95031-1
Assistive Devices for Everyday Activities
Active
95042-8 In the past month, has the person used, or expressed or demonstrated a need for an assistive device?
Observation ID in Form
GG0125AA
Fully-Specified Name
- Component
- Used or needed assistive devices in the past Mo
- Property
- Find
- Time
- 1Mo
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.68
- Order vs. Observation
- Observation
Normative Answer List LL251-0
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | 0 | LA32-8 | |
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | 1 | LA33-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
94879-4 Cane/crutch
Observation ID in Form
GG0125A
Fully-Specified Name
- Component
- Need for and availability of a cane &or crutch
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94880-2 Walker
Observation ID in Form
GG0125B
Fully-Specified Name
- Component
- Need for and availability of a walker
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94881-0 Standard folding walker
Observation ID in Form
GG0125B1
Fully-Specified Name
- Component
- Need for and availability of a standard folding walker
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94882-8 Walker with seat
Observation ID in Form
GG0125B2
Fully-Specified Name
- Component
- Need for and availability of a walker with seat
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94883-6 Walker wtih wheels
Observation ID in Form
GG0125B3
Fully-Specified Name
- Component
- Need for and availability of a walker with wheels
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94884-4 Wheelchair
Observation ID in Form
GG0125C
Fully-Specified Name
- Component
- Need for and availability of a wheelchair
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94885-1 Manual wheelchair
Observation ID in Form
GG0125C1
Fully-Specified Name
- Component
- Need for and availability of a manual wheelchair
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94886-9 Motorized wheelchair and/or scooter
Observation ID in Form
GG0125C2
Fully-Specified Name
- Component
- Need for and availability of a motorized wheelchair &or scooter
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94887-7 Limb prosthesis
Observation ID in Form
GG0125D
Fully-Specified Name
- Component
- Need for and availability of a limb prosthesis
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94888-5 Specialized seating pad (e.g. air-filled, gel, shaped foam)
Observation ID in Form
GG0125E
Fully-Specified Name
- Component
- Need for and availability of a specialized seating pad
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94889-3 Mechanical lift
Observation ID in Form
GG0125F
Fully-Specified Name
- Component
- Need for and availability of a mechanical lift
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94890-1 Reacher/Grabber
Observation ID in Form
GG0125G
Fully-Specified Name
- Component
- Need for and availability of a reacher &or grabber
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94891-9 Sock aid
Observation ID in Form
GG0125H
Fully-Specified Name
- Component
- Need for and availability of a sock aid
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94892-7 Orthotics/Brace
Observation ID in Form
GG0125I
Fully-Specified Name
- Component
- Need for and availability of an orthotic &or brace
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94893-5 Bed rail
Observation ID in Form
GG0125J
Fully-Specified Name
- Component
- Need for and availability of a bed rail
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94894-3 Electronic bed
Observation ID in Form
GG0125K
Fully-Specified Name
- Component
- Need for and availability of an electronic bed
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94895-0 Grab bars
Observation ID in Form
GG0125L
Fully-Specified Name
- Component
- Need for and availability of grab bars
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94896-8 Transfer board
Observation ID in Form
GG0125M
Fully-Specified Name
- Component
- Need for and availability of a transfer board
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94897-6 Shower/commode chair
Observation ID in Form
GG0125N
Fully-Specified Name
- Component
- Need for and availability of a shower &or commode chair
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94898-4 Walk/wheel-in shower
Observation ID in Form
GG0125O
Fully-Specified Name
- Component
- Need for and availability of a walk or wheel-in shower
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94899-2 Glasses or contact lenses
Observation ID in Form
GG0125P
Fully-Specified Name
- Component
- Need for and availability of glasses or contact lenses
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94900-8 Hearing aid
Observation ID in Form
GG0125Q
Fully-Specified Name
- Component
- Need for and availability of a hearing aid
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94901-6 Communication device
Observation ID in Form
GG0125R
Fully-Specified Name
- Component
- Need for and availability of a communication device
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94902-4 Stair rails
Observation ID in Form
GG0125S
Fully-Specified Name
- Component
- Need for and availability of stair rails
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94903-2 Lift chair
Observation ID in Form
GG0125T
Fully-Specified Name
- Component
- Need for and availability of a lift chair
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94904-0 Ramps
Observation ID in Form
GG0125U
Fully-Specified Name
- Component
- Need for and availability of ramps
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94905-7 Raised toilet seat
Observation ID in Form
GG0125V
Fully-Specified Name
- Component
- Need for and availability of a raised toilet seat
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94906-5 Glucometer
Observation ID in Form
GG0125W
Fully-Specified Name
- Component
- Need for and availability of a glucometer
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94907-3 CPAP
Observation ID in Form
GG0125X
Fully-Specified Name
- Component
- Need for and availability of Continuous Positive Airway Pressure device
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94908-1 Oxygen concentrator
Observation ID in Form
GG0125Y
Fully-Specified Name
- Component
- Need for and availability of an oxygen concentrator
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94910-7 Other
Observation ID in Form
GG0125Z
Fully-Specified Name
- Component
- Need for and availability of other assistive devices
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Example Answer List LL5572-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Assistive device needed and available - Person needs this device to complete daily activities and has the device in the home. | 02 | LA30918-9 | |
| Assistive device needed but current device unsuitable - Device is in home but no longer meets person's needs. | 01 | LA30919-7 | |
| Assistive device needed but not available - Person needs the device but it is not available in the home. | 00 | LA30920-5 | |
| Person refused - Person chooses to not use needed device. | 07 | LA30921-3 | |
| Not applicable - Person does not need this device. | 11 | LA30922-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 105175-4 | Functional assessment standardized items (FASI) - v1.1 during assessment period [CMS Assessment] |
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |
94909-9 Specify:
Observation ID in Form
GG0125Z_Specify
Fully-Specified Name
- Component
- Assistive devices needed
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Nom
- Method
- CMS Assessment
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.68
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Observation
Normative Answer List LL5581-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Stair glide | LA30948-6 | ||
| Pillbox | LA30949-4 | ||
| Cognitive aids, such as computer or electrical assistive devices to aid in memory, attention or other cognitive challenges | LA30950-2 | ||
| Voice recognition program | LA30951-0 | ||
| Computer or device screen reader | LA30952-8 | ||
| Computer screen enlargement applications | LA30953-6 | ||
| Automatic page turners | LA30954-4 | ||
| Book holder | LA30955-1 | ||
| Adapted pencil grips | LA30956-9 | ||
| Adaptive switches | LA30957-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 94848-9 | Functional assessment standardized items (FASI) - version 1.0 [CMS Assessment] |