File5_508_CMS-10298PRA_DOTPA_Instrument_Change_Crosswalk_2010_02_25

File5_508_CMS-10298PRA_DOTPA_Instrument_Change_Crosswalk_2010_02_25.pdf

Data Collection for Developing Outpatient Therapy Payment Alternatives (DOTPA)

File5_508_CMS-10298PRA_DOTPA_Instrument_Change_Crosswalk_2010_02_25

OMB: 0938-1096

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Revisions Crosswalk – DOTPA Data Collection Instruments (CMS-10298 PRA)
Section/item
Type of
Form1
changed
change
CARE-C II.C.5
Modification

1

CARE-C II.F.2

Modification

CARE-C II.F.3

Modification

CARE-C II.F.4

New Items

CARE-C III.A

Modification

CARE-C III.B

Modification

CARE-C III.C.4

Modification

CARE-C VI.D

New Items

CARE-F

II.A.3

Modification

CARE-F

III.A

Modification

CARE-F

III.B

Modification

CARE-F

III.E.3

Modification

CARE-F

V.E.1

Modification

Description of change
Add clarifying language to chest pain
and peripheral vascular condition
response categories.
Modify the set of activities to increase
the range of function over which a
score can be computed.
Modify the set of activities to increase
the range of function over which a
score can be computed.
Add three patient-reported items based
on the PM-PAC to measure patient
participation.
Modify several response categories to
separate specific body structures and
body functions; and distinguish left
and right versus unilateral versus
bilateral.
Modify response categories for
pulmonary/respiratory medical
condition.
Change wording of the memory and
attention item for clarity (“one or
more” of specified problems rather
than “some or more”).
Add three patient-reported items based
on the PM-PAC to measure patient
participation.
Add loss of caregiver as a response
category for receiving Part B therapy.
Modify several response categories to
separate specific body structures and
body functions; and distinguish left
and right versus unilateral versus
bilateral.
Modify response categories for
pulmonary/respiratory medical
condition.
Add depth of pressure ulcer to mirror
latest version of CARE Tool.
Modify wording of item to mirror more
recent version (12-10-2009) of CARE
Tool.

Unless specified, modification applies to both admission and discharge version of form.

Reason for
change
Response to
Public Comment
Response to
Public Comment
Response to
Public Comment
Public Comment
& Internal Review
Response to
Public Comment

Response to
Public Comment
Response to
Public Comment
Public Comment
& Internal Review
Response to
Public Comment
Response to
Public Comment

Response to
Public Comment
Internal Review
Internal Review


File Typeapplication/pdf
File TitleRevisions Crosswalk – DOTPA Data Collection Instruments (CMS-10298 PRA)
SubjectMedicare, outpatient therapy, Paperwork Reduction Act
AuthorCenters for Medicare & Medicaid Services
File Modified2010-03-23
File Created2010-03-16

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