LL4681-4
CMS_LCDS v4 Functional abilities & goals
Active
Basic Properties
- OID
- 1.3.6.1.4.1.12009.10.1.3590
- Name
- CMS_LCDS v4 Functional abilities & goals
- Description
- Answers: 10; Scale: Ord; Code: 1-88; Score: -
- LOINCs using this list
- 132
Answer List
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Independent - Patient completes the activity by themself with no assistance from a helper. | 06 | LA9983-3 | |
| Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. | 05 | LA10073-7 | |
| Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. | 04 | LA28225-3 | |
| Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort. | 03 | LA10055-4 | |
| Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. | 02 | LA11759-0 | |
| Dependent - Helper does all of the effort. Patient does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the patient to complete the activity. | 01 | LA27665-1 | |
| Patient refused | 07 | LA10058-8 | |
| Not applicable - Not attempted and the patient did not perform this activity prior to the current illness, exacerbation, or injury. | 09 | LA28226-1 | |
| Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints) | 10 | LA28227-9 | |
| Not attempted due to medical condition or safety concerns | 88 | LA26735-3 |
LOINC terms using this Answer List
| 89421-2 | 1 step (curb) - functional ability during assessment period [CMS Assessment] |
| 89419-6 | 12 steps - functional ability during assessment period [CMS Assessment] |
| 89417-0 | 4 steps - functional ability during assessment period [CMS Assessment] |
| 94968-5 | Answering telephone call - most dependent performance during the past month [CMS Assessment] |
| 94981-8 | Answering telephone call - usual functional ability during assessment period [CMS Assessment] |
| 89415-4 | Bed-to-chair transfer - functional ability during assessment period [CMS Assessment] |
| 89413-9 | Car transfer - functional ability during assessment period [CMS Assessment] |
| 89412-1 | Car transfer - functional goal during assessment period [CMS Assessment] |
| 94946-1 | Car transfer - most dependent performance during the past month [CMS Assessment] |
| 95005-5 | Car transfer - usual functional ability during assessment period [CMS Assessment] |
| 94956-0 | Carries something in both hands - most dependent performance during the past month [CMS Assessment] |
| 94995-8 | Carries something in both hands - usual functional ability during assessment period [CMS Assessment] |
| 89414-7 | Chair/bed-to-chair transfer - functional goal during assessment period [CMS Assessment] |
| 94944-6 | Chair/bed-to-chair transfer - most dependent performance during the past month [CMS Assessment] |
| 95007-1 | Chair/bed-to-chair transfer - usual functional ability during assessment period [CMS Assessment] |
| 101597-3 | CMS - Tub and or shower transfer - functional goal [CMS Assessment] |
| 94974-3 | Complex financial management - most dependent performance during the past month [CMS Assessment] |
| 94987-5 | Complex financial management - usual functional ability during assessment period [CMS Assessment] |
| 89410-5 | Eating - functional ability during assessment period [CMS Assessment] |
| 89409-7 | Eating - functional goal during assessment period [CMS Assessment] |
| 94933-9 | Eating - most dependent performance during the past month [CMS Assessment] |
| 95019-6 | Eating - usual functional ability during assessment period [CMS Assessment] |
| 89418-8 | Go up and down 12 steps - functional goal during assessment period [CMS Assessment] |
| 94953-7 | Go up and down 12 steps - most dependent performance during the past month [CMS Assessment] |
| 94998-2 | Go up and down 12 steps - usual functional ability during assessment period [CMS Assessment] |
| 89416-2 | Go up and down 4 steps - functional goal during assessment period [CMS Assessment] |
| 94952-9 | Go up and down 4 steps - most dependent performance during the past month [CMS Assessment] |
| 94999-0 | Go up and down 4 steps - usual functional ability during assessment period [CMS Assessment] |
| 89420-4 | Go up and down a curb/step - functional goal during assessment period [CMS Assessment] |
| 94951-1 | Go up and down a curb/step - most dependent performance during the past month [CMS Assessment] |
| 95000-6 | Go up and down a curb/step - usual functional ability during assessment period [CMS Assessment] |
| 94966-9 | Heavier periodic housework - most dependent performance during the past month [CMS Assessment] |
| 94979-2 | Heavier periodic housework - usual functional ability during assessment period [CMS Assessment] |
| 94965-1 | Light daily housework - most dependent performance during the past month [CMS Assessment] |
| 94978-4 | Light daily housework - usual functional ability during assessment period [CMS Assessment] |
| 94980-0 | Light shopping - usual functional ability during assessment period [CMS Assessment] |
| 94967-7 | Light shopping- most dependent performance during the past month [CMS Assessment] |
| 89407-1 | Lower body dressing - functional ability during assessment period [CMS Assessment] |
| 89406-3 | Lower body dressing - functional goal during assessment period [CMS Assessment] |
| 94938-8 | Lower body dressing - most dependent performance during the past month [CMS Assessment] |
| 95013-9 | Lower body dressing - usual functional ability during assessment period [CMS Assessment] |
| 94942-0 | Lying to sitting on side of bed - most dependent performance during the past month [CMS Assessment] |
| 95009-7 | Lying to sitting on side of bed - usual functional ability during assessment period [CMS Assessment] |
| 94963-6 | Makes a light cold meal - most dependent performance during the past month [CMS Assessment] |
| 94976-8 | Makes a light cold meal - usual functional ability during assessment period [CMS Assessment] |
| 94964-4 | Makes a light hot meal - most dependent performance during the past month [CMS Assessment] |
| 94977-6 | Makes a light hot meal - usual functional ability during assessment period [CMS Assessment] |
| 101325-9 | MDS v3.0 - RAI v1.18.11 - Tub/shower transfer - functional goal [CMS Assessment] |
| 94971-9 | Medication management.inhalant/mist medications - most dependent performance during the past month [CMS Assessment] |
| 94984-2 | Medication management.inhalant/mist medications - usual functional ability during assessment period [CMS Assessment] |
| 94972-7 | Medication management.injectable medications - most dependent performance during the past month [CMS Assessment] |
| 94985-9 | Medication management.injectable medications - usual functional ability during assessment period [CMS Assessment] |
| 94970-1 | Medication management.oral medications - most dependent performance during the past month [CMS Assessment] |
| 94983-4 | Medication management.oral medications - usual functional ability during assessment period [CMS Assessment] |
| 89405-5 | Oral hygiene - functional ability during assessment period [CMS Assessment] |
| 89404-8 | Oral hygiene - functional goal during assessment period [CMS Assessment] |
| 94934-7 | Oral hygiene - most dependent performance during the past month [CMS Assessment] |
| 95018-8 | Oral hygiene - usual functional ability during assessment period [CMS Assessment] |
| 89403-0 | Picking up object - functional ability during assessment period [CMS Assessment] |
| 89402-2 | Picking up object - functional goal during assessment period [CMS Assessment] |
| 94954-5 | Picking up object - most dependent performance during the past month [CMS Assessment] |
| 94997-4 | Picking up object - usual functional ability during assessment period [CMS Assessment] |
| 94969-3 | Placing telephone call - most dependent performance during the past month [CMS Assessment] |
| 94982-6 | Placing telephone call - usual functional ability during assessment period [CMS Assessment] |
| 89401-4 | Putting on and taking off footwear - functional ability during assessment period [CMS Assessment] |
| 89400-6 | Putting on and taking off footwear - functional goal during assessment period [CMS Assessment] |
| 94939-6 | Putting on and taking off footwear - most dependent performance during the past month [CMS Assessment] |
| 95012-1 | Putting on/taking off footwear - usual functional ability during assessment period [CMS Assessment] |
| 89399-0 | Roll left and right - functional ability during assessment period [CMS Assessment] |
| 89398-2 | Roll left and right - functional goal during assessment period [CMS Assessment] |
| 94940-4 | Roll left and right - most dependent performance during the past month [CMS Assessment] |
| 95011-3 | Roll left and right - usual functional ability during assessment period [CMS Assessment] |
| 89397-4 | Shower/bathe self - functional ability during assessment period [CMS Assessment] |
| 89396-6 | Shower/bathe self - functional goal during assessment period [CMS Assessment] |
| 94936-2 | Shower/bathe self - most dependent performance during the past month [CMS Assessment] |
| 95015-4 | Shower/bathe self - usual functional ability during assessment period [CMS Assessment] |
| 94973-5 | Simple financial management - most dependent performance during the past month [CMS Assessment] |
| 94986-7 | Simple financial management - usual functional ability during assessment period [CMS Assessment] |
| 89395-8 | Sit to lying - functional ability during assessment period [CMS Assessment] |
| 89394-1 | Sit to lying - functional goal during assessment period [CMS Assessment] |
| 94941-2 | Sit to lying - most dependent performance during the past month [CMS Assessment] |
| 95010-5 | Sit to lying - usual functional ability during assessment period [CMS Assessment] |
| 89393-3 | Sit to stand - functional ability during assessment period [CMS Assessment] |
| 89392-5 | Sit to stand - functional goal during assessment period [CMS Assessment] |
| 94943-8 | Sit to stand - most dependent performance during the past month [CMS Assessment] |
| 95008-9 | Sit to stand - usual functional ability during assessment period [CMS Assessment] |
| 89390-9 | Toilet transfer - functional goal during assessment period [CMS Assessment] |
| 94945-3 | Toilet transfer - most dependent performance during the past month [CMS Assessment] |
| 95006-3 | Toilet transfer - usual functional ability during assessment period [CMS Assessment] |
| 89389-1 | Toileting hygiene - functional goal during assessment period [CMS Assessment] |
| 95043-6 | Toileting hygiene - most dependent performance during the past month [CMS Assessment] |
| 95017-0 | Toileting hygiene - usual functional ability during assessment period [CMS Assessment] |
| 89388-3 | Upper body dressing - functional ability during assessment period [CMS Assessment] |
| 89387-5 | Upper body dressing - functional goal during assessment period [CMS Assessment] |
| 94937-0 | Upper body dressing - most dependent performance during the past month [CMS Assessment] |
| 95014-7 | Upper body dressing - usual functional ability during assessment period [CMS Assessment] |
| 89386-7 | Walk 10 feet - functional ability during assessment period [CMS Assessment] |
| 89385-9 | Walk 10 feet - functional goal during assessment period [CMS Assessment] |
| 94947-9 | Walk 10 feet - most dependent performance during the past month [CMS Assessment] |
| 95004-8 | Walk 10 feet - usual functional ability during assessment period [CMS Assessment] |
| 89384-2 | Walk 150 feet - functional ability during assessment period [CMS Assessment] |
| 89383-4 | Walk 150 feet - functional goal during assessment period [CMS Assessment] |
| 94949-5 | Walk 150 feet - most dependent performance during the past month [CMS Assessment] |
| 95002-2 | Walk 150 feet - usual functional ability during assessment period [CMS Assessment] |
| 89382-6 | Walk 50 feet with two turns - functional ability during assessment period [CMS Assessment] |
| 89381-8 | Walk 50 feet with two turns - functional goal during assessment period [CMS Assessment] |
| 94948-7 | Walk 50 feet with two turns - most dependent performance during the past month [CMS Assessment] |
| 95003-0 | Walk 50 feet with two turns - usual functional ability during assessment period [CMS Assessment] |
| 89380-0 | Walking 10 feet on uneven surfaces - functional ability during assessment period [CMS Assessment] |
| 89379-2 | Walking 10 feet on uneven surfaces - functional goal during assessment period [CMS Assessment] |
| 94950-3 | Walking 10 feet on uneven surfaces - most dependent performance during the past month [CMS Assessment] |
| 95001-4 | Walking 10 feet on uneven surfaces - usual functional ability during assessment period [CMS Assessment] |
| 94958-6 | Walks across a street - most dependent performance during the past month [CMS Assessment] |
| 94993-3 | Walks across a street - usual functional ability during assessment period [CMS Assessment] |
| 94957-8 | Walks for 15 minutes - most dependent performance during the past month [CMS Assessment] |
| 94994-1 | Walks for 15 minutes - usual functional ability during assessment period [CMS Assessment] |
| 94955-2 | Walks indoors - most dependent performance during the past month [CMS Assessment] |
| 94996-6 | Walks indoors - usual functional ability during assessment period [CMS Assessment] |
| 94935-4 | Wash upper body - most dependent performance during the past month [CMS Assessment] |
| 95016-2 | Wash upper body - usual functional ability during assessment period [CMS Assessment] |
| 89378-4 | Wheel 150 feet - functional ability during assessment period [CMS Assessment] |
| 89377-6 | Wheel 150 feet - functional goal during assessment period [CMS Assessment] |
| 94960-2 | Wheel 150 feet - most dependent performance during the past month [CMS Assessment] |
| 94991-7 | Wheel 150 feet - usual functional ability during assessment period [CMS Assessment] |
| 89376-8 | Wheel 50 feet with two turns - functional ability during assessment period [CMS Assessment] |
| 89375-0 | Wheel 50 feet with two turns - functional goal during assessment period [CMS Assessment] |
| 94959-4 | Wheel 50 feet with two turns - most dependent performance during the past month [CMS Assessment] |
| 94992-5 | Wheel 50 feet with two turns - usual functional ability during assessment period [CMS Assessment] |
| 94962-8 | Wheels across a street - most dependent performance during the past month [CMS Assessment] |
| 94989-1 | Wheels across a street - usual functional ability during assessment period [CMS Assessment] |
| 94961-0 | Wheels for 15 minutes - most dependent performance during the past month [CMS Assessment] |
| 94990-9 | Wheels for 15 minutes - usual functional ability during assessment period [CMS Assessment] |
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