4 Little interest or pleasure in doing things
IndentIndentIndentIndent54639-0 Feeling down, depressed or hopeless
IndentIndentIndentIndent54641-6 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54643-2 Feeling tired or having little energy
IndentIndentIndentIndent54645-7 Poor appetite or overeating
IndentIndentIndentIndent54647-3 Feeling bad about yourself - or that you are a failure or have let yourself or your family down
IndentIndentIndentIndent54649-9 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54651-5 Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual
IndentIndentIndentIndent54653-1 Thoughts that you would be better off dead, or of hurting yourself in some way
IndentIndent54654-9 Total Severity Score {score}
IndentIndent54657-2 Staff Assessment of Resident Mood (PHQ-9-OV)
IndentIndentIndent86833-1 Symptom Presence
IndentIndentIndentIndent54658-0 Little interest or pleasure in doing things
IndentIndentIndentIndent54660-6 Feeling or appearing down, depressed, or hopeless
IndentIndentIndentIndent54662-2 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54664-8 Feeling tired or having little energy
IndentIndentIndentIndent54666-3 Poor appetite or overeating
IndentIndentIndentIndent54668-9 Indicating that s/he feels bad about self, is a failure, or has let self or family down
IndentIndentIndentIndent54670-5 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54672-1 Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that s/he has been moving around a lot more than usual
IndentIndentIndentIndent54673-9 States that life isn't worth living, wishes for death, or attempts to harm self
IndentIndentIndentIndent54675-4 Being short-tempered, easily annoyed
IndentIndentIndent86891-9 Symptom Frequency
IndentIndentIndentIndent54659-8 Little interest or pleasure in doing things
IndentIndentIndentIndent54661-4 Feeling or appearing down, depressed, or hopeless
IndentIndentIndentIndent54663-0 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54665-5 Feeling tired or having little energy
IndentIndentIndentIndent54667-1 Poor appetite or overeating
IndentIndentIndentIndent54669-7 Indicating that s/he feels bad about self, is a failure, or has let self or family down
IndentIndentIndentIndent54671-3 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54904-8 Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that s/he has been moving around a lot more than usual
IndentIndentIndentIndent54674-7 States that life isn't worth living, wishes for death, or attempts to harm self
IndentIndentIndentIndent54676-2 Being short-tempered, easily annoyed
IndentIndent54677-0 Total Severity Score {score}
Indent86815-8 Behavior
IndentIndent86597-2 Potential Indicators of Psychosis 1..2
IndentIndent54514-5 Behavioral Symptom - Presence & Frequency
IndentIndentIndent54682-0 Physical behavioral symptoms directed toward others d/(7.d)
IndentIndentIndent54683-8 Verbal behavioral symptoms directed toward others d/(7.d)
IndentIndentIndent54684-6 Other behavioral symptoms not directed toward others d/(7.d)
IndentIndent54692-9 Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being? d/(7.d)
IndentIndent54693-7 Wandering - Presence & Frequency. Has the resident wandered? d/(7.d)
Indent90526-5 Functional Abilities and Goals - Interim Payment Assessment
IndentIndent90540-6 Self-Care - Interim Performance
IndentIndentIndent95019-6 Eating
IndentIndentIndent95018-8 Oral hygiene
IndentIndentIndent95017-0 Toileting hygiene
IndentIndent90541-4 Mobility - Interim Performance
IndentIndentIndent95010-5 Sit to lying
IndentIndentIndent95009-7 Lying to sitting on side of bed
IndentIndentIndent95008-9 Sit to stand
IndentIndentIndent95007-1 Chair/bed-to-chair transfer
IndentIndentIndent95006-3 Toilet transfer
IndentIndentIndent95004-8 Walk 10 feet
IndentIndentIndent95003-0 Walk 50 feet with two turns
IndentIndentIndent95002-2 Walk 150 feet
Indent90507-5 Bladder and Bowel
IndentIndent86624-4 Appliances 1..2
IndentIndent54769-5 Urinary Toileting Program. Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence?
IndentIndent88695-2 Bowel Toileting Program. Is a toileting program currently being used to manage the resident's bowel continence?
Indent90485-4 Active Diagnoses
IndentIndent89045-9 Indicate the resident's primary medical condition category 1..1
IndentIndent52797-8 ICD Code
IndentIndent86671-5 Active Diagnoses in the last 7 days 1..*
IndentIndent52797-8 Additional active diagnoses 0..10
Indent90488-8 Health Conditions
IndentIndent86889-3 Other Health Conditions
IndentIndentIndent86675-6 Shortness of Breath (dyspnea) 1..1
IndentIndentIndent86676-4 Problem Conditions 1..2
IndentIndent90542-2 Recent Surgery Requiring Active SNF Care-Did the resident have a major surgical procedure during the prior inpatient hospital stay that requires active care during the SNF stay?
IndentIndent90745-1 Surgical Procedures
Indent90509-1 Swallowing/Nutritional Status
IndentIndent86677-2 Swallowing Disorder. Signs and symptoms of possible swallowing disorder 1..4
IndentIndent54863-6 Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months
IndentIndent54568-1 Nutritional Approaches
IndentIndentIndent71444-4 Nutritional Approaches. While NOT a Resident 0..2
IndentIndentIndent71445-1 Nutritional Approaches. While a Resident 1..3
IndentIndent90543-0 Percent Intake by Artificial Route
IndentIndentIndent86681-4 Proportion of total calories the resident received through parenteral or tube feeding. While a Resident
IndentIndentIndent86687-1 Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days
IndentIndentIndent86683-0 Average fluid intake per day by IV or tube feeding. While a Resident mL/d;L/d
IndentIndentIndent86684-8 Average fluid intake per day by IV or tube feeding. During Entire 7 Days mL/d;L/d
Indent89051-7 Skin Conditions
IndentIndent58214-8 Unhealed Pressure Ulcers/Injuries. Does this resident have one or more unhealed pressure ulcers/injuries?
IndentIndent86892-7 Current Number of Unhealed Pressure Ulcers/Injuries 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 {#}
IndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndent54970-9 Number of Venous and Arterial Ulcers {#}
IndentIndent88696-0 Other Ulcers, Wounds and Skin Problems 1..6
IndentIndent86748-1 Skin and Ulcer/Injury Treatments 1..9
Indent90513-3 Medications
IndentIndent58217-1 Insulin
IndentIndentIndent58127-2 Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days d/(7.d)
IndentIndentIndent58128-0 Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days d/(7.d)
Indent90519-0 Special Treatments, Procedures, and Programs
IndentIndent86761-4 While a Resident 1..10
IndentIndent86849-7 Respiratory therapy
IndentIndentIndent45766-3 Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days d/(7.d)
IndentIndent86773-9 Restorative Nursing Programs
IndentIndentIndent86774-7 Technique. Range of motion (passive) d/(7.d)
IndentIndentIndent86775-4 Technique. Range of motion (active) d/(7.d)
IndentIndentIndent86776-2 Technique. Splint or brace assistance d/(7.d)
IndentIndentIndent86777-0 Training and Skill Practice In: Bed mobility d/(7.d)
IndentIndentIndent86778-8 Training and Skill Practice In: Transfer d/(7.d)
IndentIndentIndent86779-6 Training and Skill Practice In: Walking d/(7.d)
IndentIndentIndent86780-4 Training and Skill Practice In: Dressing and/or grooming d/(7.d)
IndentIndentIndent86781-2 Training and Skill Practice In: Eating and/or swallowing d/(7.d)
IndentIndentIndent86782-0 Training and Skill Practice In: Amputation/prostheses care d/(7.d)
IndentIndentIndent86783-8 Training and Skill Practice In: Communication d/(7.d)
Indent91579-3 Correction Request
IndentIndent85632-8 Type of Provider
IndentIndent87226-7 Name of Resident
IndentIndentIndent45392-8 Patient First (Given) name
IndentIndentIndent45394-4 Patient Last (Family) name
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent45396-9 Social Security Number
IndentIndent90522-4 Optional State Assessment. Is this assessment for state payment purposes only?
IndentIndent91580-1 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent58108-2 Entry/discharge reporting
IndentIndent54593-9 Date on existing record to be modified/inactivated. Assessment Reference Date {mm/dd/yyyy}
IndentIndent87209-3 Correction Attestation Section
IndentIndentIndent58200-7 Correction Number {#}
IndentIndentIndent87217-6 Reasons for Modification 1..5
IndentIndentIndent87225-9 Reasons for Inactivation 1..2
IndentIndentIndent87218-4 RN Assessment Coordinator Attestation of Completion
IndentIndentIndentIndent87219-2 Attesting individual's first name
IndentIndentIndentIndent87220-0 Attesting individual's last name
IndentIndentIndentIndent87221-8 Attesting individual's title
IndentIndentIndentIndent87222-6 Attestation date {mm/dd/yyyy}
Indent90495-3 Assessment Administration
IndentIndent90498-7 Medicare Part A Billing
IndentIndentIndent55065-7 Medicare Part A HIPPS code
IndentIndentIndent55081-4 Version code

Fully-Specified Name

Component
MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set
Property
-
Time
Pt
System
^Patient
Scale
-
Method
CMS Assessment

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.66
Last Updated
Version 2.68
Change Reason
Release 2.68: DefinitionDescription: Added missing Term Description; COMPONENT: Version 1.17.2 was added to the Component because this panel now represents both versions.; Release 2.67: DefinitionDescription: Added missing Term Description
Order vs. Observation
Order
Panel Type
Panel

LOINC FHIR® API Example - CodeSystem and Questionnaire Requests Get Info

https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=90480-5 https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/90480-5