Opportunities for Engaging Long-Term and Post-Acute Care Providers in Health Information Exchange Activities: Exchanging Interoperable Patient Assessment Information. MDS3.0 Items Mapping -- Model Of Meaning

12/01/2011

Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
A     Identification Information                
  A0100A   Facility National Provider Identifier (NPI)     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0100B   Facility CMS Certification Number (CCN)     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0100C   State provider number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0200   Type of provider     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0200 1 Nursing home (SNF/NF)                
  A0200 2 Swing bed                
  A0310A   Type of assessment: OBRA     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0310A 1 Admission assessment (required by day 14)                
  A0310A 2 Quarterly review assessment                
  A0310A 3 Annual assessment                
  A0310A 4 Significant change in status assessment                
  A0310A 5 Significant correction to prior comprehensive assessment                
  A0310A 6 Significant correction to prior quarterly assessment                
  A0310A 99 Not OBRA required assessment/ tracking                
  A0310B   Type of assessment: PPS     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0310B 1 5-day scheduled assessment                
  A0310B 2 14-day scheduled assessment                
  A0310B 3 30-day scheduled assessment                
  A0310B 4 60-day scheduled assessment                
  A0310B 5 90-day scheduled assessment                
  A0310B 6 Readmission/return assessment                
  A0310B 7 Unscheduled assessment used for PPS (OMRA, significant or clinical change, or significant correction assessment)                
  A0310B 99 Not a PPS assessment                
  A0310C   Type of assessment: OMRA     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0310C 0 No                
  A0310C 1 Start of therapy assessment                
  A0310C 2 End of therapy assessment                
  A0310C 3 Both Start and End of therapy assessment                
  A0310D   Swing bed clinical change assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0310D 0 No                
  A0310D 1 Yes                
  A0310E   First assessment since most recent entry     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0310E 0 No                
  A0310E 1 Yes                
  A0310F   Entry/discharge reporting     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0310F 1 Entry record                
  A0310F 10 Discharge assessment - return not anticipated                
  A0310F 11 Discharge assessment - return anticipated                
  A0310F 12 Death in facility record                
  A0310F 99 Not entry/discharge record                
  A0410   Submission requirement     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0410 1 Neither federal nor state required submission                
  A0410 2 State but not federal required submission (FOR NURSING HOMES ONLY)                
  A0410 3 Federal required submission                
  A0500A   Resident first name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0500B   Resident middle initial     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0500C   Resident last name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0500D   Resident name suffix     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0600A   Social Security Number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0600B   Resident Medicare/ railroad insurance number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0700   Resident Medicaid number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0800   Gender     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A0800 1 Male                
  A0800 2 Female                
  A0900   Birthdate     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1000A   Ethnicity: American Indian or Alaska Native *ONC Final Rule (7/28/2010) requires use of the Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, October 30, 1997. This is not a vocabulary.
*HITSP Component C-32 (HITSP Summary Documents Using HL7 Continuity of Care Document (CCD)) requires use of the CDC Race and Ethnicity vocabulary for reporting race and ethnicity (see Column Q).
*See DSTU for detailis on representation of Race/ Ethnicity data.
ETHNICITY PATTERN         1002-5  
  A1000B   Ethnicity: Asian   ETHNICITY PATTERN         2028-9  
  A1000C   Ethnicity: Black or African American   ETHNICITY PATTERN         2054-5  
  A1000D   Ethnicity: Hispanic or Latino   ETHNICITY PATTERN         2135-2  
  A1000E   Ethnicity: Native Hawaiian/Pacific Islander   ETHNICITY PATTERN         2076-8  
  A1000F   Ethnicity: White   ETHNICITY PATTERN         2106-3  
  A1100A   Does the resident need or want an interpreter   ASSERTION PATTERN            
  A1100A 0 No   Assertion pattern 315595002 interpreter not needed (finding)        
  A1100A 1 Yes   Assertion pattern 315594003 interpreter needed (finding)        
  A1100A 9 Unable to determine     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  A1100B   Preferred language     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  A1200   Marital status     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1200 1 Never married                
  A1200 2 Married                
  A1200 3 Widowed                
  A1200 4 Separated                
  A1200 5 Divorced                
  A1300A MDCL_REC_ NUM Medical record number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1300B ROOM_NUM Room number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1300C PREFRD_NAME Name by which resident prefers to be addressed     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1300D   Lifetime occupation(s)     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  A1500   Resident evaluated by PASRR     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1500 0 No                
  A1500 1 Yes                
  A1500 9 Not a Medicaid certified unit                
  A1550A   MR/DD status: Down syndrome   Assertion pattern 41040004 complete trisomy 21 syndrome (disorder)        
  A1550B   MR/DD status: Autism   Assertion pattern 408856003 autistic disorder (disorder)        
  A1550C   MR/DD status: Epilepsy   Assertion pattern 84757009 epilepsy (disorder)        
  A1550D   MR/DD status: other organic MR/DD condition     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  A1550E   MR/DD status: MR/DD with no organic condition     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  A1550Z   MR/DD status: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  A1600   Entry date (date of admission/reentry in facility)     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1700   Type of entry     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1700 1 Admission                
  A1700 2 Reentry                
  A1800   Entered from     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A1800 1 Community (private home/apt., board/ care, assisted living, group home)                
  A1800 2 Another nursing home or swing bed                
  A1800 3 Acute hospital                
  A1800 4 Psychiatric hospital                
  A1800 5 Inpatient rehabilitation facility                
  A1800 6 MR/DD facility                
  A1800 7 Hospice                
  A1800 99 Other                
  A2000   Discharge date     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A2100   Discharge status     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A2100 1 Community (private home/apt., board/ care, assisted living, group home)                
  A2100 2 Another nursing home or swing bed                
  A2100 3 Acute hospital                
  A2100 4 Psychiatric hospital                
  A2100 5 Inpatient rehabilitation facility                
  A2100 6 MR/DD facility                
  A2100 7 Hospice                
  A2100 8 Deceased                
  A2100 99 Other                
  A2200   Previous asmt reference date for signif correction     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A2300   Assessment reference date     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A2400A   Has resident had Medicare-covered stay     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A2400A 0 No                
  A2400A 1 Yes                
  A2400B   Start date of most recent Medicare stay     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
  A2400C   End date of most recent Medicare stay     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/ clinicians
         
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
B     Hearing, Speech, and Vision                
  B0100   Comatose   ASSERTION PATTERN            
  B0100 0 No   Assertion pattern 271591004 fully conscious (finding)        
  B0100 1 Yes   Assertion pattern 371632003 coma (disorder)        
  B0200   Hearing   ASSERTION PATTERN            
  B0200 0 Adequate - no difficulty in normal conversation, social interaction, listening to TV   Assertion pattern 162339002 hearing normal (finding)        
  B0200 1 Minimal difficulty - difficulty in some environments (e.g., when person speaks softly or setting is noisy)   Assertion pattern 162340000 hearing difficulty (finding)        
  B0200 2 Moderate difficulty - speaker has to increase volume and speak distinctly   Assertion pattern 425091001 difficulty hearing normal speech tones (finding)        
  B0200 3 Highly impaired - absence of useful hearing   Assertion pattern 306972000 unable to hear loud voice (finding)        
  B0300   Hearing aid   ASSERTION PATTERN            
  B0300 0 No   Assertion pattern 285056001 does not use hearing aid (finding)        
  B0300 1 Yes   Assertion pattern 285055002 does use hearing aid (finding)        
  B0600   Speech clarity   ASSERTION PATTERN            
  B0600 0 Clear speech - distinct intelligible words   Assertion pattern 286296002 does articulate clearly (finding)        
  B0600 1 Unclear speech - slurred or mumbled words   Assertion pattern 286298001 does not articulate clearly (finding)        
  B0600 2 No speech - absence of spoken words   Assertion pattern 286371003 does not speak (finding)        
  B0700   Makes self understood   QUESTION/ ANSWER PATTERN 288743004 ability to make self understood (observable entity)        
  B0700 0 Understood   Question/Answer pattern 288746007 does make self understood (finding)        
  B0700 1 Usually understood - difficulty communicating some words or finishing thoughts but is able if prompted or given time   Question/Answer pattern 288748008 difficulty making self understood (finding)        
  B0700 2 Sometimes understood - ability is limited to making concrete requests   Question/Answer pattern 288748008 difficulty making self understood (finding)        
  B0700 3 Rarely/never understood   Question/Answer pattern 288747003 does not make self understood (finding)        
  B0800   Ability to understand others   QUESTION/ ANSWER PATTERN 395659009 ability to comprehend (observable entity)        
  B0800 0 Understands - clear comprehension     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  B0800 1 Usually understands - misses some part/ intent of message but comprehends most conversation   Question/Answer pattern 64270008 disturbance of understand-ing (finding)        
  B0800 2 Sometimes understands - responds adequately to simple, direct communication only   Question/Answer pattern 64270008 disturbance of understand-ing (finding)        
  B0800 3 Rarely/never understands   Question/Answer pattern 53314000 Akatamath-esia (finding)        
  B1000   Vision   QUESTION/ ANSWER PATTERN 415823006 vision observable (observable entity)        
  B1000 0 Adequate - sees fine detail, including regular print in newspapers/books   Question/Answer pattern 45089002 normal vision (finding)        
  B1000 1 Impaired - sees large print, but not regular print in newspapers/books   Question/Answer pattern 424883003 difficulty seeing small print (finding)        
  B1000 2 Moderately Impaired - limited vision; not able to see newspaper headlines but can identify objects   Question/Answer pattern 285163004 able to recognize objects by sight (finding)        
  B1000 3 Highly impaired - object identification in question, but eyes appear to follow objects   Question/Answer pattern 170728008 poor visual acuity (finding)        
  B1000 4 Severely impaired - no vision or sees only light, colors or shapes; eyes do not appear to follow objects   Question/Answer pattern 397541004 severe visual impairment (disorder)        
  B1200   Corrective lenses   ASSERTION PATTERN            
  B1200 0 No     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  B1200 1 Yes   Assertion pattern 365237006 finding related to ability to use appliances for sensory impairment (finding)        
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
C     Cognitive Patterns                
  C0100   BIMS: should resident interview be conducted   ASSERTION PATTERN            
  C0100 0 No (resident is rarely/never understood)   Assertion pattern 288747003 does not make self understood (finding)        
  C0100 1 Yes   Assertion pattern 288744005 able to make self understood (finding)        
  C0200   BIMS res interview: repetition of three words     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  C0200 0 None     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  C0200 1 One     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  C0200 2 Two     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  C0200 3 Three     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  C0300A   BIMS res interview: able to report correct year   QUESTION/ ANSWER PATTERN 285195003 ability to remember current year (observable entity)        
  C0300A 0 Missed by > 5 years or no answer   Question/Answer pattern 285197006 unable to remember current year (finding)        
  C0300A 1 Missed by 2-5 years   Question/Answer pattern 285197006 unable to remember current year (finding)        
  C0300A 2 Missed by 1 year   Question/Answer pattern 285197006 unable to remember current year (finding)        
  C0300A 3 Correct   Question/Answer pattern 285196002 able to remember current year (finding)        
  C0300B   BIMS res interview: able to report correct month   QUESTION/ ANSWER PATTERN 283895004 ability to remember month of year (observable entity)        
  C0300B 0 Missed by > 1 month or no answer   Question/Answer pattern 285194004 unable to remember month of year (finding)        
  C0300B 1 Missed by 6 days to 1 month   Question/Answer pattern 285194004 unable to remember month of year (finding)        
  C0300B 2 Accurate within 5 days   Question/Answer pattern 285193005 able to remember month of year (finding)        
  C0300C   BIMS res interview: can report correct day of week   QUESTION/ ANSWER PATTERN 283894000 ability to remember day of the week (observable entity)        
  C0300C 0 Incorrect or no answer   Question/Answer pattern 285191007 unable to remember day of the week (finding)        
  C0300C 1 Correct   Question/Answer pattern 28519008 unable to remember day of the week (finding)        
  C0400A   BIMS res interview: able to recall “sock”   QUESTION/ ANSWER PATTERN 363891004 memory test observable (observable entity)        
  C0400A 0 No - could not recall   Question/Answer pattern 285225003 unable to remember objects (finding)        
  C0400A 1 Yes, after cueing (“something to wear”)   Question/Answer pattern 285224004 able to remember objects (finding)        
  C0400A 2 Yes, no cue required   Question/Answer pattern 285224004 able to remember objects (finding)        
  C0400B   BIMS res interview: able to recall “blue”   QUESTION/ ANSWER PATTERN 363891004 memory test observable (observable entity)        
  C0400B 0 No - could not recall   Question/Answer pattern 285225003 unable to remember objects (finding)        
  C0400B 1 Yes, after cueing (“a color”)   Question/Answer pattern 285224004 able to remember objects (finding)        
  C0400B 2 Yes, no cue required   Question/Answer pattern 285224004 able to remember objects (finding)        
  C0400C   BIMS res interview: able to recall “bed”   QUESTION/ ANSWER PATTERN 363891004 memory test observable (observable entity)        
  C0400C 0 No - could not recall   Question/Answer pattern 285225003 unable to remember objects (finding)        
  C0400C 1 Yes, after cueing (“a piece of furniture”)   Question/Answer pattern 285224004 able to remember objects (finding)        
  C0400C 2 Yes, no cue required   Question/Answer pattern 285224004 able to remember objects (finding)        
  C0500   BIMS res interview: summary score     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  C0600   Staff asmt mental status: conduct asmt   QUESTION/ ANSWER PATTERN 247571009 general mental state (observable entity)        
  C0600 0 No (resident was able to  complete interview)   Question/Answer pattern 288732007 able to respond to communica-tion by others (finding)        
  C0600 1 Yes (resident was unable to complete interview)   Question/Answer pattern 288733002 unable to respond to communica-tion by others (finding)        
  C0700   Staff asmt mental status: short-term memory OK   ASSERTION PATTERN            
  C0700 0 Memory OK   Assertion pattern 247590001 short-term memory within normal limits (finding)        
  C0700 1 Memory problem   Assertion pattern 247592009 poor short-term memory (finding)        
  C0800   Staff asmt mental status: long-term memory OK   ASSERTION PATTERN            
  C0800 0 Memory OK   Assertion pattern 247587007 long-term memory within normal limits (finding)        
  C0800 1 Memory problem   Assertion pattern 247588002 poor long-term memory (finding)        
  C0900A   Staff asmt mental status: recall current season   Assertion pattern 165284008 memory: present time known (finding)        
  C0900B   Staff asmt mental status: recall location of room   Assertion pattern 165287001 memory: present place known (finding)        
  C0900C   Staff asmt mental status: recall staff names/faces   Assertion pattern 285227006 able to remember faces (finding)        
  C0900D   Staff asmt mental status: recall in nursing home   Assertion pattern 165287001 memory: present place known (finding)        
  C0900Z   Staff asmt mental status: none of above recalled   Assertion pattern 386807006 memory impairment (finding)        
  C1000   Cognitive skills for daily decision making   QUESTION/ ANSWER PATTERN 413383002 ability to make decisions (observable entity)        
  C1000 0 Independent - decisions consistent/ reasonable   Question/Answer pattern 304650003 able to use decision making strategies (finding)        
  C1000 1 Modified independence - some difficulty in new situations only   Question/Answer pattern 304652006 difficulty using decision making strategies (finding)        
  C1000 2 Moderately impaired - decisions poor; cues/ supervision required   Question/Answer pattern 304652006 difficulty using decision making strategies (finding)        
  C1000 3 Severely impaired - never/rarely made decisions   Question/Answer pattern 304651004 unable to use decision making strategies (finding)        
  C1300A   Signs of delirium: inattention   QUESTION/ ANSWER PATTERN 52963003 attentiveness (observable entity)        
  C1300A 0 Behavior not present   Question/Answer pattern 288769005 able to direct attention (finding)        
  C1300A 1 Behavior continuously present, does not fluctuate   Question/Answer pattern 288773008 difficulty directing attention (finding)        
  C1300A 2 Behavior present, fluctuates (comes and goes, changes in severity)   Question/Answer pattern 247767009 integrated attention for short spells (finding)        
  C1300B   Signs of delirium: disorganized thinking   QUESTION/ ANSWER PATTERN 88952004 thinking, function (observable entity)        
  C1300B 0 Behavior not present   Question/Answer pattern 225662002 able to think clearly (finding)        
  C1300B 1 Behavior continuously present, does not fluctuate   Question/Answer pattern 247640008 unable to think clearly (finding)        
  C1300B 2 Behavior present, fluctuates (comes and goes, changes in severity)   Question/Answer pattern 88962006 incomplete clearminded-ness (finding)        
  C1300C   Signs of delirium: altered level of consciousness   QUESTION/ ANSWER PATTERN 6942003 level of conscious-ness (observable entity)        
  C1300C 0 Behavior not present   Question/Answer pattern 248222000 conscious-ness unimpaired (finding)        
  C1300C 1 Behavior continuously present, does not fluctuate   Question/Answer pattern 3006004 disturbance of conscious-ness (finding)        
  C1300C 2 Behavior present, fluctuates (comes and goes, changes in severity)   Question/Answer pattern 3006004 disturbance of conscious-ness (finding)        
  C1300D   Signs of delirium: psychomotor retardation   QUESTION/ ANSWER PATTERN 48761009 motor behavior (observable entity)        
  C1300D 0 Behavior not present   Question/Answer pattern 17621005 normal (qualifier value)        
  C1300D 1 Behavior continuously present, does not fluctuate   Question/Answer pattern 398991009 motor retardation (finding)        
  C1300D 2 Behavior present, fluctuates (comes and goes, changes in severity)   Question/Answer pattern 398991009 motor retardation (finding)        
  C1600   Acute onset mental status change   ASSERTION PATTERN            
  C1600 0 No   Assertion pattern 359748005 patient's condition the same (finding)        
  C1600 1 Yes   Assertion pattern 419284004 altered mental status (finding)        
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
D     Mood                
  D0100   PHQ: should resident mood interview be conducted   ASSERTION PATTERN            
  D0100 0 No (resident is rarely/never understood)   Assertion pattern 288745006 unable to make self understood (finding)        
  D0100 1 Yes   Assertion pattern 288744005 able to make self understood (finding)        
  D0200A1   PHQ res: little interest or pleasure - presence   ASSERTION PATTERN            
  D0200A1 0 No (enter 0 in column 2)   Assertion pattern 134417007 level of mood - normal (finding)        
  D0200A1 1 Yes (enter 0-3 in column 2)   Assertion pattern 247753000 loss of interest (finding)        
  D0200A1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200A2   PHQ res: little interest or pleasure - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200A2 0 Never or 1 day                
  D0200A2 1 2-6 Days (Several days)                
  D0200A2 2 7-11 Days (Half or more of the days)                
  D0200A2 3 12-14 Days (Nearly every day)                
  D0200B1   PHQ res: feeling down, depressed - presence   ASSERTION PATTERN            
  D0200B1 0 No (enter 0 in column 2)   Assertion pattern 134416003 normal mood symptoms (finding)        
  D0200B1 1 Yes (enter 0-3 in column 2)   Assertion pattern 394924000 Symptoms of depression (finding)        
  D0200B1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200B2   PHQ res: feeling down, depressed - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200B2 0 Never or 1 day                
  D0200B2 1 2-6 Days (Several days)                
  D0200B2 2 7-11 Days (Half or more of the days)                
  D0200B2 3 12-14 Days (Nearly every day)                
  D0200C1   PHQ res: trouble with sleep - presence   ASSERTION PATTERN            
  D0200C1 0 No (enter 0 in column 2)   Assertion pattern 433206003 able to sleep (finding)        
  D0200C1 1 Yes (enter 0-3 in column 2)   Assertion pattern 301345002 difficulty sleeping (finding)        
  D0200C1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200C2   PHQ res: trouble with sleep - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200C2 0 Never or 1 day                
  D0200C2 1 2-6 Days (Several days)                
  D0200C2 2 7-11 Days (Half or more of the days)                
  D0200C2 3 12-14 Days (Nearly every day)                
  D0200D1   PHQ res: feeling tired/ little energy - presence   ASSERTION PATTERN            
  D0200D1 0 No (enter 0 in column 2)   Assertion pattern 248272003 energy (finding)        
  D0200D1 1 Yes (enter 0-3 in column 2)   Assertion pattern 248274002 lack of energy (finding)        
  D0200D1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200D2   PHQ res: feeling tired/ little energy - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200D2 0 Never or 1 day                
  D0200D2 1 2-6 Days (Several days)                
  D0200D2 2 7-11 Days (Half or more of the days)                
  D0200D2 3 12-14 Days (Nearly every day)                
  D0200E1   PHQ res: poor appetite or overeating - presence   ASSERTION PATTERN            
  D0200E1 0 No (enter 0 in column 2)   Assertion pattern 161825005 appetite normal (finding)        
  D0200E1 1 Yes (enter 0-3 in column 2)   Assertion pattern 51575000 abnormal food appetite (finding)        
  D0200E1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200E2   PHQ res: poor appetite or overeating - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200E2 0 Never or 1 day                
  D0200E2 1 2-6 Days (Several days)                
  D0200E2 2 7-11 Days (Half or more of the days)                
  D0200E2 3 12-14 Days (Nearly every day)                
  D0200F1   PHQ res: feeling bad about self - presence   ASSERTION PATTERN            
  D0200F1 0 No (enter 0 in column 2)   Assertion pattern 280948003 normal sense of identity (finding)        
  D0200F1 1 Yes (enter 0-3 in column 2)   Assertion pattern 267077006 loss of self-esteem (finding)        
  D0200F1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200F2   PHQ res: feeling bad about self - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200F2 0 Never or 1 day                
  D0200F2 1 2-6 Days (Several days)                
  D0200F2 2 7-11 Days (Half or more of the days)                
  D0200F2 3 12-14 Days (Nearly every day)                
  D0200G1   PHQ res: trouble concentrating - presence   ASSERTION PATTERN            
  D0200G1 0 No (enter 0 in column 2)   Assertion pattern 134419005 normal concentration (finding)        
  D0200G1 1 Yes (enter 0-3 in column 2)   Assertion pattern 26329005 poor concentration (finding)        
  D0200G1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200G2   PHQ res: trouble concentrating - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200G2 0 Never or 1 day                
  D0200G2 1 2-6 Days (Several days)                
  D0200G2 2 7-11 Days (Half or more of the days)                
  D0200G2 3 12-14 Days (Nearly every day)                
  D0200H1   PHQ res: slow, fidgety, restless - presence   ASSERTION PATTERN            
  D0200H1 0 No (enter 0 in column 2)   Assertion pattern 276416006 good control of movement (finding)        
  D0200H1 1 Yes (enter 0-3 in column 2)   Assertion pattern 162221009 restlessness (finding)        
  D0200H1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200H2   PHQ res: slow, fidgety, restless - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200H2 0 Never or 1 day                
  D0200H2 1 2-6 Days (Several days)                
  D0200H2 2 7-11 Days (Half or more of the days)                
  D0200H2 3 12-14 Days (Nearly every day)                
  D0200I1   PHQ res: thoughts better off dead - presence   ASSERTION PATTERN            
  D0200I1 0 No (enter 0 in column 2)   Assertion pattern 225446002 positive self thoughts (finding)        
  D0200I1 1 Yes (enter 0-3 in column 2)   Assertion pattern 102911000 thoughts of self harm (finding)        
  D0200I1 9 No response (leave column 2 blank)   Assertion pattern 288766003 does not communicate feelings (finding)        
  D0200I2   PHQ res: thoughts better off dead - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0200I2 0 Never or 1 day                
  D0200I2 1 2-6 Days (Several days)                
  D0200I2 2 7-11 Days (Half or more of the days)                
  D0200I2 3 12-14 Days (Nearly every day)                
  D0300   PHQ res: total mood severity score     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  D0350   PHQ res: safety notification     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  D0350 0 No                
  D0350 1 Yes                
  D0500A1   PHQ staff: little interest or pleasure - presence   ASSERTION PATTERN            
  D0500A1 0 No (enter 0 in column 2)   Assertion pattern 134417007 level of mood - normal (finding)        
  D0500A1 1 Yes (enter 0-3 in column 2)   Assertion pattern 247753000 loss of interest (finding)        
  D0500A2   PHQ staff: little interest or pleasure - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500A2 0 Never or 1 day                
  D0500A2 1 2-6 Days (Several days)                
  D0500A2 2 7-11 Days (Half or more of the days)                
  D0500A2 3 12-14 Days (Nearly every day)                
  D0500B1   PHQ staff: feeling down, depressed - presence   ASSERTION PATTERN            
  D0500B1 0 No (enter 0 in column 2)   Assertion pattern 134416003 normal mood symptoms (finding)        
  D0500B1 1 Yes (enter 0-3 in column 2)   Assertion pattern 394924000 Symptoms of depression (finding)        
  D0500B2   PHQ staff: feeling down, depressed - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500B2 0 Never or 1 day                
  D0500B2 1 2-6 Days (Several days)                
  D0500B2 2 7-11 Days (Half or more of the days)                
  D0500B2 3 12-14 Days (Nearly every day)                
  D0500C1   PHQ staff: trouble with sleep - presence   ASSERTION PATTERN            
  D0500C1 0 No (enter 0 in column 2)   Assertion pattern 433206003 able to sleep (finding)        
  D0500C1 1 Yes (enter 0-3 in column 2)   Assertion pattern 301345002 difficulty sleeping (finding)        
  D0500C2   PHQ staff: trouble with sleep - frequency                
  D0500C2 0 Never or 1 day                
  D0500C2 1 2-6 Days (Several days)                
  D0500C2 2 7-11 Days (Half or more of the days)                
  D0500C2 3 12-14 Days (Nearly every day)                
  D0500D1   PHQ staff: feeling tired/little energy - presence   ASSERTION PATTERN            
  D0500D1 0 No (enter 0 in column 2)   Assertion pattern 248272003 energy (finding)        
  D0500D1 1 Yes (enter 0-3 in column 2)   Assertion pattern 248274002 lack of energy (finding)        
  D0500D2   PHQ staff: feeling tired/little energy - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500D2 0 Never or 1 day                
  D0500D2 1 2-6 Days (Several days)                
  D0500D2 2 7-11 Days (Half or more of the days)                
  D0500D2 3 12-14 Days (Nearly every day)                
  D0500E1   PHQ staff: poor appetite or overeating - presence   ASSERTION PATTERN            
  D0500E1 0 No (enter 0 in column 2)   Assertion pattern 161825005 appetite normal (finding)        
  D0500E1 1 Yes (enter 0-3 in column 2)   Assertion pattern 51575000 abnormal food appetite (finding)        
  D0500E2   PHQ staff: poor appetite or overeating - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500E2 0 Never or 1 day                
  D0500E2 1 2-6 Days (Several days)                
  D0500E2 2 7-11 Days (Half or more of the days)                
  D0500E2 3 12-14 Days (Nearly every day)                
  D0500F1   PHQ staff: feeling bad about self - presence   ASSERTION PATTERN            
  D0500F1 0 No (enter 0 in column 2)   Assertion pattern 280948003 normal sense of identity (finding)        
  D0500F1 1 Yes (enter 0-3 in column 2)   Assertion pattern 267077006 loss of self-esteem (finding)        
  D0500F2   PHQ staff: feeling bad about self - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500F2 0 Never or 1 day                
  D0500F2 1 2-6 Days (Several days)                
  D0500F2 2 7-11 Days (Half or more of the days)                
  D0500F2 3 12-14 Days (Nearly every day)                
  D0500G1   PHQ staff: trouble concentrating - presence   ASSERTION PATTERN            
  D0500G1 0 No (enter 0 in column 2)   Assertion pattern 134419005 normal concentration (finding)        
  D0500G1 1 Yes (enter 0-3 in column 2)   Assertion pattern 26329005 poor concentration (finding)        
  D0500G2   PHQ staff: trouble concentrating - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500G2 0 Never or 1 day                
  D0500G2 1 2-6 Days (Several days)                
  D0500G2 2 7-11 Days (Half or more of the days)                
  D0500G2 3 12-14 Days (Nearly every day)                
  D0500H1   PHQ staff: slow, fidgety, restless - presence   ASSERTION PATTERN            
  D0500H1 0 No (enter 0 in column 2)   Assertion pattern 276416006 good control of movement (finding)        
  D0500H1 1 Yes (enter 0-3 in column 2)   Assertion pattern 162221009 restlessness (finding)        
  D0500H2   PHQ staff: slow, fidgety, restless - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500H2 0 Never or 1 day                
  D0500H2 1 2-6 Days (Several days)                
  D0500H2 2 7-11 Days (Half or more of the days)                
  D0500H2 3 12-14 Days (Nearly every day)                
  D0500I1   PHQ staff: thoughts better off dead - presence   ASSERTION PATTERN            
  D0500I1 0 No (enter 0 in column 2)   Assertion pattern 225446002 positive self thoughts (finding)        
  D0500I1 1 Yes (enter 0-3 in column 2)   Assertion pattern 102911000 thoughts of self harm (finding)        
  D0500I2   PHQ staff: thoughts better off dead - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500I2 0 Never or 1 day                
  D0500I2 1 2-6 Days (Several days)                
  D0500I2 2 7-11 Days (Half or more of the days)                
  D0500I2 3 12-14 Days (Nearly every day)                
  D0500J1   PHQ staff: short-tempered - presence   ASSERTION PATTERN            
  D0500J1 0 No (enter 0 in column 2)   Assertion pattern 285848000 able to control anger (finding)        
  D0500J1 1 Yes (enter 0-3 in column 2)   Assertion pattern 248012001 temper problem (finding)        
  D0500J2   PHQ staff: short-tempered - frequency     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  D0500J2 0 Never or 1 day                
  D0500J2 1 2-6 Days (Several days)                
  D0500J2 2 7-11 Days (Half or more of the days)                
  D0500J2 3 12-14 Days (Nearly every day)                
  D0600   PHQ staff: total mood score     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  D0650   PHQ staff: safety notification     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  D0650 0 No                
  D0650 1 Yes                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
E     Behavior                
  E0100A   Psychosis: hallucinations   Assertion pattern 7011001 hallucinations (finding)        
  E0100B   Psychosis: delusions   Assertion pattern 2073000 delusions (finding)        
  E0100Z   Psychosis: none of the above   Assertion pattern 247700009 normal perception (finding)        
  E0200A   Physical behav symptoms directed toward others   ASSERTION PATTERN            
  E0200A 0 Behavior not exhibited   Assertion pattern 51746009 normal behavior (finding)        
  E0200A 1 Behavior of this type occurred 1 to 3 days   Assertion pattern 225480004 physically abusive behavior (finding)        
  E0200A 2 Behavior of this type occurred 4 to 6 days, but less than daily   Assertion pattern 225480004 physically abusive behavior (finding)        
  E0200A 3 Behavior of this type occurred daily   Assertion pattern 225480004 physically abusive behavior (finding)        
  E0200B   Verbal behav symptoms directed toward others   ASSERTION PATTERN            
  E0200B 0 Behavior not exhibited   Assertion pattern 51746009 normal behavior (finding)        
  E0200B 1 Behavior of this type occurred 1 to 3 days   Assertion pattern 225478005 verbally abusive behavior (finding)        
  E0200B 2 Behavior of this type occurred 4 to 6 days, but less than daily   Assertion pattern 225478005 verbally abusive behavior (finding)        
  E0200B 3 Behavior of this type occurred daily   Assertion pattern 225478005 verbally abusive behavior (finding)        
  E0200C   Other behav symptoms not directed toward others   ASSERTION PATTERN            
  E0200C 0 Behavior not exhibited   Assertion pattern 51746009 normal behavior (finding)        
  E0200C 1 Behavior of this type occurred 1 to 3 days     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD.
         
  E0200C 2 Behavior of this type occurred 4 to 6 days, but less than daily     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD.
         
  E0200C 3 Behavior of this type occurred daily     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD.
         
  E0300   Overall presence of behavioral symptoms     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  E0300 0 No                
  E0300 1 Yes                
  E0500A   Behav symptoms put res at risk for illness/injury   ASSERTION PATTERN            
  E0500A 0 No   Assertion pattern 51746009 normal behavior (finding)        
  E0500A 1 Yes   Assertion pattern 81763001 at risk for injury (finding)        
  E0500B   Behav symptoms interfere with resident care   ASSERTION PATTERN            
  E0500B 0 No   Assertion pattern 51746009 normal behavior (finding)        
  E0500B 1 Yes     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  E0500C   Behav symptoms interfere with social activities   ASSERTION PATTERN            
  E0500C 0 No   Assertion pattern 51746009 normal behavior (finding)        
  E0500C 1 Yes   Assertion pattern 88598008 impaired social interaction (finding)        
  E0600A   Behav symptoms put others at risk for injury   ASSERTION PATTERN            
  E0600A 0 No   Assertion pattern 51746009 normal behavior (finding)        
  E0600A 1 Yes   Assertion pattern 391155006 at risk of harming others (finding)        
  E0600B   Behav symptoms intrude on privacy of others   ASSERTION PATTERN            
  E0600B 0 No   Assertion pattern 51746009 normal behavior (finding)        
  E0600B 1 Yes     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  E0600C   Behav symptoms disrupt care or living environment   ASSERTION PATTERN            
  E0600C 0 No   Assertion pattern 51746009 normal behavior (finding)        
  E0600C 1 Yes     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  E0800   Rejection of care: presence and frequency   QUESTION/ ANSWER PATTERN 405078008 compliance behavior (observable entity)        
  E0800 0 Behavior not exhibited   Question/Answer pattern 386673006 does comply with treatment (finding)        
  E0800 1 Behavior of this type occurred 1 to 3 days   Question/Answer pattern 105480006 refusal of treatment by patient (situation)        
  E0800 2 Behavior of this type occurred 4 to 6 days, but less than daily   Question/Answer pattern 105480006 refusal of treatment by patient (situation)        
  E0800 3 Behavior of this type occurred daily   Question/Answer pattern 105480006 refusal of treatment by patient (situation)        
  E0900   Wandering: presence and frequency   QUESTION/ ANSWER PATTERN 363896009 behavior observable (observable entity)        
  E0900 0 Behavior not exhibited   Question/Answer pattern 51746009 normal behavior (finding)        
  E0900 1 Behavior of this type occurred 1 to 3 days   Question/Answer pattern 50239007 wandering (finding)        
  E0900 2 Behavior of this type occurred 4 to 6 days, but less than daily   Question/Answer pattern 50239007 wandering (finding)        
  E0900 3 Behavior of this type occurred daily   Question/Answer pattern 50239007 wandering (finding)        
  E1000A   Wandering: risk of getting to dangerous place   ASSERTION PATTERN            
  E1000A 0 No   Assertion pattern 225859003 safe to be left unattended (finding)        
  E1000A 1 Yes   Assertion pattern 225861007 unsafe to be left alone (finding)        
  E1000B   Wandering: intrude on privacy of others     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  E1000B 0 No                
  E1000B 1 Yes                
  E1100   Change in behavioral or other symptoms   QUESTION/ ANSWER PATTERN 315244000 change in behavior (observable entity)        
  E1100 0 Same   Question/Answer pattern 409051000 stabilized (qualifier value)        
  E1100 1 Improved   Question/Answer pattern 385425000 improved (qualifier value)        
  E1100 2 Worse   Question/Answer pattern 231877006 worse (qualifier value)        
  E1100 9 N/A because no prior MDS assessment     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
F     Preferences for Customary Routine and Activities                
  F0300   Conduct res interview for daily/activity prefs   ASSERTION PATTERN            
  F0300 0 No (resident is rarely/never understood and family/significant other not available)   Assertion pattern 288745006 unable to make self understood (finding)        
  F0300 1 Yes   Assertion pattern 288744005 able to make self understood (finding)        
  F0400A   Res interview: choose clothes to wear   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400A 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400A 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400A 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400A 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400A 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400A 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400B   Res interview: take care of personal belongings   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400B 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400B 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400B 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400B 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400B 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400B 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400C   Res interview: choose tub, bath, shower, sponge   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400C 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400C 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400C 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400C 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400C 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400C 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400D   Res interview: have snacks between meals   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400D 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400D 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400D 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400D 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400D 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400D 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400E   Res interview: choose own bedtime   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400E 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400E 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400E 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400E 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400E 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400E 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400F   Res interview: discuss care with family/friend   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400F 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400F 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400F 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400F 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400F 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400F 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400G   Res interview: use phone in private   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400G 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400G 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400G 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400G 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400G 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400G 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0400H   Res interview: lock things to keep them safe   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0400H 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0400H 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0400H 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0400H 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0400H 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0400H 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500A   Res interview: have books, newspaper, mags to read   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500A 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500A 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500A 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500A 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500A 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500A 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500B   Res interview: listen to music   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500B 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500B 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500B 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500B 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500B 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500B 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500C   Res interview: be around animals/ pets   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500C 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500C 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500C 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500C 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500C 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500C 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500D   Res interview: keep up with news   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500D 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500D 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500D 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500D 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500D 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500D 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500E   Res interview: do things with groups of people   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500E 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500E 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500E 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500E 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500E 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500E 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500F   Res interview: do favorite activities   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500F 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500F 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500F 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500F 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500F 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500F 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500G   Res interview: go outside when good weather   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500G 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500G 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500G 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500G 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500G 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500G 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0500H   Res interview: participate in religious practices   QUESTION/ ANSWER PATTERN 304686002 ability to make considered choices (observable entity)        
  F0500H 1 Very important   Question/Answer pattern 371926006 highly significant (qualifier value)        
  F0500H 2 Somewhat important   Question/Answer pattern 371927002 moderately significant (qualifier value)        
  F0500H 3 Not very important   Question/Answer pattern 371929004 minimally significant (qualifier value)        
  F0500H 4 Not important at all   Question/Answer pattern 371928007 not significant (qualifier value)        
  F0500H 5 Important, but can't do or no choice     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  F0500H 9 No response or non-responsive   Question/Answer pattern 288766003 does not communicate feelings (finding)        
  F0600   Primary respondent: daily/activities prefs     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  F0600 1 Resident                
  F0600 2 Family or significant other (close friend or other representative)                
  F0600 9 Interview could not be completed by resident or family/significant other (“No Response” to 3 or more items)                
  F0700   Conduct staff assessment for daily/activity prefs     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  F0700 0 No (because Interview for Daily and Activity Preferences (F0400 and F0500) was completed by resident or family/ significant other)                
  F0700 1 Yes (because 3 or more items in Interview for Daily and Activity Preferences (F0400 and F0500) were not completed by resident or family/ significant other)                
  F0800A   Staff assessment: choosing clothes to wear   Assertion pattern 366007004 finding of individual style of dress (finding)        
  F0800B   Staff assessment: caring for personal belongings     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  F0800C   Staff assessment: receiving tub bath   Assertion pattern 13749006 bathing patient in tub (procedure)        
  F0800D   Staff assessment: receiving shower   Assertion pattern 20565007 bathing patient in shower (procedure)        
  F0800E   Staff assessment: receiving bed bath   Assertion pattern 58530006 bathing patient in bed (procedure)        
  F0800F   Staff assessment: receiving sponge bath   Assertion pattern 34466005 bathing patient with tepid sponge (procedure)        
  F0800G   Staff assessment: snacks between meals   Assertion pattern 248121003 eats between meals (finding)        
  F0800H   Staff assessment: staying up past 8PM   Assertion pattern 247950007 sleep behavior finding (finding)        
  F0800I   Staff assessment: discuss care with family/other   Assertion pattern 406546002 relatives involved with care (finding)        
  F0800J   Staff assessment: use phone in private   Assertion pattern 300727008 does perform telephone activities (finding)        
  F0800K   Staff assessment: place to lock personal things     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  F0800L   Staff assessment: reading books, newspapers, mags   Assertion pattern 300740003 does participate in leisure activities (finding)        
  F0800M   Staff assessment: listening to music   Assertion pattern 300740003 does participate in leisure activities (finding)        
  F0800N   Staff assessment: being around animals/pets   Assertion pattern 224152001 keeps pets (finding)        
  F0800O   Staff assessment: keeping up with news     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  F0800P   Staff assessment: doing things with groups   Assertion pattern 129874008 social interaction finding (finding)        
  F0800Q   Staff assessment: participate favorite activities   Assertion pattern 300740003 does participate in leisure activities (finding)        
  F0800R   Staff assessment: spend time away from nursing home     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  F0800S   Staff assessment: spend time outdoors   Assertion pattern 300740003 does participate in leisure activities (finding)        
  F0800T   Staff assessment: participate religious activities   Assertion pattern 300806005 does pursue religious activities (finding)        
  F0800Z   Staff assessment: none of above activities     Concept Not Mapped (Reason #5) -- Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT          
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
G     Functional Status                
  G0110A1   Bed mobility: self-performance   QUESTION/ ANSWER PATTERN 301680009 ability to move in bed (observable entity)        
  G0110A1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110A1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110A1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110A1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110A1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110A1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 301684000 does not move in bed (finding)        
  G0110A1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 301684000 does not move in bed (finding)        
  G0110A2   Bed mobility: support provided   QUESTION/ ANSWER PATTERN 301680009 ability to move in bed (observable entity)        
  G0110A2 0 No setup or physical help from staff     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110A2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110A2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110A2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110A2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 301684000 does not move in bed (finding)        
  G0110B1   Transfer: self-performance   QUESTION/ ANSWER PATTERN 165236004 chair/bed transfer ability (observable entity)        
  G0110B1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110B1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110B1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110B1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110B1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110B1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 302266005 does not transfer (finding)        
  G0110B1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 302266005 does not transfer (finding)        
  G0110B2   Transfer: support provided   QUESTION/ ANSWER PATTERN 364666007 ability to transfer location (observable entity)        
  G0110B2 0 No setup or physical help from staff   Question/Answer pattern 129079002 transfer independent (finding)        
  G0110B2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110B2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110B2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110B2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 302266005 does not transfer (finding)        
  G0110C1   Walk in room: self-performance   QUESTION/ ANSWER PATTERN 129006008 walking (observable entity)        
  G0110C1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110C1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110C1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110C1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110C1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110C1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 282147000 does not walk (finding)        
  G0110C1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 282147000 does not walk (finding)        
  G0110C2   Walk in room: support provided   QUESTION/ ANSWER PATTERN 282097004 ability to walk (observable entity)        
  G0110C2 0 No setup or physical help from staff   Question/Answer pattern 165245003 independent walking (finding)        
  G0110C2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110C2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110C2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110C2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 282147000 does not walk (finding)        
  G0110D1   Walk in corridor: self-performance   QUESTION/ ANSWER PATTERN 129006008 walking (observable entity)        
  G0110D1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110D1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110D1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110D1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110D1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110D1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 282147000 does not walk (finding)        
  G0110D1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 282147000 does not walk (finding)        
  G0110D2   Walk in corridor: support provided   QUESTION/ ANSWER PATTERN 282097004 ability to walk (observable entity)        
  G0110D2 0 No setup or physical help from staff   Question/Answer pattern 165245003 independent walking (finding)        
  G0110D2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110D2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110D2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110D2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 282147000 does not walk (finding)        
  G0110E1   Locomotion on unit: self-performance   QUESTION/ ANSWER PATTERN 418305009 self-propelled locomotion activity (observable entity)        
  G0110E1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110E1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110E1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110E1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110E1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110E1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 302045007 does not mobilize (finding)        
  G0110E1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 302045007 does not mobilize (finding)        
  G0110E2   Locomotion on unit: support provided   QUESTION/ ANSWER PATTERN 301438001 ability to mobilize (observable entity)        
  G0110E2 0 No setup or physical help from staff   Question/Answer pattern 160680006 fully mobile (finding)        
  G0110E2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110E2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110E2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110E2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 302045007 does not mobilize (finding)        
  G0110F1   Locomotion off unit: self-performance   QUESTION/ ANSWER PATTERN 418305009 self-propelled locomotion activity (observable entity)        
  G0110F1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110F1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110F1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110F1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110F1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110F1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 302045007 does not mobilize (finding)        
  G0110F1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 302045007 does not mobilize (finding)        
  G0110F2   Locomotion off unit: support provided   QUESTION/ ANSWER PATTERN 301438001 ability to mobilize (observable entity)        
  G0110F2 0 No setup or physical help from staff   Question/Answer pattern 160680006 fully mobile (finding)        
  G0110F2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110F2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110F2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110F2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 302045007 does not mobilize (finding)        
  G0110G1   Dressing: self-performance   QUESTION/ ANSWER PATTERN 129003000 dressing (observable entity)        
  G0110G1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110G1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110G1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110G1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110G1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110G1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 284971009 does not perform dressing activity (finding)        
  G0110G1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 284971009 does not perform dressing activity (finding)        
  G0110G2   Dressing: support provided   QUESTION/ ANSWER PATTERN 165235000 ability to dress (observable entity)        
  G0110G2 0 No setup or physical help from staff   Question/Answer pattern 129035000 independent with dressing (finding)        
  G0110G2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110G2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110G2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110G2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 284971009 does not perform dressing activity (finding)        
  G0110H1   Eating: self-performance   QUESTION/ ANSWER PATTERN 48263008 eating (observable entity)        
  G0110H1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110H1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110H1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110H1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110H1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110H1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 289003008 does not feed self (finding)        
  G0110H1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 289003008 does not feed self (finding)        
  G0110H2   Eating: support provided   QUESTION/ ANSWER PATTERN 288843005 eating abilities (observable entity)        
  G0110H2 0 No setup or physical help from staff   Question/Answer pattern 165224005 independent feeding (finding)        
  G0110H2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110H2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110H2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110H2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 289003008 does not feed self (finding)        
  G0110I1   Toilet use: self-performance   QUESTION/ ANSWER PATTERN 129004006 toileting (observable entity)        
  G0110I1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110I1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110I1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110I1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110I1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110I1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 284903008 does not perform toileting activities (finding)        
  G0110I1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 284903008 does not perform toileting activities (finding)        
  G0110I2   Toilet use: support provided   QUESTION/ ANSWER PATTERN 284899001 ability to perform toileting activities (observable entity)        
  G0110I2 0 No setup or physical help from staff   Question/Answer pattern 129062008 independent in toilet (finding)        
  G0110I2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110I2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110I2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110I2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 284903008 does not perform toileting activities (finding)        
  G0110J1   Personal hygiene: self-performance   QUESTION/ ANSWER PATTERN 286850002 personal hygiene activities, function (observable entity)        
  G0110J1 0 Independent - no help or staff oversight at any time   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0110J1 1 Supervision - oversight, encouragement or cueing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110J1 2 Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance   Question/Answer pattern 255469002 limited (qualifier value)        
  G0110J1 3 Extensive assistance - resident involved in activity, staff provide weight-bearing support   Question/Answer pattern 41118005 extensive (qualifier value)        
  G0110J1 4 Total dependence - full staff performance every time during entire 7-day period   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0110J1 7 Activity occurred only once or twice - activity did occur but only once or twice.   Question/Answer pattern 284783002 does not perform personal hygiene activity (finding)        
  G0110J1 8 Activity did not occur - activity (or any part of the ADL) was not performed by resident or staff at all over the entire 7-day period   Question/Answer pattern 284783002 does not perform personal hygiene activity (finding)        
  G0110J2   Personal hygiene: support provided   QUESTION/ ANSWER PATTERN 284779002 ability to perform personal hygiene activity (observable entity)        
  G0110J2 0 No setup or physical help from staff     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110J2 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110J2 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110J2 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0110J2 8 ADL activity itself did not occur during entire period   Question/Answer pattern 284783002 does not perform personal hygiene activity (finding)        
  G0120A   Bathing: self-performance   QUESTION/ ANSWER PATTERN 129002005 bathing (observable entity)        
  G0120A 0 Independent - no help provided   Question/Answer pattern 371153006 independently able (qualifier value)        
  G0120A 1 Supervision - oversight help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0120A 2 Physical help limited to transfer only   Question/Answer pattern 255469002 limited (qualifier value)        
  G0120A 3 Physical help in part of bathing activity   Question/Answer pattern 255469002 limited (qualifier value)        
  G0120A 4 Total dependence   Question/Answer pattern 371156003 does not, dependent (qualifier value)        
  G0120A 8 Activity did not occur during the entire period   Question/Answer pattern 284801006 does not perform bathing activity (finding)        
  G0120B   Bathing: support provided   QUESTION/ ANSWER PATTERN 165250009 ability to bathe self (observable entity)        
  G0120B 0 No setup or physical help from staff   Question/Answer pattern 129041007 independent bathing (finding)        
  G0120B 1 Setup help only     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0120B 2 One person physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0120B 3 Two+ persons physical assist     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0120B 8 ADL activity itself did not occur during entire period   Question/Answer pattern 284801006 does not perform bathing activity (finding)        
  G0300A   Balance: moving from seated to standing position   QUESTION/ ANSWER PATTERN 249982003 balance (observable entity)        
  G0300A 0 Steady at all times   Question/Answer pattern 298312007 balance normal (finding)        
  G0300A 1 Not steady, but able to stabilize without human assistance   Question/Answer pattern 267084003 unsteadiness present (finding)        
  G0300A 2 Not steady, only able to stabilize with human assistance   Question/Answer pattern 271713000 general unsteadiness (finding)        
  G0300A 8 Activity did not occur   Question/Answer pattern 282320002 does not stand alone (finding)        
  G0300B   Balance: walking (with assistive device if used)   QUESTION/ ANSWER PATTERN 363841003 feature of walking balance (observable entity)        
  G0300B 0 Steady at all times   Question/Answer pattern 298312007 balance normal (finding)        
  G0300B 1 Not steady, but able to stabilize without human assistance   Question/Answer pattern 267084003 unsteadiness present (finding)        
  G0300B 2 Not steady, only able to stabilize with human assistance   Question/Answer pattern 271713000 general unsteadiness (finding)        
  G0300B 8 Activity did not occur   Question/Answer pattern 282147000 does not walk (finding)        
  G0300C   Balance: turning around while walking   QUESTION/ ANSWER PATTERN 363842005 feature of turning balance when walking (observable entity)        
  G0300C 0 Steady at all times   Question/Answer pattern 298312007 balance normal (finding)        
  G0300C 1 Not steady, but able to stabilize without human assistance   Question/Answer pattern 267084003 unsteadiness present (finding)        
  G0300C 2 Not steady, only able to stabilize with human assistance   Question/Answer pattern 271713000 general unsteadiness (finding)        
  G0300C 8 Activity did not occur   Question/Answer pattern 282147000 does not walk (finding)        
  G0300D   Balance: moving on and off toilet     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0300D 0 Steady at all times                
  G0300D 1 Not steady, but able to stabilize without human assistance                
  G0300D 2 Not steady, only able to stabilize with human assistance                
  G0300D 8 Activity did not occur                
  G0300E   Balance: surface-to-surface transfer     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0300E 0 Steady at all times                
  G0300E 1 Not steady, but able to stabilize without human assistance                
  G0300E 2 Not steady, only able to stabilize with human assistance                
  G0300E 8 Activity did not occur                
  G0400A   ROM limitation: upper extremity   QUESTION/ ANSWER PATTERN 364564000 range of joint movement (observable entity)        
  G0400A 0 No impairment     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  G0400A 1 Impairment on one side   Question/Answer pattern 70733008 limitation of joint movement (finding)        
  G0400A 2 Impairment on both sides   Question/Answer pattern 70733008 limitation of joint movement (finding)        
  G0400B   ROM limitation: lower extremity   QUESTION/ ANSWER PATTERN 364564000 range of joint movement (observable entity)        
  G0400B 0 No impairment     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  G0400B 1 Impairment on one side   Question/Answer pattern 70733008 limitation of joint movement (finding)        
  G0400B 2 Impairment on both sides   Question/Answer pattern 70733008 limitation of joint movement (finding)        
  G0600A   Mobility devices: cane/ crutch   Assertion pattern 365112008 finding of walking aid use (finding)        
  G0600B   Mobility devices: walker   Assertion pattern 365112008 finding of walking aid use (finding)        
  G0600C   Mobility devices: wheelchair (manual or electric)   Assertion pattern 301578005 does mobilize using wheelchair (finding)        
  G0600D   Mobility devices: limb prosthesis     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0600Z   Mobility devices: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  G0900A   Resident believes capable of increased independ     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0900A 0 No                
  G0900A 1 Yes                
  G0900A 9 Unable to determine                
  G0900B   Staff believes res capable of increased independ     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  G0900B 0 No                
  G0900B 1 Yes                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
H     Bladder and Bowel                
  H0100A   Appliances: indwelling catheter   Assertion pattern 266765001 indwelling catheter inserted (situation)        
  H0100B   Appliances: external catheter     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  H0100C   Appliances: ostomy   Assertion pattern 385712009 ostomy care (regime/therapy)        
  H0100D   Appliances: intermittent catheterization   Assertion pattern 225103006 intermittent urethral catheterization (procedure)        
  H0100Z   Appliances: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  H0200A   Urinary toileting program: has been attempted   ASSERTION PATTERN            
  H0200A 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  H0200A 1 Yes   Assertion pattern 37799002 urinary bladder training (regime/therapy)        
  H0200A 9 Unable to determine     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  H0200B   Urinary toileting program: response   QUESTION/ ANSWER PATTERN 406218000 urinary continence status (observable entity)        
  H0200B 0 No improvement   Question/Answer pattern 359748005 patient's condition the same (finding)        
  H0200B 1 Decreased wetness   Question/Answer pattern 268910001 patient's condition improved (finding)        
  H0200B 2 Completely dry (continent)   Question/Answer pattern 165234001 bladder: fully continent (finding)        
  H0200B 9 Unable to determine or trial in progress     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  H0200C   Urinary toileting program: current program/trial   ASSERTION PATTERN            
  H0200C 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  H0200C 1 Yes   Assertion pattern 37799002 urinary bladder training (regime/therapy)        
  H0300   Urinary continence   QUESTION/ ANSWER PATTERN 249282008 frequency of incontinence (observable entity)        
  H0300 0 Always continent   Question/Answer pattern 260413007 none (qualifier value)        
  H0300 1 Occasionally incontinent (less than 7 episodes of incontinence)   Question/Answer pattern 84638005 occasional (qualifier value)        
  H0300 2 Frequently incontinent (7 or more episodes of urinary incontinence, but at least one episode of continent voiding)   Question/Answer pattern 70232002 frequent (qualifier value)        
  H0300 3 Always incontinent (no episodes of continent voiding)   Question/Answer pattern 255619001 total (qualifier value)        
  H0300 9 Not rated, resident had a catheter (indwelling, condom), urinary ostomy, or no urine output for entire 7 days     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  H0400   Bowel continence   QUESTION/ ANSWER PATTERN 406217005 bowel continence status (observable entity)        
  H0400 0 Always continent   Question/Answer pattern 260413007 bowels: fully continent (finding)        
  H0400 1 Occasionally incontinent (one episode of bowel incontinence)   Question/Answer pattern 165230005 bowels: occasional accident (finding)        
  H0400 2 Frequently incontinent (2 or more episodes of bowel incontinence, but at least one continent bowel movement)     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  H0400 3 Always incontinent (no episodes of continent bowel movements)   Question/Answer pattern 72042002 incontinence of feces (finding)        
  H0400 9 Not rated, resident had an ostomy or did not have a bowel movement for the entire 7 days     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  H0500   Bowel toileting program being used   ASSERTION PATTERN            
  H0500 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  H0500 1 Yes   Assertion pattern 385976008 bowel training (regime/therapy)        
  H0600   Constipation   ASSERTION PATTERN            
  H0600 0 No   Assertion pattern 162081000 not constipated (finding)        
  H0600 1 Yes   Assertion pattern 14760008 constipation (disorder)        
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
I     Active Disease Diagnosis                
  I0100   Cancer (with or without metastasis)   Assertion pattern 363346000 malignant neoplastic disease (disorder) 199.1 C80.0    
  I0200   Anemia   Assertion pattern 271737000 anemia (disorder) 285.9 D64.9    
  I0300   Atrial fibrillation and other dysrhythmias   Assertion pattern 44808001 conduction disorder of the heart (disorder) 427.9 I49.9    
  I0400   Coronary artery disease (CAD)   Assertion pattern 56265001 heart disease (disorder) 414.9 I25.10    
  I0500   Deep venous thrombosis (DVT), PE, or PTE     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  Concept Not Mapped - Venous emobolism/ thrombois (e.g. DVT) and pulmonary embolus do not have a common representation Concept Not Mapped - Venous emobolism/ thrombois (e.g. DVT) and pulmonary embolus do not have a common representation    
  I0600   Heart failure     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  428.9 I50.9    
  I0700   Hypertension   Assertion pattern 38341003 hypertensive disorder, systemic arterial (disorder) 401.9 I10    
  I0800   Orthostatic hypotension   Assertion pattern 28651003 orthostatic hypotension (disorder) 458.0 I95.1    
  I0900   Peripheral vascular disease (PVD) or PAD     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  443.9 I73.9    
  I1100   Cirrhosis   Assertion pattern 19943007 cirrhosis of liver (disorder) 571.5 K74.60    
  I1200   Gastroesophageal reflux disease (GERD) or ulcer   Assertion pattern 119291004 disorder of upper gastrointestinal tract (disorder) Concept Not Mapped - Disorders of the esophagus (e.g. GERD) and ulcers of the upper GI tract do not have a common representa-tion Concept Not Mapped - Disorders of the esophagus (e.g. GERD) and ulcers of the upper GI tract do not have a common representa-tion    
  I1300   Ulcerative colitis, Crohn’s, inflam bowel disease   Assertion pattern 24526004 inflammatory bowel disease (disorder) Concept Not Mapped - Regional enteritis (e.g. Crohn's), ulcerative colitis and unspecified colitis do not have a common representa-tion Concept Not Mapped - Regional enteritis (e.g. Crohn's), ulcerative colitis and unspecified colitis do not have a common representa-tion    
  I1400   Benign prostatic hyperplasia (BPH)   Assertion pattern 266569009 benign prostatic hyperplasia (disorder) 600.00 N40.0    
  I1500   Renal insufficiency, renal failure, ESRD   Assertion pattern 42399005 renal failure syndrome (disorder) 593.9 N28.9    
  I1550   Neurogenic bladder   Assertion pattern 398064005 neurogenic bladder (finding) 596.54 N31.9    
  I1650   Obstructive uropathy   Assertion pattern 7163005 urinary tract obstruction (disorder) 599.60 N13.9    
  I1700   Multidrug resistant organism (MDRO)     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  V09.91 Z16    
  I2000   Pneumonia   Assertion pattern 233604007 pneumonia (disorder) 486 J18.9    
  I2100   Septicemia   Assertion pattern 105592009 septicemia (disorder) 038.9 A41.9    
  I2200   Tuberculosis   Assertion pattern 56717001 tuberculosis (disorder) 011.90 A15.9    
  I2300   Urinary tract infection (UTI) (LAST 30 DAYS)   Assertion pattern 68566005 urinary tract infectious disease (disorder) 599.0 N39.0    
  I2400   Viral hepatitis (includes type A, B, C, D, and E)   Assertion pattern 3738000 viral hepatitis (disorder) 070.9 B19.9    
  I2500   Wound infection (other than foot)     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
  Concept Not Mapped - Open wounds of upper limbs, lower limbs, and other body sites do not have a common representa-tion Concept Not Mapped - Open wounds of upper limbs, lower limbs, and other body sites do not have a common representa-tion    
  I2900   Diabetes mellitus (DM)   Assertion pattern 73211009 diabetes mellitus (disorder) 250.00 E11.9    
  I3100   Hyponatremia   Assertion pattern 89627008 hyponatremia (disorder) 276.1 E87.1    
  I3200   Hyperkalemia   Assertion pattern 14140009 hyperkalemia (disorder) 276.8 E87.6    
  I3300   Hyperlipidemia (e.g., hypercholesterolemia)   Assertion pattern 55822004 hyperlipidemia (disorder) 272.4 E78.5    
  I3400   Thyroid disorder   Assertion pattern 14304000 disorder of thyroid gland (disorder) 246.9 E07.9    
  I3700   Arthritis   Assertion pattern 399269003 arthropathy (disorder) 716.90 M19.90    
  I3800   Osteoporosis   Assertion pattern 64859006 osteoporosis (disorder) 733.00 M81.0    
  I3900   Hip fracture   Assertion pattern 263225007 fracture of proximal end of femur (disorder) 820.9 S72.00    
  I4000   Other fracture     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
  Concept Not Mapped - Fractures of any site (excluding hip) do not have a common representation Concept Not Mapped - Fractures of any site (excluding hip) do not have a common representation    
  I4200   Alzheimer's disease   Assertion pattern 26929004 Alzheimer's disease (disorder) 331.0 G30.9, with additional code to identify delirium, (if applicable) F05, F02.81, F02.80    
  I4300   Aphasia   Assertion pattern 87486003 aphasia (finding) 784.3 R47.01    
  I4400   Cerebral palsy   Assertion pattern 128188000 cerebral palsy (disorder) 343.9 G80.9    
  I4500   Cerebrovascular accident (CVA), TIA, or stroke   Assertion pattern 62914000 cerebrovascular disease (disorder) Concept Not Mapped - CVA and TIA do not have a common representation Concept Not Mapped - CVA and TIA do not have a common representation    
  I4800   Dementia   Assertion pattern 52448006 dementia (disorder) 294.8 F03    
  I4900   Hemiplegia or hemiparesis   Assertion pattern 23853001 disorder of the central nervous system (disorder) 342.90 G81.90    
  I5000   Paraplegia   Assertion pattern 60389000 paraplegia (disorder) 344.1 G82.30    
  I5100   Quadriplegia   Assertion pattern 11538006 quadriplegia (disorder) 344.09 G82.50    
  I5200   Multiple sclerosis   Assertion pattern 24700007 multiple sclerosis (disorder) 340 G35    
  I5250   Huntington's disease   Assertion pattern 58756001 Huntington's chorea (disorder) 333.4 G10    
  I5300   Parkinson's disease   Assertion pattern 49049000 Parkinson's disease (disorder) 332.0 G20    
  I5350   Tourette's syndrome   Assertion pattern 5158005 Gilles de la Tourette's syndrome (disorder) 307.23 F95.2    
  I5400   Seizure disorder or epilepsy   Assertion pattern 128613002 seizure disorder (disorder) 345.90 G40.909    
  I5500   Traumatic brain injury (TBI)   Assertion pattern 127295002 traumatic brain injury (disorder) 854.00 Concept Not Mapped - Traumatic Brain Injury requires further specification - code for head injury NOS is S09.90x    
  I5600   Malnutrition (protein, calorie), risk of malnutrit   Assertion pattern 2492009 nutritional disorder (disorder) 263.9 E46    
  I5700   Anxiety disorder   Assertion pattern 197480006 anxiety disorder (disorder) 300.00 F41.9    
  I5800   Depression (other than bipolar)   Assertion pattern 35489007 depressive disorder (disorder) 311 F32.9    
  I5900   Manic depression (bipolar disease)   Assertion pattern 13746004 bipolar disorder (disorder) 296.80 F31.9    
  I5950   Psychotic disorder (other than schizophrenia)     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  298.9 F29    
  I6000   Schizophrenia     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  295.90 F20.9    
  I6100   Post-traumatic stress disorder (PTSD)   Assertion pattern 47505003 posttraumatic stress disorder (disorder) 309.81 F43.10    
  I6200   Asthma (COPD) or chronic lung disease     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
  Concept Not Mapped - Asthma and Chronic lung Disease/ COPD do not have a common representation Concept Not Mapped - Asthma and Chronic lung Disease/ COPD do not have a common representation    
  I6300   Respiratory failure   Assertion pattern 409622000 respiratory failure (disorder) 518.81 J96.90    
  I6500   Cataracts, glaucoma, or macular degeneration   Assertion pattern 371405004 disorder of eye proper (disorder) Concept Not Mapped - Cataracts, glaucoma and macular degeneration do not have a common representation Concept Not Mapped - Cataracts, glaucoma and macular degeneration do not have a common representation    
  I7900   None of above active diseases within last 7 days     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  I8000A   Additional active ICD diagnosis 1     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000B   Additional active ICD diagnosis 2     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000C   Additional active ICD diagnosis 3     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000D   Additional active ICD diagnosis 4     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000E   Additional active ICD diagnosis 5     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000F   Additional active ICD diagnosis 6     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000G   Additional active ICD diagnosis 7     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000H   Additional active ICD diagnosis 8     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000I   Additional active ICD diagnosis 9     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
  I8000J   Additional active ICD diagnosis 10     Concept Not Mapped (Reason #6) --
Question responses are free text format and do not provide a fixed concept for SNOMED CT mapping
         
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
J     Health Conditions                
  J0100A   Pain: been on scheduled pain med regimen   ASSERTION PATTERN            
  J0100A 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  J0100A 1 Yes   Assertion pattern 410240006 pain control management (procedure)        
  J0100B   Pain: received PRN pain medications   ASSERTION PATTERN            
  J0100B 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  J0100B 1 Yes   Assertion pattern 52685006 administration of analgesic (procedure)        
  J0100C   Pain: received non-medication intervention   ASSERTION PATTERN            
  J0100C 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  J0100C 1 Yes   Assertion pattern 370821005 implementation of alternative methods of pain control (procedure)        
  J0200   Should pain assessment interview be conducted   ASSERTION PATTERN            
  J0200 0 No (resident rarely/never understood)   Assertion pattern 288745006 unable to make self understood (finding)        
  J0200 1 Yes   Assertion pattern 288746007 does make self understood (finding)        
  J0300   Res pain interview: presence   ASSERTION PATTERN            
  J0300 0 No   Assertion pattern 301379001 no present pain (finding)        
  J0300 1 Yes   Assertion pattern 22253000 pain (finding)        
  J0300 9 Unable to answer   Assertion pattern 288733002 unable to respond to communication by others (finding)        
  J0400   Res pain interview: frequency   QUESTION/ ANSWER PATTERN 364631005 pattern of pain (observable entity)        
  J0400 1 Almost constantly   Question/Answer pattern 255238004 continuous (qualifier value)        
  J0400 2 Frequently   Question/Answer pattern 70232002 frequent (qualifier value)        
  J0400 3 Occasionally   Question/Answer pattern 84638005 occasional (qualifier value)        
  J0400 4 Rarely   Question/Answer pattern 89292003 rare (qualifier value)        
  J0400 9 Unable to answer   Question/Answer pattern 288733002 unable to respond to communication by others (finding)        
  J0500A   Res pain interview: made it hard to sleep   ASSERTION PATTERN            
  J0500A 0 No   Assertion pattern 433206003 able to sleep (finding)        
  J0500A 1 Yes   Assertion pattern 429038000 pain onset during sleep (finding)        
  J0500A 9 Unable to answer   Assertion pattern 288733002 unable to respond to communication by others (finding)        
  J0500B   Res pain interview: limited daily activities   ASSERTION PATTERN            
  J0500B 0 No     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  J0500B 1 Yes   Assertion pattern 77427003 activity intolerance (finding)        
  J0500B 9 Unable to answer   Assertion pattern 288733002 unable to respond to communication by others (finding)        
  J0600A   Res pain interview: intensity rating scale     225908003 pain score (observable entity)        
  J0600B   Res pain interview: verbal descriptor scale   QUESTION/ ANSWER PATTERN 406127006 pain intensity (observable entity)        
  J0600B 1 Mild   Question/Answer pattern 40196000 mild pain (finding)        
  J0600B 2 Moderate   Question/Answer pattern 50415004 moderate pain (finding)        
  J0600B 3 Severe   Question/Answer pattern 76948002 severe pain (finding)        
  J0600B 4 Very severe, horrible   Question/Answer pattern 301383001 horrible present pain (finding)        
  J0600B 9 Unable to answer   Question/Answer pattern 288733002 unable to respond to communication by others (finding)        
  J0700   Should staff assessment for pain be conducted     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  J0700 0 No (J0400=1 thru 4)                
  J0700 1 Yes (J0200=0 or J0300=9 or J0400=9)                
  J0800A   Staff pain asmt: non-verbal sounds   ASSERTION PATTERN            
  J0800B   Staff pain asmt: vocal complaints of pain   Assertion pattern 424295009 pain behavior present (situation)        
  J0800C   Staff pain asmt: facial expressions   Assertion pattern 424295009 pain behavior present (situation)        
  J0800D   Staff pain asmt: protective movements/postures   Assertion pattern 424295009 pain behavior present (situation)        
  J0800Z   Staff pain asmt: none of these signs observed     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  J0850   Staff pain asmt: frequency of pain   QUESTION/ ANSWER PATTERN 364631005 pattern of pain (observable entity)        
  J0850 1 Indicators of pain or possible pain observed 1 to 2 days   Question/Answer pattern 84638005 occasional (qualifier value)        
  J0850 2 Indicators of pain or possible pain observed 3 to 4 days   Question/Answer pattern 70232002 frequent (qualifier value)        
  J0850 3 Indicators of possible pain observed daily   Question/Answer pattern 69620002 daily (qualifier value)        
  J1100A   Short breath/trouble breathing: with exertion   Assertion pattern 60845006 dyspnea on exertion (finding)        
  J1100B   Short breath/trouble breathing: sitting at rest   Assertion pattern 161941007 dyspnea at rest (finding)        
  J1100C   Short breath/trouble breathing: lying flat   Assertion pattern 62744007 orthopnea (finding)        
  J1100Z   Short breath/trouble breathing: none of above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  J1300   Current tobacco use   ASSERTION PATTERN            
  J1300 0 No   Assertion pattern 8392000 non-smoker (finding)        
  J1300 1 Yes   Assertion pattern 110483000 tobacco user (finding)        
  J1400   Prognosis: life expectancy of less than 6 months   ASSERTION PATTERN            
  J1400 0 No   Assertion pattern 170968001 prognosis good (finding)        
  J1400 1 Yes   Assertion pattern 170969009 prognosis bad (finding)        
  J1550A   Problem conditions: fever   Assertion pattern 386661006 fever (finding)        
  J1550B   Problem conditions: vomiting   Assertion pattern 249497008 vomiting symptom (finding)        
  J1550C   Problem conditions: dehydrated   Assertion pattern 34095006 dehydration (disorder)        
  J1550D   Problem conditions: internal bleeding   Assertion pattern 131148009 bleeding (finding)        
  J1550Z   Problem conditions: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  J1700A   Fall history: fall during month before admission   ASSERTION PATTERN            
  J1700A 0 No   Assertion pattern 298345007 does not fall (finding)        
  J1700A 1 Yes   Assertion pattern 428942009 history of fall (situation)        
  J1700A 9 Unable to determine     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  J1700B   Fall history: fall 2-6 months before admission   ASSERTION PATTERN            
  J1700B 0 No   Assertion pattern 298345007 does not fall (finding)        
  J1700B 1 Yes   Assertion pattern 428942009 history of fall (situation)        
  J1700B 9 Unable to determine     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  J1700C   Fall history: fracture from fall 6 month pre admit     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  J1700C 0 No                
  J1700C 1 Yes                
  J1700C 9 Unable to determine                
  J1800   Falls since admit/prior asmt: any falls   ASSERTION PATTERN            
  J1800 0 No   Assertion pattern 298345007 does not fall (finding)        
  J1800 1 Yes   Assertion pattern 161898004 falls (finding)        
  J1900A   Falls since admit/prior asmt: no injury     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  J1900A 0 None                
  J1900A 1 One                
  J1900A 2 Two or more                
  J1900B   Falls since admit/prior asmt: injury (not major)     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  J1900B 0 None                
  J1900B 1 One                
  J1900B 2 Two or more                
  J1900C   Falls since admit/prior asmt: major injury     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  J1900C 0 None                
  J1900C 1 One                
  J1900C 2 Two or more                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
K     Swallowing/Nutritional Status                
  K0100A   Swallow disorder: loss liquids/solids from mouth   Assertion pattern 288904007 does not retain food in mouth (finding)        
  K0100B   Swallow disorder: holds food in mouth/cheeks   Assertion pattern 288903001 does retain food in mouth (finding)        
  K0100C   Swallow disorder: cough/ choke with meals/meds     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  K0100D   Swallow disorder: difficulty or pain swallowing     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  K0100Z   Swallow disorder: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  K0200A   Height (in inches)     50373000 body height measure (observable entity)        
  K0200B   Weight (in pounds)     27113001 body weight (observable entity)        
  K0300   Weight loss   QUESTION/ ANSWER PATTERN 363806002 weight loss (amount) (observable entity)        
  K0300 0 No, or unknown     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  K0300 1 Yes, on physician - prescribed weight - loss regimen   Question/Answer pattern 416528001 intentional weight loss (finding)        
  K0300 2 Yes, not on physician - prescribed weight - loss regimen     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  K0500A   Nutritional approaches: parenteral /IV feeding   Assertion pattern 25156005 intravenous feeding of patient (regime/therapy)        
  K0500B   Nutritional approaches: feeding tube   Assertion pattern 61420007 tube feeding of patient (regime/therapy)        
  K0500C   Nutritional approaches: mechanically altered diet   Assertion pattern 226207007 modified texture diet (finding)        
  K0500D   Nutritional approaches: therapeutic diet   Assertion pattern 226077000 therapeutic diets (finding)        
  K0500Z   Nutritional approaches: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  K0700A   Proportion total calories via parenteral/tube feed     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  K0700A 1 25% or less                
  K0700A 2 26-50%                
  K0700A 3 51% or more                
  K0700B   Average fluid intake per day by IV or tube     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  K0700B 1 500 cc/day or less                
  K0700B 2 501 cc/day or more                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
L     Oral/Dental Status                
  L0200A   Dental: broken or loosely fitting denture   Assertion pattern 278542003 dental appliance or restoration finding (finding)        
  L0200B   Dental: no natural teeth or tooth fragment(s)   Assertion pattern 278650002 edentulous (finding)        
  L0200C   Dental: abnormal mouth tissue     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  L0200D   Dental: cavity or broken natural teeth     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  L0200E   Dental: inflamed/bleeding gums or loose teeth     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  L0200F   Dental: pain, discomfort, difficulty chewing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  L0200G   Dental: unable to examine   Assertion pattern 418185003 oral cavity opening not assessable (finding)        
  L0200Z   Dental: none of the above     Concept Not Mapped (Reason #5) - Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT          
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
M     Skin Conditions                
  M0100A   Risk determination: has ulcer, scar, or dressing     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  M0100B   Risk determination: formal assessment   Assertion pattern 225392000 pressure sore risk assessment (procedure)        
  M0100C   Risk determination: clinical assessment   Assertion pattern 225392000 pressure sore risk assessment (procedure)        
  M0100Z   Risk determination: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  M0150   Is resident at risk of developing pressure ulcer   ASSERTION PATTERN            
  M0150 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  M0150 1 Yes   Assertion pattern 285304000 at risk of pressure sore (finding)        
  M0210   Resident has Stage 1 or higher pressure ulcers   ASSERTION PATTERN            
  M0210 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  M0210 1 Yes   Assertion pattern 421076008 pressure ulcer stage 1 (disorder)        
  M0300A   Stage 1 pressure ulcers: number present     264892003 number of pressure sores (observable entity)        
  M0300B1   Stage 2 pressure ulcers: number present     264892003 number of pressure sores (observable entity)        
  M0300B2   Stage 2 pressure ulcers: number at admit/reentry     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0300B3   Stage 2 pressure ulcers: date of oldest     298059007 date of onset (observable entity)        
  M0300C1   Stage 3 pressure ulcers: number present     264892003 number of pressure sores (observable entity)        
  M0300C2   Stage 3 pressure ulcers: number at admit/reentry     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0300D1   Stage 4 pressure ulcers: number present     264892003 number of pressure sores (observable entity)        
  M0300D2   Stage 4 pressure ulcers: number at admit/reentry     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0300E1   Unstaged due to dressing: number present     264892003 number of pressure sores (observable entity)        
  M0300E2   Unstaged due to dressing: number at admit/reentry     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0300F1   Unstaged slough/eschar: number present     264892003 number of pressure sores (observable entity)        
  M0300F2   Unstaged slough/eschar: number at admit/reentry     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0300G1   Unstageable - deep tissue: number present     264892003 number of pressure sores (observable entity)        
  M0300G2   Unstageable - deep tissue: number at admit/reentry     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0610A   Stage 3 or 4 pressure ulcer longest length     401238003 length of wound (observable entity)        
  M0610B   Stage 3 or 4 pressure ulcer width (same ulcer)     401239006 width of wound (observable entity)        
  M0610C   Stage 3 or 4 pressure ulcer depth (same ulcer)     425094009 depth of wound (observable entity)        
  M0700   Tissue type for ulcer at most advanced stage   QUESTION/ ANSWER PATTERN 405040006 tissue integrity status (observable entity)        
  M0700 1 Epithelial Tissue - new skin growing in superficial ulcer. It can be light pink and shiny, even in persons with darkly pigmented skin.     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  M0700 2 Granulation Tissue - pink or red tissue with shiny, moist, granular appearance   Question/Answer pattern 225541009 granulation of tissue (finding)        
  M0700 3 Slough - yellow or white tissue that adheres to the ulcer bed in strings or thick clumps, or is mucinous   Question/Answer pattern 95347000 skin necrosis (disorder)        
  M0700 4 Necrotic Tissue (Eschar) - black, brown, or tan tissue that adheres firmly to the wound bed or ulcer edges, may be softer or harder than surrounding skin.   Question/Answer pattern 421306004 necrotic eschar (disorder)        
  M0800A   Worsened since prior asmt: Stage 2 pressure ulcers     271618001 impaired wound healing (finding)        
  M0800B   Worsened since prior asmt: Stage 3 pressure ulcers     271618001 impaired wound healing (finding)        
  M0800C   Worsened since prior asmt: Stage 4 pressure ulcers     271618001 impaired wound healing (finding)        
  M0900A   Pressure ulcers on prior assessment     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M0900A 0 No                
  M0900A 1 Yes                
  M0900B   Healed pressure ulcers: Stage 2     298006005 wound healed (finding)        
  M0900C   Healed pressure ulcers: Stage 3     298006005 wound healed (finding)        
  M0900D   Healed pressure ulcers: Stage 4     298006005 wound healed (finding)        
  M1030   Number of venous and arterial ulcers     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  M1040A   Other skin probs: infection of the foot   Assertion pattern 299990002 infection of foot (disorder)        
  M1040B   Other skin probs: diabetic foot ulcer(s)   Assertion pattern 371087003 diabetic foot ulcer (disorder)        
  M1040C   Other skin probs: other open lesion(s) on the foot     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  M1040D   Other skin probs: lesions not ulcers, rashes, cuts   Assertion pattern 95324001 skin lesion (disorder)        
  M1040E   Other skin probs: surgical wound(s)   Assertion pattern 419635000 surgical wound finding (finding)        
  M1040F   Other skin probs: burn(s) (second or third degree)   Assertion pattern 125666000 burn (disorder)        
  M1040Z   Other skin probs: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  M1200A   Skin/ulcer treat: pressure reduce device for chair   Assertion pattern 228617000 provision of pressure relief equipment (procedure)        
  M1200B   Skin/ulcer treat: pressure reducing device for bed   Assertion pattern 228617000 provision of pressure relief equipment (procedure)        
  M1200C   Skin/ulcer treat: turning/ repositioning   Assertion pattern 308739004 repositioning (procedure)        
  M1200D   Skin/ulcer treat: nutrition/ hydration     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  M1200E   Skin/ulcer treat: ulcer care   Assertion pattern 440461005 Skin ulcer care (regime/therapy)        
  M1200F   Skin/ulcer treat: surgical wound care   Assertion pattern 226007004 post-surgical wound care (regime/therapy)        
  M1200G   Skin/ulcer treat: application of dressings   Assertion pattern 3895009 application of dressing (procedure)        
  M1200H   Skin/ulcer treat: apply ointments/medications   Assertion pattern 431695009 administration of drug or medicament to skin via topical route (procedure)        
  M1200I   Skin/ulcer treat: apply dressings to feet   Assertion pattern 3895009 application of dressing (procedure)        
  M1200Z   Skin/ulcer treat: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
N     Medications                
  N0300   Number of days injectable medications received     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  N0350A   Insulin: insulin injections     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  N0350B   Insulin: orders for insulin     Concept Not Mapped (Reason #3) --
Data element is a complex expression that is not mappable to a single SNOMED CT concept and requires post coordination.
         
  N0400A   Medications: antipsychotic   Assertion Pattern 408490001 antipsychotic drug therapy (procedure)        
  N0400B   Medications: antianxiety     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  N0400C   Medications: antidepressant     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  N0400D   Medications: hypnotic     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  N0400E   Medications: anticoagulant   Assertion Pattern 182764009 anticoagulant therapy (procedure)        
  N0400F   Medications: antibiotic   Assertion Pattern 281789004 antibiotic therapy (procedure)        
  N0400G   Medications: diuretic   Assertion Pattern 395011005 prophylactic diuretic therapy (procedure)        
  N0400Z   Medications: none of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
O     Special Treatments and Procedures                
  O0100A1   Treatment: chemotherapy - while not resident   Assertion Pattern 367336001 chemotherapy (procedure)        
  O0100A2   Treatment: chemotherapy - while resident   Assertion Pattern 367336001 chemotherapy (procedure)        
  O0100B1   Treatment: radiation - while not resident   Assertion Pattern 108290001 radiation oncology AND/ OR radiotherapy (procedure)        
  O0100B2   Treatment: radiation - while resident   Assertion Pattern 108290001 radiation oncology AND/ OR radiotherapy (procedure)        
  O0100C1   Treatment: oxygen therapy - while not resident   Assertion Pattern 57485005 oxygen therapy (procedure)        
  O0100C2   Treatment: oxygen therapy - while resident   Assertion Pattern 57485005 oxygen therapy (procedure)        
  O0100D1   Treatment: suctioning - while not resident   Assertion Pattern 58058006 suction of patient (procedure)        
  O0100D2   Treatment: suctioning - while resident   Assertion Pattern 58058006 suction of patient (procedure)        
  O0100E1   Treatment: tracheostomy care - while not resident   Assertion Pattern 385858000 tracheostomy care (regime/therapy)        
  O0100E2   Treatment: tracheostomy care - while resident   Assertion Pattern 385858000 tracheostomy care (regime/therapy)        
  O0100F1   Treatment: vent/respirator - while not resident   Assertion Pattern 409025002 ventilator care (regime/therapy)        
  O0100F2   Treatment: vent/respirator - while resident   Assertion Pattern 409025002 ventilator care (regime/therapy)        
  O0100G1   Treatment: BiPAP/CPAP - while not resident   Assertion Pattern 243141005 mechanically assisted spontaneous ventilation (procedure)        
  O0100G2   Treatment: BIPAP/CPAP - while resident   Assertion Pattern 243141005 mechanically assisted spontaneous ventilation (procedure)        
  O0100H1   Treatment: IV medications - while not resident   Assertion Pattern 386358000 administration of drug or medicament via intravenous route (procedure)        
  O0100H2   Treatment: IV medications - while resident   Assertion Pattern 386358000 administration of drug or medicament via intravenous route (procedure)        
  O0100I1   Treatment: transfusions - while not resident   Assertion Pattern 116859006 transfusion of blood product (procedure)        
  O0100I2   Treatment: transfusions - while resident   Assertion Pattern 116859006 transfusion of blood product (procedure)        
  O0100J1   Treatment: dialysis - while not resident   Assertion Pattern 108241001 dialysis procedure (procedure)        
  O0100J2   Treatment: dialysis - while resident   Assertion Pattern 108241001 dialysis procedure (procedure)        
  O0100K1   Treatment: hospice care - while not resident   Assertion Pattern 385763009 hospice care (regime/therapy)        
  O0100K2   Treatment: hospice care - while resident   Assertion Pattern 385763009 hospice care (regime/therapy)        
  O0100L2   Treatment: respite care - while resident   Assertion Pattern 105386004 respite care of patient (regime/therapy)        
  O0100M1   Treatment: isolate/ quarantine - while not resident   Assertion Pattern 275823006 isolation nursing (procedure)        
  O0100M2   Treatment: isolate/ quarantine - while resident   Assertion Pattern 275823006 isolation nursing (procedure)        
  O0100Z1   Treatment: none of above - while not resident     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  O0100Z2   Treatment: none of above - while resident     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  O0250A   Was influenza vaccine received   ASSERTION PATTERN            
  O0250A 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
        Concept Not Mapped - No comparable CVX concept is available.
  O0250A 1 Yes   Assertion pattern 86198006 influenza vaccination (procedure)       141
  O0250B   Date influenza vaccine received.     439272007 date of procedure (observable entity)        
  O0250C   If influenza vaccine not received, state reason   QUESTION/ ANSWER PATTERN 445032002 reason procedure not performed (observable entity)       Concept Not Mapped - No comparable CVX concept is available.
  O0250C 1 Resident not in facility during this year's flu season     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  O0250C 2 Received outside of this facility   Question/Answer pattern 308532005 influenza vaccination status (finding)        
  O0250C 3 Not eligible - medical contraindication   Question/Answer pattern 390796006 influenza vaccination contraindicated (situation)        
  O0250C 4 Offered and declined   Question/Answer pattern 315640000 influenza vaccination declined (situation)        
  O0250C 5 Not offered   Question/Answer pattern 171262002 immunization not offered (finding)        
  O0250C 6 Inability to obtain vaccine due to a declared shortage   Question/Answer pattern 182850000 drugs not issued (finding)        
  O0250C 9 None of the above     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  O0300A   Is pneumococcal vaccination up to date   ASSERTION PATTERN           Concept Not Mapped - No comparable CVX concept is available.
  O0300A 0 No   Assertion pattern 171259000 not up-to-date with immunizations (finding)        
  O0300A 1 Yes   Assertion pattern 171258008 up-to-date with immunizations (finding)        
  O0300B   If pneumococcal vacc not received, state reason   QUESTION/ ANSWER PATTERN 445032002 reason procedure not performed (observable entity)       Concept Not Mapped - No comparable CVX concept is available.
  O0300B 1 Not eligible - medical contraindication   Question/Answer pattern 390795005 pneumococcal vaccination contraindicated (situation)        
  O0300B 2 Offered and declined   Question/Answer pattern 401086001 pneumococcal vaccination declined (situation)        
  O0300B 3 Not offered   Question/Answer pattern 171262002 immunization not offered (finding)        
  O0400A1   Speech-language/ audiology: individ minutes   Assertion pattern 276239002 therapy (regime/ therapy)        
  O0400A2   Speech-language/ audiology: concur minutes   Assertion pattern 276239002 therapy (regime/ therapy)        
  O0400A3   Speech-language/ audiology: group minutes   Assertion pattern 276239002 therapy (regime/ therapy)        
  O0400A4   Speech-language/ audiology: number of days   Assertion pattern 276239002 therapy (regime/ therapy)        
  O0400A5   Speech-language/ audiology: start date   Assertion pattern 413946009 date treatment started (observable entity)        
  O0400A6   Speech-language/ audiology: end date   Assertion pattern 413947000 date treatment stopped (observable entity)        
  O0400B1   Occupational therapy: individ minutes   Assertion pattern 84478008 occupational therapy (regime/ therapy)        
  O0400B2   Occupational therapy: concur minutes   Assertion pattern 84478008 occupational therapy (regime/ therapy)        
  O0400B3   Occupational therapy: group minutes   Assertion pattern 84478008 occupational therapy (regime/ therapy)        
  O0400B4   Occupational therapy: number of days   Assertion pattern 84478008 occupational therapy (regime/ therapy)        
  O0400B5   Occupational therapy: start date   Assertion pattern 413946009 date treatment started (observable entity)        
  O0400B6   Occupational therapy: end date   Assertion pattern 413947000 date treatment stopped (observable entity)        
  O0400C1   Physical therapy: individ minutes   Assertion pattern 91251008 physical therapy procedure (regime/therapy)        
  O0400C2   Physical therapy: concur minutes   Assertion pattern 91251008 physical therapy procedure (regime/therapy)        
  O0400C3   Physical therapy: group minutes   Assertion pattern 91251008 physical therapy procedure (regime/therapy)        
  O0400C4   Physical therapy: number of days   Assertion pattern 91251008 physical therapy procedure (regime/therapy)        
  O0400C5   Physical therapy: start date   Assertion pattern 413946009 date treatment started (observable entity)        
  O0400C6   Physical therapy: end date   Assertion pattern 413947000 date treatment stopped (observable entity)        
  O0400D1   Respiratory therapy: number of minutes   Assertion pattern 53950000 respiratory therapy (procedure)        
  O0400D2   Respiratory therapy: number of days   Assertion pattern 53950000 respiratory therapy (procedure)        
  O0400E1   Psychological therapy: number of minutes   Assertion pattern 75516001 psychotherapy (regime/therapy)        
  O0400E2   Psychological therapy: number of days   Assertion pattern 75516001 psychotherapy (regime/therapy)        
  O0400F1   Recreational therapy: number of minutes   Assertion pattern 42364006 recreational therapy (regime/ therapy)        
  O0400F2   Recreational therapy: number of days   Assertion pattern 42364006 recreational therapy (regime/ therapy)        
  O0450A   Has therapy resumed NEW RUGs ITEMS              
  O0450B   Therapy resumption date NEW RUGs ITEMS              
  O0500A   Range of motion (passive): number of days   Assertion pattern 72736008 musculoskeletal exercise, passive (regime/therapy)        
  O0500B   Range of motion (active): number of days   Assertion pattern 72628009 musculoskeletal exercise, active (regime/therapy)        
  O0500C   Splint or brace assistance: number of days   Assertion pattern 223490009 appliance procedures (procedure)        
  O0500D   Bed mobility training: number of days   Assertion pattern 410267000 mobility/transfers education, guidance, and counseling (procedure)        
  O0500E   Transfer training: number of days   Assertion pattern 78089009 transfer training (procedure)        
  O0500F   Walking training: number of days   Assertion pattern 359665005 ambulation training (procedure)        
  O0500G   Dressing and/or grooming training: number of days     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  O0500H   Eating and/or swallowing training: number of days     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  O0500I   Amputation/prosthesis training: number of days   Assertion pattern 54483009 amputation education (procedure)        
  O0500J   Communication training: number of days   Assertion pattern 310829009 communication skills training (procedure)        
  O0600   Physician examinations: number of days   Assertion pattern 162673000 general examination of patient (procedure)        
  O0700   Physician orders: number of days   Assertion pattern 410145008 medical regimen orders management (procedure)        
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
P     Restraints                
  P0100A   Restraints used in bed: bed rail   ASSERTION PATTERN            
  P0100A 0 Not used     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  P0100A 1 Used less than daily   Assertion pattern 64373007 placing bedrails (procedure)        
  P0100A 2 Used daily   Assertion pattern 64373007 placing bedrails (procedure)        
  P0100B   Restraints used in bed: trunk restraint     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  P0100B 0 Not used                
  P0100B 1 Used less than daily                
  P0100B 2 Used daily                
  P0100C   Restraints used in bed: limb restraint     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  P0100C 0 Not used                
  P0100C 1 Used less than daily                
  P0100C 2 Used daily                
  P0100D   Restraints used in bed: other     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  P0100D 0 Not used                
  P0100D 1 Used less than daily                
  P0100D 2 Used daily                
  P0100E   Restraints in chair/out of bed: trunk restraint     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  P0100E 0 Not used                
  P0100E 1 Used less than daily                
  P0100E 2 Used daily                
  P0100F   Restraints in chair/out of bed: limb restraint     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  P0100F 0 Not used                
  P0100F 1 Used less than daily                
  P0100F 2 Used daily                
  P0100G   Restraints in chair/out of bed: chair stops rising     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  P0100G 0 Not used                
  P0100G 1 Used less than daily                
  P0100G 2 Used daily                
  P0100H   Restraints in chair/out of bed: other     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  P0100H 0 Not used                
  P0100H 1 Used less than daily                
  P0100H 2 Used daily                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
Q     Participation in Assessment and Goal Setting                
  Q0100A   Resident participated in assessment   QUESTION/ANSWER PATTERN 225992008 involving client in planning care (procedure)        
  Q0100A 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  Q0100A 1 Yes   Question/Answer pattern 248448006 involved (qualifier value)        
  Q0100B   Family/signif other participated in assessment   QUESTION/ ANSWER PATTERN 225329001 involving family and friends in care (procedure)        
  Q0100B 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  Q0100B 1 Yes   Question/Answer pattern 248448006 involved (qualifier value)        
  Q0100B 9 No family or significant other   Question/Answer pattern 224089000 no known relatives (finding)        
  Q0100C   Guardian/legal rep participated in assessment     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0100C 0 No                
  Q0100C 1 Yes                
  Q0100C 9 No guardian or legally authorized representative                
  Q0300A   Resident's overall goal   QUESTION/ ANSWER PATTERN 312010007 cognitive function: goal setting (observable entity)        
  Q0300A 1 Expects to be discharged to the community   Question/Answer pattern 306691003 discharge to residential home (procedure)        
  Q0300A 2 Expects to remain in this facility     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0300A 3 Expects to be discharged to another facility/institution   Question/Answer pattern 19712007 patient transfer, to another health care facility (procedure)        
  Q0300A 9 Unknown or uncertain     Concept Not Mapped (Reason #5) --
Ambiguous concepts such as "none", "other", "unknown", etc., cannot be mapped to SNOMED CT
         
  Q0300B   Information source for resident's goal     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0300B 1 Resident                
  Q0300B 2 If not resident, then family or significant other                
  Q0300B 3 If not resident, family or significant other, then guardian or legally authorized representative                
  Q0300B 9 None of the above                
  Q0400A   Active discharge plan for return to community   ASSERTION PATTERN            
  Q0400A 0 No     Concept Not Mapped (Reason #4) --
Negated/frequency/ qualifier data elements addressed through the vendor information model or in the CCD
         
  Q0400A 1 Yes   Assertion pattern 394830001 action plan (community) (procedure)        
  Q0400B   Determination regarding discharge to community   QUESTION/ ANSWER PATTERN 404984000 readiness for discharge to independent living (observable entity)        
  Q0400B 0 Determination not made     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0400B 1 Discharge to community determined to be feasible   Question/Answer pattern 306689006 discharge home (procedure)        
  Q0400B 2 Discharge to community determined to be not feasible     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0500A   Resident been asked about return to community     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0500A 0 No                
  Q0500A 1 Yes--previous response was "no"                
  Q0500A 2 Yes--previous response was "yes"                
  Q0500A 3 Yes--previous response was "unknown"                
  Q0500B   Do you want to talk about returning to community     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0500B 0 No                
  Q0500B 1 Yes                
  Q0500B 9 Unknown or uncertain                
  Q0600   Referral been made to local contact agency     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  Q0600 0 No--determination has been made by the resident and the care planning team that contact is not required                
  Q0600 1 No--referral not made                
  Q0600 2 Yes                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
T     Therapy Supplement for Medicare PPS                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
V                      
  V0100A   Prior OBRA reason for assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  V0100A 1 Admission assessment (required by day 14)                
  V0100A 2 Quarterly review assessment                
  V0100A 3 Annual assessment                
  V0100A 4 Significant change in status assessment                
  V0100A 5 Significant correction to prior comprehensive assessment                
  V0100A 6 Significant correction to prior quarterly assessment                
  V0100A 99 Not OBRA required assessment/tracking                
  V0100B   Prior PPS reason for assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  V0100B 1 5-day scheduled assessment                
  V0100B 2 14-day scheduled assessment                
  V0100B 3 30-day scheduled assessment                
  V0100B 4 60-day scheduled assessment                
  V0100B 5 90-day scheduled assessment                
  V0100B 6 Readmission/return assessment                
  V0100B 7 Unscheduled assessment used for PPS (OMRA, significant or clinical change, or significant correction assessment)                
  V0100B 99 Not PPS assessment                
  V0100C   Prior assessment reference date     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  V0100D   Prior assessment BIMS summary score     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0100E   Prior asmt PHQ res: total mood severity score     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0100F   Prior asmt PHQ staff: total mood score     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A01A   CAA-Delirium: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A01B   CAA-Delirium: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A02A   CAA-Cognitive loss/ dementia: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A02B   CAA-Cognitive loss/ dementia: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A03A   CAA-Visual function: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A03B   CAA-Visual function: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A04A   CAA-Communication: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A04B   CAA-Communication: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A05A   CAA-ADL functional/ rehab potential: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A05B   CAA-ADL functional/ rehab potential: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A06A   CAA-Urinary incont/ indwell catheter: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A06B   CAA-Urinary incont/ indwell catheter: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A07A   CAA-Psychosocial well-being: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A07B   CAA-Psychosocial well-being: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A08A   CAA-Mood state: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A08B   CAA-Mood state: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A09A   CAA-Behavioral symptoms: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A09B   CAA-Behavioral symptoms: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A10A   CAA-Activities: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A10B   CAA-Activities: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A11A   CAA-Falls: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A11B   CAA-Falls: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A12A   CAA-Nutritional status: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A12B   CAA-Nutritional status: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A13A   CAA-Feeding tubes: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A13B   CAA-Feeding tubes: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A14A   CAA-Dehydration/fluid maintenance: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A14B   CAA-Dehydration/fluid maintenance: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A15A   CAA-Dental care: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A15B   CAA-Dental care: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A16A   CAA-Pressure ulcer: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A16B   CAA-Pressure ulcer: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A17A   CAA-Psychotropic drug use: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A17B   CAA-Psychotropic drug use: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A18A   CAA-Physical restraints: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A18B   CAA-Physical restraints: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A19A   CAA-Pain: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A19B   CAA-Pain: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A20A   CAA-Return to community referral: triggered     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200A20B   CAA-Return to community referral: plan     Concept Not Mapped (Reason #2) --
No comparable SNOMED CT concept is available for either 1:1 equivalent or most proximal parent mapping
         
  V0200B2   CAA-Assessment process signature date                
  V0200C2   CAA-Care planning signature date                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
X                      
  X0100   Correction: type of transaction     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0100 1 Add new record                
  X0100 2 Modify existing record                
  X0100 3 Inactivate existing record                
  X0150   Correction: type of provider     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0150 1 Nursing home (SNF/NF)                
  X0150 2 Swing bed                
  X0200A   Correction: resident first name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0200C   Correction: resident last name                
  X0300   Correction: resident gender     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0300 1 Male                
  X0300 2 Female                
  X0400   Correction: resident birth date     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0500   Correction: resident social security number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0600A   Correction: OBRA reason for assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0600A 1 Admission assessment (required by day 14)                
  X0600A 2 Quarterly review assessment                
  X0600A 3 Annual assessment                
  X0600A 4 Significant change in status assessment                
  X0600A 5 Significant correction to prior comprehensive assessment                
  X0600A 6 Significant correction to prior quarterly assessment                
  X0600A 99 Not OBRA required assessment/tracking                
  X0600B   Correction: PPS reason for assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0600B 1 5-day scheduled assessment                
  X0600B 2 14-day scheduled assessment                
  X0600B 3 30-day scheduled assessment                
  X0600B 4 60-day scheduled assessment                
  X0600B 5 90-day scheduled assessment                
  X0600B 6 Readmission/return assessment                
  X0600B 7 Unscheduled assessment used for PPS (OMRA, significant or clinical change, or significant correction assessment)                
  X0600B 99 Not PPS assessment                
  X0600C   Correction: OMRA assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0600C 0 No                
  X0600C 1 Start of therapy assessment                
  X0600C 2 End of therapy assessment                
  X0600C 3 Both Start and End of therapy assessment                
  X0600D   Correction: Swing bed clinical change asmt     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0600D 0 No                
  X0600D 1 Yes                
  X0600F   Correction: entry/ discharge reporting     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0600F 1 Entry record                
  X0600F 10 Discharge assessment - return not anticipated                
  X0600F 11 Discharge assessment - return anticipated                
  X0600F 12 Death in facility record                
  X0600F 99 Not entry/discharge                
  X0700A   Correction: assessment reference date     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0700B   Correction: discharge date                
  X0700C   Correction: entry date                
  X0800   Correction: correction number     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0900A   Correction: modif reasons - transcription error     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X0900B   Correction: modif reasons - data entry error                
  X0900C   Correction: modif reasons - software error                
  X0900D   Correction: modif reasons - item coding error                
  X0900Z   Correction: modif reasons - other error                
  X1050A   Correction: inact reasons - event did not occur     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X1050Z   Correction: inact reasons - other reason                
  X1100A   Correction: attestor first name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  X1100B   Correction: attestor last name                
  X1100E   Correction: attestation date                
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
Z     Assessment Administration                
  Z0100A   Medicare Part A: HIPPS code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  Z0100B   Medicare Part A: RUG version code                
  Z0100C   Medicare Part A: Medicare short stay asmt     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  Z0100C 0 No                
  Z0100C 1 Yes                
  Z0150A   Medicare Part A: non-therapy HIPPS code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  Z0150B   Medicare Part A: non-therapy RUG version code                
  Z0200A   State case mix: RUG group     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  Z0200B   State case mix: RUG version code                
  Z0250A   State case mix: Alternate RUG group     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  Z0250B   State case mix: Alternate RUG version code                
  Z0500B   Date RN signed assessment as complete     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
Section CMS Question ID Answer CMS Description
Light Orange Shading Indicates Start of New Question per CMS Data Dictionary
General Guidance Mapping Based on the Following Pattern for Representation of Data Element SNOMED CT Code SNOMED CT Fully Specified Name ICD-9-CM Code - Section 1 Only ICD-10-CM Code - Section 1 Only CDC Race & Ethnicity Codes* Codes for Vaccines Administered (CVX) - Section O Only
OTHER                      
  FAC_ID   Assigned facility/provider submission ID     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ PROD_ NAME   Software product name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ PROD_ NAME   Software product name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ PROD_VRSN_CD   Software product version code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ PROD_VRSN_CD   Software product version code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ VNDR_ EMAIL_ ADR   Software vendor email address     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ VNDR_ EMAIL_ADR   Software vendor email address     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ VNDR_ ID   Software vendor federal employer tax ID     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ VNDR_ ID   Software vendor federal employer tax ID     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ VNDR_ NAME   Software vendor company name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SFTWR_ VNDR_ NAME   Software vendor company name     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SPEC_ VRSN_CD   Specifications version code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  SPEC_ VRSN_CD   Specifications version code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD   Item subset code     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NCN Nursing home comprehensive assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NCP Nursing home comprehensive assessment coupled with PPS assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NDE Nursing home discharge coupled with EMCA     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NDN Nursing home discharge     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NEN Nursing home entry     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NNE Nursing home EMCA     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NNN Nursing home not OMBRA and not PPS assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NNP Nursing home PPS assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NQN Nursing home quarterly assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD NQP Nursing home quarterly assessment coupled with PPS assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SDE Swing bed discharge coupled with EMCA     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SDN Swing bed discharge     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SEN Swing bed entry     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SNE Swing bed EMCA     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SNN Swing bed not a PPS assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SNP Swing bed PPS assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD SNS Swing bed clinical change assessment     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  ITM_SBST_ CD XXX Inactivation transaction     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  PRODN_ TEST_ CD   Production/test indicator     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  PRODN_ TEST_ CD P Product submission     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         
  PRODN_TEST_ CD T Test submission     Concept Not Mapped (Reason #1) --
This demographic/ administrative data element is mapped to the CDA Header or is not relevant/useful to other providers/clinicians
         

 

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