-3900
Property | Specification |
Data System | LTCH |
Data Specs | V4.00.1 |
Edit Type | Consistency |
Severity | Warning |
Edit Text | A dash (-) submitted in this item may result in a payment reduction for your facility of two percentage points for the affected payment determination. |
Version Notes |
[V4.00.0]-Removed references to C1610A, C1610B, C1610C, C1610D, C1610E1, C1610E2, O0250A, O0250C as they were deleted. Updated edit text. Unmapped items I5101, I5200, I5250, I5300, I5450, I5460 and I5470. Added mappings to A1110A, B0200, B1000, C0100, C0200, C0300A, C0300B, C0300C, C0400A, C0400B, C0400C, C0500, C1310A, C1310B, C1310C, C1310D, D0150A1, D0150A2, D0150B1, D0150B2, D0150C1, D0150C2, D0150D1, D0150D2, D0150E1, D0150E2, D0150F1, D0150F2, D0150G1, D0150G2, D0150H1, D0150H2, D0150I1, D0150I2, D0160, GG0170G1, GG0170G3, GG0170L1, GG0170L3, GG0170M1, GG0170M3, GG0170N1, GG0170N3, GG0170O1, GG0170O3, GG0170P1, GG0170P3, K0520A1, K0520A4, K0520A5, K0520B1, K0520B4, K0520B5, K0520C1, K0520C4, K0520C5, K0520D1, K0520D4, K0520D5, K0520Z1, K0520Z4, K0520Z5, M0300B1, M0300C1, M0300D1, M0300E1, M0300F1, M0300G1, N0415A1, N0415A2, N0415E1, N0415E2, N0415F1, N0415F2, N0415H1, N0415H2, N0415I1, N0415I2, N0415J1, N0415J2, O0110A1A, O0110A1C, O0110A2A, O0110A2C, O0110A3A, O0110A3C, O0110A10A, O0110A10C, O0110B1A, O0110B1C, O0110C1A, O0110C1C, O0110C2A, O0110C2C, O0110C3A, O0110C3C, O0110C4A, O0110C4C, O0110D1A, O0110D1C, O0110D2A, O0110D2C, O0110D3A, O0110D3C, O0110E1A, O0110E1C, O0110F1C, O0110G1A, O0110G1C, O0110G2A, I0110G2C, O0110G3A, O0110G3C, O0110H1A, O0110H1C, O0110H2A, O0110H2C, O0110H3A, O0110H3C, O0110H4A, O0110H4C, O0110H10A, O0110H10C, O0110I1A, O0110I1C, O0110J1A, O0110J1C, O0110J2A, O0110J2C, O0110J3A, O0110J3C, O0110O1A, O0110O1C, O0110O2A, O0110O2C, O0110O3A, O0110O3C, O0110O4A, O0110O4C, O0110Z1A, O0110Z1C, O0150A2. [V4.00.1] - Mapped edit to item N0415Z1. |
Item List | |
Item ID | Description |
A1110A | Preferred language |
B0100 | Comatose |
B0200 | Hearing |
B1000 | Vision |
BB0700 | Expression of Ideas and Wants (3-day asmt period) |
BB0800 | Understand Verbal/Non-Verbal Content (3-day asmt) |
C0100 | Brief Interview for Mental Status |
C0200 | Repetition of three words |
C0300A | Temporal Orientation: Able to report correct year |
C0300B | Temporal Orientation: Able to report correct month |
C0300C | Temporal Orientation: Able to report correct day |
C0400A | Recall: Able to recall "sock" |
C0400B | Recall: Able to recall "blue" |
C0400C | Recall: Able to recall "bed" |
C0500 | BIMS Summary Score |
C1310A | Delirium: Acute Onset Mental Status Change |
C1310B | Delirium: Inattention |
C1310C | Delirium: Disorganized thinking |
C1310D | Delirium: Altered level of consciousness |
D0150A1 | Mood: Little interest/pleasure doing things: Pres |
D0150A2 | Mood: Little interest/pleasure doing things: Freq |
D0150B1 | Mood: Feeling down, depressed, or hopeless: Pres |
D0150B2 | Mood: Feeling down, depressed, or hopeless: Freq |
D0150C1 | Mood: Trouble falling or staying asleep: Pres |
D0150C2 | Mood: Trouble falling or staying asleep: Freq |
D0150D1 | Mood: Feeling tired or having little energy: Pres |
D0150D2 | Mood: Feeling tired or having little energy: Freq |
D0150E1 | Mood: Poor appetite or overeating: Pres |
D0150E2 | Mood: Poor appetite or overeating: Freq |
D0150F1 | Mood: Feeling bad about yourself: Pres |
D0150F2 | Mood: Feeling bad about yourself: Freq |
D0150G1 | Mood: Trouble concentrating on things: Pres |
D0150G2 | Mood: Trouble concentrating on things: Freq |
D0150H1 | Mood: Moving or speaking so slowly: Pres |
D0150H2 | Mood: Moving or speaking so slowly: Freq |
D0150I1 | Mood: Thoughts of better off dead: Pres |
D0150I2 | Mood: Thoughts of better off dead: Freq |
D0160 | Total severity score |
GG0130A1 | Self-Care (Adm Perf) - Eating |
GG0130A3 | Self-Care (Dschg Perf) - Eating |
GG0130B1 | Self-Care (Adm Perf) - Oral hygiene |
GG0130B3 | Self-Care (Dschg Perf) - Oral hygiene |
GG0130C1 | Self-Care (Adm Perf) - Toileting hygiene |
GG0130C3 | Self-Care (Dschg Perf) - Toileting hygiene |
GG0130D1 | Self-Care (Adm Perf) - Wash upper body |
GG0130D3 | Self-Care (Dschg Perf) - Wash upper body |
GG0170A1 | Func Mobil (Adm Perf) - Roll left and right |
GG0170A3 | Func Mobil (Dschg Perf) - Roll left and right |
GG0170B1 | Func Mobil (Adm Perf) - Sit to lying |
GG0170B3 | Func Mobil (Dschg Perf) - Sit to lying |
GG0170C1 | Func Mobil (Adm Perf) - Lying to sitting on side |
GG0170C3 | Func Mobil (Dschg Perf) - Lying to sitting on side |
GG0170D1 | Func Mobil (Adm Perf) - Sit to stand |
GG0170D3 | Func Mobil (Dschg Perf) - Sit to stand |
GG0170E1 | Func Mobil (Adm Perf) - Chair/bed-to-chair trans |
GG0170E3 | Func Mobil (Dschg Perf) - Chair/bed-to-chair trans |
GG0170F1 | Func Mobil (Adm Perf) - Toilet transfer |
GG0170F3 | Func Mobil (Dschg Perf) - Toilet transfer |
GG0170G1 | Func Mobil (Adm Perf) - Car Transfer |
GG0170G3 | Mobil Perf (Dischrg Perf) - Car Transfer |
GG0170I1 | Func Mobil (Adm Perf) - Walk 10 feet |
GG0170I3 | Func Mobil (Dschg Perf) - Walk 10 feet |
GG0170J1 | Func Mobil (Adm Perf) - Walk 50 feet w/2 turns |
GG0170J3 | Func Mobil (Dschg Perf) - Walk 50 feet w/2 turns |
GG0170K1 | Func Mobil (Adm Perf) - Walk 150 feet |
GG0170K3 | Func Mobil (Dschg Perf) - Walk 150 feet |
GG0170L1 | Func Mobil (Adm Perf) - Walking 10ft uneven surf |
GG0170L3 | Func Mobil (Dschg Perf) - Walk 10ft uneven surf |
GG0170M1 | Func Mobil (Adm Perf) - 1 step (curb) |
GG0170M3 | Func Mobil (Dschg Perf) - 1 step (curb) |
GG0170N1 | Func Mobil (Adm Perf) - 4 steps |
GG0170N3 | Func Mobil (Dschg Perf) - 4 steps |
GG0170O1 | Func Mobil (Adm Perf) - 12 steps |
GG0170O3 | Func Mobil (Dschg Perf) - 12 steps |
GG0170P1 | Func Mobil (Adm Perf) - Picking up an object |
GG0170P3 | Func Mobil (Dschg Perf) - Picking up an object |
GG0170Q1 | Does the patient use a wheelchair and/or scooter |
GG0170Q3 | Does the patient use a wheelchair and/or scooter |
GG0170R1 | Func Mobil (Adm Perf) - Wheel 50 feet w/2 turns |
GG0170R3 | Func Mobil (Dschg Perf) - Wheel 50 feet w/2 turns |
GG0170RR1 | Indicate the type of wheelchair or scooter used |
GG0170RR3 | Indicate the type of wheelchair or scooter used |
GG0170S1 | Func Mobil (Adm Perf) - Wheel 150 feet |
GG0170S3 | Func Mobil (Dschg Perf) - Wheel 150 feet |
GG0170SS1 | Indicate the type of wheelchair or scooter used |
GG0170SS3 | Indicate the type of wheelchair or scooter used. |
H0350 | Bladder continence |
H0400 | Bowel continence |
I0900 | Peripheral vascular disease (PVD) or PAD |
I2900 | Diabetes mellitus (DM) |
J1900C | Num Falls Since Admission - Major injury |
K0200A | Height (in inches) |
K0200B | Weight (in pounds) |
K0520A1 | Nutritional Approaches (Admission): Parenteral |
K0520A4 | Nutritional Approaches (7 days): Parenteral |
K0520A5 | Nutritional Approaches (Discharge): Parenteral |
K0520B1 | Nutritional Approaches (Admission): Feeding tube |
K0520B4 | Nutritional Approaches (7 days): Feeding tube |
K0520B5 | Nutritional Approaches (Discharge): Feeding Tube |
K0520C1 | Nutritional Approaches (Admission) : Mech Alt Diet |
K0520C4 | Nutritional Approaches (7 days): Mech Alt Diet |
K0520C5 | Nutritional Approaches (Discharge): Mech Alt Diet |
K0520D1 | Nutritional Approaches (Admission) : Therapeutic |
K0520D4 | Nutritional Approaches (7 day): Therapeutic |
K0520D5 | Nutritional Approaches (Discharge): Therapeutic |
K0520Z1 | Nutritional Approaches (Admission) : None |
K0520Z4 | Nutritional Approaches (7 days): None |
K0520Z5 | Nutritional Approaches (Discharge): None |
M0300B1 | Stage 2 pressure ulcers: number present |
M0300B2 | Stage 2 pressure ulcers: number at admit |
M0300C1 | Stage 3 pressure ulcers: number present |
M0300C2 | Stage 3 pressure ulcers: number at admit |
M0300D1 | Stage 4 pressure ulcers: number present |
M0300D2 | Stage 4 pressure ulcers: number at admit |
M0300E1 | Unstageable due to dressing/device: number present |
M0300E2 | Unstageable due to dressing/device: number at adm |
M0300F1 | Unstageable slough/eschar: number present |
M0300F2 | Unstageable slough/eschar: number at admit |
M0300G1 | Unstageable as deep tissue: num present |
M0300G2 | Unstageable as deep tissue: num at adm |
N0415A1 | High-Risk Drug (Is Taking): Antipsychotic |
N0415A2 | High-Risk Drug (Indication) : Antipsychotic |
N0415E1 | High-Risk Drug (Is taking): Anticoagulant |
N0415E2 | High-Risk Drug (Indication): Anticoagulant |
N0415F1 | High-Risk Drug (Is taking): Antibiotic |
N0415F2 | High-Risk Drug (Indication): Antibiotic |
N0415H1 | High-Risk Drug (Is taking): Opioid |
N0415H2 | High-Drug Risk (Indication): Opioid |
N0415I1 | High-Risk Drug (Is taking): Antiplatelet |
N0415I2 | High-Risk Drug (Indication): Antiplatelet |
N0415J1 | High-Risk Drug (Is taking): Hypoglycemic |
N0415J2 | High-Risk Drug (Indication): Hypoglycemic |
N0415Z1 | High-Risk Drug (Is taking): None of the above |
N2001 | Drug Regimen Review |
N2003 | Medication Follow-up |
N2005 | Medication Intervention |
O0110A1A | Treatment: Chemotherapy (Admission) |
O0110A1C | Treatment: Chemotherapy (Discharge) |
O0110A2A | Treatment: Chemo - IV (Admission) |
O0110A2C | Treatment: Chemo - IV (Discharge) |
O0110A3A | Treatment: Chemo - Oral (Admission) |
O0110A3C | Treatment: Chemo - Oral (Discharge) |
O0110A10A | Treatment: Chemo - Other (Admission) |
O0110A10C | Treatment: Chemo - Other (Discharge) |
O0110B1A | Treatment: Radiation (Admission) |
O0110B1C | Treatment: Radiation (Discharge) |
O0110C1A | Therapies: Oxygen Therapy (Admission) |
O0110C1C | Therapies: Oxygen Therapy (Discharge) |
O0110C2A | Therapies: Oxygen - Continuous (Admission) |
O0110C2C | Therapies: Oxygen - Continuous (Discharge) |
O0110C3A | Therapies: Oxygen - Intermittent (Admission) |
O0110C3C | Therapies: Oxygen - Intermittent (Discharge) |
O0110C4A | Therapies: Oxygen - High-concentration (Admission) |
O0110C4C | Therapies: Oxygen - High-concentration (Discharge) |
O0110D1A | Therapies: Suctioning (Admission) |
O0110D1C | Therapies: Suctioning (Discharge) |
O0110D2A | Therapies: Suctioning - Scheduled (Admission) |
O0110D2C | Therapies: Suctioning - Scheduled (Discharge) |
O0110D3A | Therapies: Suctioning - As Needed (Admission) |
O0110D3C | Therapies: Suctioning - As Needed (Discharge) |
O0110E1A | Therapies: Tracheostomy Care (Admission) |
O0110E1C | Therapies: Tracheostomy Care (Discharge) |
O0110F1C | Therapies: Invasive Mechanical Ventilator (Disch) |
O0110G1A | Therapies: Non-Invas Mechanical Ventilator (Admis) |
O0110G1C | Therapies: Non-Invas Mechanical Ventilator (Disch) |
O0110G2A | Therapies: BiPAP (Admission) |
O0110G2C | Therapies: BiPAP (Discharge) |
O0110G3A | Therapies: CPAP (Admission) |
O0110G3C | Therapies: CPAP (Discharge) |
O0110H1A | Other: IV Medications (Admission) |
O0110H1C | Other: IV Medications (Discharge) |
O0110H2A | Other: IV - Vasoactive medications (Admission) |
O0110H2C | Other: IV - Vasoactive medications (Discharge) |
O0110H3A | Other: IV - Antibiotics (Admission) |
O0110H3C | Other: IV - Antibiotics (Discharge) |
O0110H4A | Other: IV - Anticoagulation (Admission) |
O0110H4C | Other: IV - Anticoagulation (Discharge) |
O0110H10A | Other: IV - Other (Admission) |
O0110H10C | Other: IV - Other (Discharge) |
O0110I1A | Other: Transfusions (Admission) |
O0110I1C | Other: Transfusions (Discharge) |
O0110J1A | Other: Dialysis (Admission) |
O0110J1C | Other: Dialysis (Discharge) |
O0110J2A | Other: Hemodialysis (Admission) |
O0110J2C | Other: Hemodialysis (Discharge) |
O0110J3A | Other: Peritoneal dialysis (Admission) |
O0110J3C | Other: Peritoneal dialysis (Discharge) |
O0110O1A | Other: IV Access (Admission) |
O0110O1C | Other: IV Access (Discharge) |
O0110O2A | Other: IV Access - Peripheral (Admission) |
O0110O2C | Other: IV Access - Peripheral (Discharge) |
O0110O3A | Other: IV Access - Midline (Admission) |
O0110O3C | Other: IV Access - Midline (Discharge) |
O0110O4A | Other: IV Access - Central (Admission) |
O0110O4C | Other: IV Access - Central (Discharge) |
O0110Z1A | Other: None of the above (Admission) |
O0110Z1C | Other: None of the above (Discharge) |
O0150A | SBT: Invasive Mechanical Ventilation Support |
O0150A2 | SBT: Ventilator Weaning Status |
O0150B | SBT: Assessed for readiness by day 2 |
O0150C | SBT: Deemed medically ready by day 2 |
O0150D | SBT: Documentation of reason(s) - patient unready |
O0150E | SBT: Performed by day 2 |
O0200A | Invasive Mechanical Ventilator - Liberation Status |
NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 03/21/2022 09:57:13 AM