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Hospice Item Set Change Table, V1.00.0 to V2.00.0
Hospice Item Set v2.00.0
V1.00.0
V1.00.0 Section or
Section or
Item Name
Item Number
V2.00.0
Section or
Item Number
V2.00.0 Section or
Item Name
Form
Admission,
Discharge
Change
Section A
Administrative Data
Section A
Administrative Data
A0050
Type of Record
A0050
Type of Record
A0100
Facility Provider
Numbers
A0100
Facility Provider
Numbers
Admission,
Discharge
Admission,
Discharge
A0205
Site of Service at
Admission
A0205
Site of Service at
Admission
Admission,
Discharge
No change
A0220
Admission Date
A0220
Admission Date
Admission,
Discharge
No change
A0245
Date Initial Nursing
Assessment Initiated
A0245
Date Initial Nursing
Assessment Initiated
Admission
No change
A0250
Reason for Record
A0250
Reason for Record
Admission,
Discharge
No change
A0270
Discharge Date
A0270
Discharge Date
Discharge
No change
A0500
Legal Name of Patient
A0500
Legal Name of Patient
A0550
Patient ZIP Code
Social Security and
Medicare Numbers
A0600
Social Security and
Medicare Numbers
A0600
A0700
Medicaid Number
A0700
Medicaid Number
A0800
Gender
A0800
Gender
Admission,
Discharge
Admission
Admission,
Discharge
Admission,
Discharge
Admission,
Discharge
No change
No change
No change
Rationale for Section or Item
Items in this section are needed for
record matching and management or to
calculate quality measures
Needed for record matching and
management
Needed for record matching and
management
Needed for quality measure
maintenance and for harmonization with
other item sets
Needed for record matching and
management and to calculate quality
measures.
Needed to calculate quality measures
Needed for record matching and
management
Needed for record matching and
management and to calculate quality
measures
No change
Needed for record matching
New Item
Needed for public reporting
No change
Needed for record matching
No change
Needed for record matching
No change
Needed for record matching
(continued)
2
Hospice Item Set Change Table, V1.00.0 to V2.00.0 (continued)
Hospice Item Set v2.00.0
V1.00.0
V1.00.0 Section or
Section or
Item Name
Item Number
V2.00.0
Section or
Item Number
V2.00.0 Section or
Item Name
Form
Change
Rationale for Section or Item
A0900
Birth Date
A0900
Birth Date
Admission,
Discharge
No change
Needed for record matching
A1000
Race/Ethnicity
A1000
Race/Ethnicity
Admission
No change
A1400
Payor Information
Admission
New item
A1802
Admitted From
A1802
Admitted From
Admission
No change
A2115
Reason for Discharge
A2115
Reason for Discharge
Discharge
No change
Section F
Preferences
Section F
Preferences
Admission
No change
F2000
CPR Preferences
Other Life-Sustaining
Treatments
Preferences
Hospitalization
Preference
Spiritual/Existential
Concerns
F2000
CPR Preferences
Other Life-Sustaining
Treatments
Preferences
Hospitalization
Preference
Spiritual/Existential
Concerns
Admission
No change
Needed for quality measure
maintenance and for harmonization with
other item sets
Needed for record matching and
management
Needed for quality measure
maintenance and for harmonization with
other item sets
Needed for quality measure
maintenance and for harmonization with
other item sets
Items in this section are needed to
calculate quality measures.
Needed to calculate quality measure
Admission
No change
Needed to calculate quality measure
Admission
No change
Needed for ease of use of item set and
for measure maintenance.
Admission
No change
Needed to calculate quality measure
F2100
F2200
F3000
F2100
F2200
F3000
Section I
Active Diagnoses
Section I
Active Diagnoses
Admission
No change
I0010
Principal Diagnosis
I0010
Principal Diagnosis
Admission
No change
The item in this section is needed for
quality measure maintenance and to
harmonize with other item sets
Needed for quality measure
maintenance and to harmonize with
other item sets
(continued)
3
Hospice Item Set Change Table, V1.00.0 to V2.00.0 (continued)
Hospice Item Set v2.00.0
V1.00.0
V1.00.0 Section or
Section or
Item Name
Item Number
Section J
J0900
J0910
J2030
J2040
Health Conditions
Pain Screening
Comprehensive Pain
Assessment
Screening for
Shortness of Breath
Treatment for
Shortness of Breath
V2.00.0
Section or
Item Number
Section J
V2.00.0 Section or
Item Name
Health Conditions
Form
Admission
Change
Rationale for Section or Item
No change
The items in this section are needed to
calculate quality measures addressing
pain and shortness of breath for hospice
patients.
J0900
Pain Screening
Admission
J0905
Pain Active Problem
Comprehensive Pain
Assessment
Screening for
Shortness of Breath
Treatment for
Shortness of Breath
Admission
Change skip
instruction in
J0900A0 to "Skip
to J0905, Pain
Active Problem"
and remove skip
instruction from
J0900C0.
New item
Admission
No change
Needed to calculate quality measure
Admission
No change
Needed to calculate quality measure
Admission
No change
Needed to calculate quality measure
J0910
J2030
J2040
Needed to calculate quality measures
Needed to calculate quality measure
The items in this section are needed to
calculate quality measures
Needed to calculate quality measure
Needed to calculate quality measure and
for ease of use of item set and for
measure maintenance
Needed to calculate quality measure
The items in this section are needed to
calculate quality measures
Section N
Medications
Section N
Medications
Admission
No change
N0500
Scheduled Opioid
N0500
Scheduled Opioid
Admission
No change
N0510
PRN Opioid
N0510
PRN Opioid
Admission
No change
N0520
Bowel Regimen
N0520
Bowel Regimen
Admission
No change
Section O
Service Utilization
Discharge
New section
Discharge
New item
Needed for ease of use of item set
Discharge
New item
Needed to calculate quality measure
O5000
O5010
Level of care in final 3
days
Number of hospice
visits in final 3 days
(continued)
4
Hospice Item Set Change Table, V1.00.0 to V2.00.0 (continued)
Hospice Item Set v2.00.0
V1.00.0
V1.00.0 Section or
Section or
Item Name
Item Number
V2.00.0
Section or
Item Number
O5020
O5030
Section Z
Z0400
Z0500
Record Administration
Signature(s) of
Person(s) Completing
the Record
Signature of Person
Verifying Record
Completion
Section Z
Z0400
Z0500
V2.00.0 Section or
Item Name
Level of care in final 7
days
Number of hospice
visits in 3 to 6 days
prior to death
Record Administration
Signature(s) of
Person(s) Completing
the Record
Signature of Person
Verifying Record
Completion
Form
Change
Rationale for Section or Item
Discharge
New item
Needed for ease of use of item set
Discharge
New item
Needed to calculate quality measure
Admission,
Discharge
No change
The items in this section are needed for
record management
Admission,
Discharge
No change
Needed for record management
Admission,
Discharge
No change
Needed for record management
| File Type | application/pdf |
| File Title | Hospice Item Set Change Table, V1.00.0 to V2.00.0 |
| Subject | Hospice Item Set Change Table, V1.00.0 to V2.00.0 |
| Author | RTI |
| File Modified | 2016-03-28 |
| File Created | 2016-03-28 |