| 45697-0 | Insufficient fluid; did NOT consume all or almost all liquids provided during last 3 days (qualitative) |
| 83187-5 | Wheel 50 feet with two turns - functional goal during 3 day assessment period (qualitative) |
| 83188-3 | Wheel 50 feet with two turns - functional ability during 3 day assessment period (qualitative) |
| 83189-1 | Picking up object - functional goal during 3 day assessment period (qualitative) |
| 83190-9 | Picking up object - functional ability during 3 day assessment period (qualitative) |
| 83191-7 | 12 steps - functional goal during 3 day assessment period (qualitative) |
| 83192-5 | 12 steps - functional ability during 3 day assessment period (qualitative) |
| 83193-3 | 4 steps - functional goal during 3 day assessment period (qualitative) |
| 83194-1 | 4 steps - functional ability during 3 day assessment period (qualitative) |
| 83195-8 | 1 step (curb) - functional goal during 3 day assessment period (qualitative) |
| 83196-6 | 1 step (curb) - functional ability during 3 day assessment period (qualitative) |
| 83197-4 | Walking 10 feet on uneven surfaces - functional goal during 3 day assessment period (qualitative) |
| 83198-2 | Walking 10 feet on uneven surfaces - functional ability during 3 day assessment period (qualitative) |
| 83199-0 | Walk 150 feet - functional goal during 3 day assessment period (qualitative) |
| 83200-6 | Walk 150 feet - functional ability during 3 day assessment period (qualitative) |
| 83201-4 | Walk 50 feet with two turns - functional goal during 3 day assessment period (qualitative) |
| 83202-2 | Walk 50 feet with two turns - functional ability during 3 day assessment period (qualitative) |
| 83203-0 | Walk 10 feet - functional goal during 3 day assessment period (qualitative) |
| 83204-8 | Walk 10 feet - functional ability during 3 day assessment period (qualitative) |
| 83205-5 | Car transfer - functional goal during 3 day assessment period (qualitative) |
| 83206-3 | Car transfer - functional ability during 3 day assessment period (qualitative) |
| 83207-1 | Toilet transfer - functional goal during 3 day assessment period (qualitative) |
| 83208-9 | Toilet transfer - functional ability during 3 day assessment period (qualitative) |
| 83209-7 | Bed-to-chair transfer - functional goal during 3 day assessment period (qualitative) |
| 83210-5 | Bed-to-chair transfer - functional ability during 3 day assessment period (qualitative) |
| 83211-3 | Sit to stand - functional goal during 3 day assessment period (qualitative) |
| 83212-1 | Sit to stand - functional ability during 3 day assessment period (qualitative) |
| 83213-9 | Lying to sitting on side of bed - functional goal during 3 day assessment period (qualitative) |
| 83214-7 | Lying to sitting on side of bed - functional ability during 3 day assessment period (qualitative) |
| 83215-4 | Sit to lying - functional goal during 3 day assessment period (qualitative) |
| 83216-2 | Sit to lying - functional ability during 3 day assessment period (qualitative) |
| 83217-0 | Roll left and right - functional goal during 3 day assessment period (qualitative) |
| 83218-8 | Roll left and right - functional ability during 3 day assessment period (qualitative) |
| 83219-6 | Putting on/taking off footwear - functional goal during 3 day assessment period (qualitative) |
| 83220-4 | Putting on/taking off footwear - functional ability during 3 day assessment period (qualitative) |
| 83221-2 | Lower body dressing - functional goal during 3 day assessment period (qualitative) |
| 83222-0 | Lower body dressing - functional ability during 3 day assessment period (qualitative) |
| 83223-8 | Upper body dressing - functional goal during 3 day assessment period (qualitative) |
| 83224-6 | Upper body dressing - functional ability during 3 day assessment period (qualitative) |
| 83225-3 | Shower/bathe self - functional goal during 3 day assessment period (qualitative) |
| 83226-1 | Shower/bathe self - functional ability during 3 day assessment period (qualitative) |
| 83227-9 | Toileting hygiene - functional goal during 3 day assessment period (qualitative) |
| 83228-7 | Toileting hygiene - functional ability during 3 day assessment period (qualitative) |
| 83229-5 | Oral hygiene - functional goal during 3 day assessment period (qualitative) |
| 83230-3 | Oral hygiene - functional ability during 3 day assessment period (qualitative) |
| 83231-1 | Eating - functional goal during 3 day assessment period (qualitative) |
| 83232-9 | Eating - functional ability during 3 day assessment period (qualitative) |
| 83233-7 | Self-care - admission performance |
| 83235-2 | Wheel 150 feet - functional ability during 3 day assessment period (qualitative) |
| 83236-0 | Wheel 150 feet - functional goal during 3 day assessment period (qualitative) |
| 83237-8 | Bladder and bowel |
| 83238-6 | Bladder continence during 3 day assessment period (qualitative) |
| 83242-8 | Bowel continence during 3 day assessment period (qualitative) |
| 83244-4 | IRF-PAI v2.0 - Swallowing/nutritional status - admission |
| 83245-1 | Usual ability to swallow during 3 day assessment period |
| 83248-5 | Should brief interview for mental status be conducted during 3 day assessment period (qualitative) |
| 83249-3 | Understanding verbal content during 3 day assessment period (qualitative) |
| 83250-1 | Expression of ideas and wants during 3 day assessment period (qualitative) |
| 83254-3 | Self-care - discharge performance |
| 83269-1 | IRF-PAI - Mobility - admission performance during 3 day assessment period |
| 83270-9 | Does the patient walk - admission performance during 3 day assessment period (qualitative) |
| 83271-7 | Does the patient use a wheelchair or scooter during 3 day assessment period (qualitative) |
| 83272-5 | Indicate the type of wheelchair or scooter used during 3 day assessment period |
| 83276-6 | IRF-PAI - Functional abilities and goals - discharge |
| 83277-4 | IRF-PAI - Mobility - discharge performance during 3 day assessment period |
| 83278-2 | Does the patient walk - discharge performance during 3 day assessment period (qualitative) |
| 85054-5 | Self-care - discharge goal |
| 85056-0 | Mobility - discharge goal during 3 day assessment period |
| 85629-4 | Comatose during 3 day assessment period (qualitative) |
| 85630-2 | Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity during 3 day assessment period (qualitative) |
| 85631-0 | Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said during 3 day assessment period (qualitative) |
| 85633-6 | Indicate the patient's primary medical condition category during 3 day assessment period |
| 85634-4 | Is there evidence of an acute change in mental status from the patient's baseline during 3 day assessment period (qualitative) |
| 85635-1 | LCDS v3.00 - Active diagnoses |
| 85638-5 | LCDS v3.00 - Cognitive patterns |
| 85640-1 | LCDS v3.00 - Hearing, speech, and vision |
| 85641-9 | LCDS v3.00 - Mobility - admission performance during 3 day assessment period |
| 85644-3 | LCDS v3.00 - Swallowing/nutritional status |
| 85646-8 | Level of consciousness - Alert (normal) during 3 day assessment (qualitative) |
| 85649-2 | LCDS v3.00 - Signs and Symptoms of Delirium (from CAM) |
| 85651-8 | Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject during 3 day assessment period (qualitative) |
| 85652-6 | Wash upper body - functional ability during 3 day assessment period (qualitative) |
| 85653-4 | Wash upper body - functional goal during 3 day assessment period (qualitative) |
| 85655-9 | Level of consciousness - Vigilant or lethargic or stupor or coma during 3 day assessment (qualitative) |
| 85660-9 | LCDS v3.00 - Mobility - discharge goal during 3D assessment period |
| 85661-7 | LCDS v3.00 - Self-care - discharge goal |
| 85664-1 | LCDS v3.00 - Functional abilities and goals - planned discharge |
| 85665-8 | LCDS v3.00 - Self-care - discharge performance |
| 85666-6 | LCDS v3.00 - Bladder and bowel - planned discharge |
| 85667-4 | LCDS v3.00 - Self-care - admission performance |
| 85672-4 | LCDS v3.00 - Mobility - discharge performance during 3 day assessment period |
| 85811-8 | LCDS v3.00 - Altered level of consciousness |
| 85812-6 | LCDS v3.00 - Acute onset and fluctuating course |
| 86612-9 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Functional abilities and goals - admission |
| 86613-7 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Self-care - admission performance |
| 86614-5 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Mobility - admission performance during 3 day assessment period |
| 86615-2 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Functional abilities and goals - discharge |
| 86616-0 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Self-care - discharge performance |
| 86617-8 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Mobility - discharge performance during 3 day assessment period |
| 86618-6 | MDS v3.0 - RAI v1.14.1, v1.15.1 - Self-care - discharge goal |