CDE Detailed Report

Disease: Stroke
Sub-Domain: Therapies
CRF: Rehabilitation Therapies

Displaying 1 - 28 of 28
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C58880 Assistive device type AssistiveDvcTyp Type for all assistive devices currently used by the participant/subject. Type for all assistive devices currently used by the participant/subject. IF YES, current type(s) of assistive devices AFO/ brace/ prosthetic/ orthotic/ splints;Cane (Straight/ Tripod/ Quad);Walker;Power wheelchair;Scooter;Manual wheelchair;Adaptive or Activities of Daily Living (ADL) equipment (e.g., modified eating utensils, reachers, etc.);Other, specify AFO/ brace/ prosthetic/ orthotic/ splints;Cane (Straight/ Tripod/ Quad);Walker;Power wheelchair;Scooter;Manual wheelchair;Adaptive or Activities of Daily Living (ADL) equipment (e.g., modified eating utensils, reachers, etc.);Other, specify Alphanumeric

Choose all that apply.

No references available Adult Supplemental 1.00 2020-05-18 15:46:31.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58882 Assistive device other text AssistiveDvcOthrTxt The free-text field related to 'Assistive device type' specifying other text. Type for all assistive devices currently used by the participant/subject. The free-text field related to 'Assistive device type' specifying other text. Type for all assistive devices currently used by the participant/subject. Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:57:51.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C58883 Adjunctive treatment drool surgical procedure injection specify text AdjTrtDrlSurgProcInjSpecTxt The free-text field related to 'Adjunctive treatment type' specifying the type of surgical procedure or injections for drooling text. Describe the type(s) of adjunctive treatments. The free-text field related to 'Adjunctive treatment type' specifying the type of surgical procedure or injections for drooling text. Describe the type(s) of adjunctive treatments. Surgical procedure or injections for drooling, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:59:26.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C05134 Therapy rehabilitation start date time TherpyRehabStrtDateTime Date (and time, if applicable and known) on which the therapy or rehabilitation started Date (and time, if applicable and known) on which the therapy or rehabilitation started Start Date Date or Date & Time

Investigators can choose to include this item if it is relevant to the study.

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Exploratory 3.00 2013-07-20 10:21:25.65 Rehabilitation Therapies Therapies Treatment/Intervention Data

Free-Form Entry

C58884 Supportive medical equipment indicator SupportMedEquipmentInd Indicates if the participant/ subject was provided with any supportive medical equipment. Indicates if the participant/ subject was provided with any supportive medical equipment. Provided with supportive medical equipment No;Yes;Unknown No;Yes;Unknown Alphanumeric

Choose one.

No references available Adult;Pediatric Exploratory 1.00 2020-05-18 16:00:31.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22608 Total rehabilitation session count TotRehabSessnCt The total number of rehabilitation sessions the participant/subject has been part of. The total number of rehabilitation sessions the participant/subject has been part of. Estimated total sessions Numeric Values

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2016-07-12 11:43:03.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Free-Form Entry

0
C58885 Supportive medical equipment type SupportMedEquipmentTyp If the participant/ subject was provided with any supportive medical equipment, describes the type(s) of equipment received. If the participant/ subject was provided with any supportive medical equipment, describes the type(s) of equipment received. Type(s) of supportive medical equipment Bedside commode;Hospital bed;Bathroom grab bars;Stair lifts;Raised toilet seats;Shower seats;Suction devices;Oxygen;Ramps;Other, specify Bedside commode;Hospital bed;Bathroom grab bars;Stair lifts;Raised toilet seats;Shower seats;Suction devices;Oxygen;Ramps;Other, specify Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Exploratory 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58874 Location post-acute stroke discharge other text LocPstAcutStrokeDischrgOthrTxt The free-text field related to 'Therapy or rehabilitation type' specifying other text. Indicates the participant's/subject's current location after discharge from the acute hospital for the index stroke/transient ischemic attack (TIA). The free-text field related to 'Therapy or rehabilitation type' specifying other text. Indicates the participant's/subject's current location after discharge from the acute hospital for the index stroke/transient ischemic attack (TIA). Other not defined above Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:27:10.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C58886 Supportive medical equipment other text SupportMedEquipmentOthrTxt The free-text field related to 'Supportive medical equipment type' specifying other text. If the participant/ subject was provided with any supportive medical equipment, describes the type(s) of equipment received. The free-text field related to 'Supportive medical equipment type' specifying other text. If the participant/ subject was provided with any supportive medical equipment, describes the type(s) of equipment received. Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Exploratory 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C58875 Therapy or rehabilitation received status other text TherRehabReceStatusOthrTxt The free-text field related to 'Therapy or rehabilitation received status' specifying other text. Status of therapy or rehabilitation services received by the participant/subject. The free-text field related to 'Therapy or rehabilitation received status' specifying other text. Status of therapy or rehabilitation services received by the participant/subject. Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:29:15.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C58887 Follow-up care specialist type FollowUpCareSpecTyp Type of specialist the participant/subject received follow-up care from. Type of specialist the participant/subject received follow-up care from. Follow-up care from the following specialists? Neurologist, non-vascular;Vascular neurologist;Primary care provider;PM&R or other rehabilitation physician;Other, specify: Neurologist, non-vascular;Vascular neurologist;Primary care provider;Physical medicine and rehabilitation or other rehabilitation physician;Other, specify: Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Supplemental?Highly Recommended 1.00 2020-05-18 16:08:24.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58876 Therapy or rehabilitation session week frequency TherpyRehabSessnWkFreq Frequency of therapy or rehabilitation sessions (number of session per week) the participant/subject has been part of. Frequency of therapy or rehabilitation sessions (number of session per week) the participant/subject has been part of. Estimated number of sessions/week Numeric Values

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:31:19.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Free-Form Entry

0
C58888 Follow-up care specialist other text FollowUpCareSpecOthrTxt The free-text field related to 'Follow-up care specialist type' specifying other text. Type of specialist the participant/subject received follow-up care from. The free-text field related to 'Follow-up care specialist type' specifying other text. Type of specialist the participant/subject received follow-up care from. Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 16:16:47.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C58877 Inpatient therapy or rehabilitation location type InpatTherpyRehabLocTyp Type of inpatient location where the participant subject received therapy or rehabilitation services. Type of inpatient location where the participant subject received therapy or rehabilitation services. Inpatient Acute hospital;Rehabilitation facility Acute hospital;Rehabilitation facility Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:32:56.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C58878 Therapy or rehabilitation duration TherpyRehabDur Duration in weeks of therapy or rehabilitation services the participant/subject received. Duration in weeks of therapy or rehabilitation services the participant/subject received. Estimated number of weeks Numeric Values

No instructions available

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:36:45.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Free-Form Entry

0 weeks
C58879 Assistive device use indicator AssistiveDvcUseInd Whether the participant/subject uses an assistive device (e.g., wheelchair). Whether the participant/subject uses an assistive device (e.g., wheelchair). Provided with assistive devices No;Yes;Unknown No;Yes;Unknown Alphanumeric

Choose one.

No references available Adult;Pediatric Supplemental 1.00 2020-05-18 15:41:02.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C18913 Adjunctive treatment other text AdjTreatOTH The free-text field related to 'Adjunctive treatment type' specifying other text. Describe the type(s) of adjunctive treatments. The free-text field related to 'Adjunctive treatment type' specifying other text. Describe the type(s) of adjunctive treatments. Other, specify Alphanumeric

No instructions available

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 4000

Free-Form Entry

C05104 Inpatient outpatient status InpatOutpatStatus Status describing whether the participant/subject was admitted to the hospital and stayed overnight Status describing whether the participant/subject was admitted to the hospital and stayed overnight Setting for rehabilitation therapy Inpatient;Outpatient Inpatient;Outpatient Alphanumeric

Choose one.
Outpatient is following acute hospital discharge.

No references available Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Rehabilitation Therapies Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C21667 Therapy rehabilitation ICD 10 CM code TherpyRehabICD10CMCd ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject ICD-10-CM code that describes the therapy or rehabilitation received by the participant/subject Type(s) of rehabilitation therapy/services received Alphanumeric

Code the therapy or rehabilitation service received using the ICD-10-CM codes to enable data aggregation.

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): https://www.cdc.gov/nchs/icd/icd10cm.htm Adult;Pediatric Supplemental 1.00 2013-07-20 10:21:25.65 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C05130 Therapy or rehabilitation type TherpyRehabTyp Type of therapy or rehabilitation services received by the participant/subject. Type of therapy or rehabilitation services received by the participant/subject. Type(s) of rehabilitation therapy/services received Occupational therapy;Vocational;Physical therapy;Dietary;Recreational;Other, specify;Psychological/Cognitive;Speech/Language Occupational therapy;Vocational;Physical therapy;Dietary;Recreational;Other, specify;Psychological/Cognitive;Speech/Language Alphanumeric

Choose all that apply.

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): https://www.cdc.gov/nchs/icd/icd10cm.htm Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C06005 Data collected date and time DataCollDateTime Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date information collected: Date or Date & Time

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Rehabilitation Therapies Therapies Treatment/Intervention Data

Free-Form Entry

C14284 Resource Utilization Group Version IV (RUG IV) - alpha-numeric code RUGIVAlphaNumCode Indicates the Resource Utilization Group Version IV (RUG IV). Medicare pays skilled nursing facilities (SNFs) under a Prospective Payment System (PPS). PPS payments are per diem rates based on the patient's condition as determined by classification into a specific Resource Utilization Group (RUG). This classification is done by the use of a clinical assessment tool, the Minimum Data Set (MDS) and is required to be performed periodically according to an established schedule for purposes of Medicare payment. Each MDS represents the patient's clinical status based on an assessment reference date and established look back periods for the covered days associated with that MDS. Indicates the Resource Utilization Group Version IV (RUG IV). Resource Utilization Group Version IV (RUG IV) Alphanumeric

The RUG IV codes should be entered in this format: __ __ __ (3-letter alpha-numeric code)

See http://www.cms.hhs.gov/MDS20SWSpecs/ for the most current list of RUG codes. RUG-IV went into effect October 1, 2010. Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 255

Free-Form Entry

C14285 Therapy or rehabilitation assessment indicator TherRehabAssInd Indicates if there is documentation that the participant/subject was assessed for rehabilitation services. Rehabilitation is a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible. Indicates if there is documentation that the participant/subject was assessed for rehabilitation services. Assessed for rehabilitation services Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one.

American Heart/American Stroke Association. (2018). Get With The Guidelines (GWTG) Stroke Patient Management Tool Coding Instructions (© 2018, American Heart/American Stroke Association). Available at: https://www.heart.org/-/media/files/professional/quality-improvement/get-with-the-guidelines/get-with-the-guidelines-stroke/stroke-fact-sheet_-final_ucm_501842.pdf?la=en; Paul Coverdell National Acute Stroke Registry; The Joint Commission (TJC) Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C14286 Therapy or rehabilitation received status TherRehabReceStatus If the participant/ subject was assessed for rehabilitation therapy/services, describes the status of therapy/services. If the participant/ subject was assessed for rehabilitation therapy/services, describes the status of therapy/services. Were rehabilitation therapy/services received Received rehabilitation therapy during hospitalization;Did not receive rehabilitation therapy because symptoms resolved;Ineligible to receive rehabilitation therapy due to impairment severity or medical issues;Other, specify Received rehabilitation therapy during hospitalization;Did not receive rehabilitation therapy because symptoms resolved;Ineligible to receive rehabilitation therapy due to impairment severity or medical issues (i.e.: poor prognosis, patient unable to tolerate rehabilitation therapeutic regimen);Other specify Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C14288 Adjunctive treatment indicator AdjTreatInd Indicates if any adjunctive treatments were or are being performed on the participant/subject to preserve or increase independence. Indicates if any adjunctive treatments were or are being performed on the participant/subject to preserve or increase independence. Received or receiving adjunctive treatments Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C14289 Adjunctive treatment type AdjTreatTyp Describe the type(s) of adjunctive treatments. Describe the type(s) of adjunctive treatments. Type(s) of adjunctive treatments Feeding/gastrostromy tube placement;Botulinum toxin for spasticity;Intrathecal baclofen;Functional electrical stimulation;Tracheostomy;Tendon lengthening or transfer;Contracture release;Other, specify;Potential function enhancing drugs (SSRIs, stimulants, antidepressants);Surgical procedure or injection for drooling, specify Feeding/gastrostromy tube placement;Botulinum toxin for spasticity;Intrathecal baclofen;Functional electrical stimulation;Tracheostomy;Tendon lengthening or transfer;Contracture release;Other, specify;Potential function enhancing drugs (SSRIs, stimulants, antidepressants);Surgical procedure or injection for drooling, specify Alphanumeric

Choose all that apply.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C14290 Location post-acute stroke discharge type LoctnPstAcutStrokeDischrgTyp Indicates the participant's/subject's location of acute hospital discharge for the index stroke/transient ischemic attack (TIA). Indicates the participant's/subject's location of acute hospital discharge for the index stroke/transient ischemic attack (TIA). Location of acute hospital discharge Another family member's/ friend's home;Expired;Home with home care services;Home with no in-home services;Hospice- home or medical facility providing hospice level of care;Intensive Inpatient rehabilitation facility (IRF) including distinct rehabilitation units of a hospital: three hours or greater of therapy per day;Medicare certified long term care hospital (LTCH);Other not defined above:;Skilled nursing facility (SNF)/ subacute rehab: less than two hours a day of therapy Another family member's/ friend's home;Expired;Home with home care services;Home with no in-home services;Hospice- home or medical facility providing hospice level of care;Intensive Inpatient rehabilitation facility (IRF) including distinct rehabilitation units of a hospital: three hours or greater of therapy per day;Medicare certified long term care hospital (LTCH);Other not defined above:;Skilled nursing facility (SNF)/ subacute rehab: less than two hours a day of therapy Alphanumeric

It is suggested that this data element be collected at 3, 6, and twelve months post-acute discharge.

No references available Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Rehabilitation Therapies Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C18768 Therapy or rehabilitation other text TherpyRehabOTH The free-text field related to 'Therapy or rehabilitation type' specifying other text. Type of therapy or rehabilitation services received by the participant/subject The free-text field related to 'Therapy or rehabilitation type' specifying other text. Type of therapy or rehabilitation services received by the participant/subject Other, specify Alphanumeric

No instructions available

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): https://www.cdc.gov/nchs/icd/icd10cm.htm Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Rehabilitation Therapies Therapies Treatment/Intervention Data 4000

Free-Form Entry

CSV