| 86483-5 | Showering or bathing was limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86474-4 | Walking 1 block on level ground was limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86477-7 | Hurrying or jogging (as if to catch a bus) was limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86479-3 | Swelling in your feet, ankles or legs when you woke up over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86481-9 | Fatigue limited your ability to do what you wanted over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86472-8 | Shortness of breath limited your ability to do what you wanted over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86485-0 | Sleep sitting up in a chair or with at least 3 pillows to prop you up because of shortness of breath over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86488-4 | Enjoyment of life limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86489-2 | How would you feel if you had to spend the rest of your life with your heart failure the way it is right now:Find:Pt:^Patient:Ord:KCCQ | required |
| 86491-8 | Participation in hobbies, recreational activities limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86492-6 | Participation in working or doing household chores limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86493-4 | Participation in visiting family or friends out of your home limited by heart failure over the past 2W:Find:2W:^Patient:Ord:KCCQ | required |
| 86924-8 | Overall summary score:Score:Pt:^Patient:Qn:KCCQ-12 | |
| 86923-0 | Kansas City Cardiomyopathy Questionnaire - 12 item:-:Pt:^Patient:-:KCCQ-12 | |