CDE Detailed Report

Disease: Cerebral Palsy
Subdomain Name: Therapies
CRF: Physical Therapy Individual Session

Displaying 1 - 28 of 28
CDE ID CDE Name Variable Name Definition Short Description 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 / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C22599 Therapy participant family caregiver count TherParFamCarCt The number of family members and/or caregivers participating in the treatment session The number of family members and/or caregivers participating in the treatment sessio Session participants # family/caregiver Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-12 09:41:20.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0
C22901 Therapy session cotherapy type TherapySessionCoTxTyp The type related to the co-therapy for the therapy session The type related to the co-therapy for the therapy sessio If CoTx SLP;PT;Other Speech and Language Pathologist;Physical therapist;Other Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-07 23:27:04.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22602 Therapy week frequency TherWeekFreq The weekly frequency of the patient or client's treatment session The weekly frequency of the patient or client's treatment sessio Frequency per week Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-12 09:43:32.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0 time per week
C22902 Physical therapist name PhysicalTherapistNam The name related to the physical therapist The name related to the physical therapis Therapist Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-07 13:06:51.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data 255

Free-Form Entry

C22603 Therapy month frequency TherMonFreq The monthly frequency of the patient or client's treatment session The monthly frequency of the patient or client's treatment sessio Frequency per month Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-12 09:44:16.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0 time per month
C22904 Physical therapy focus area type PTFocusAreaTyp The type related to physical therapy focus area The type related to physical therapy focus are PT focus areas Pre-functional;Sitting;Standing;Transitions/transfers;Mobility;Gait-household, community, exercise;Fitness/health/recreation management;Self-care;Gross motor;Communication;Caregiver management Pre-functional;Sitting;Standing;Transitions/transfers;Mobility;Gait-household, community, exercise;Fitness/health/recreation management;Self-care;Gross motor;Communication;Caregiver management Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C22604 Therapy consultative frequency TherConFreq The consultative frequency (less than once a month) of the patient or client's treatment session The consultative frequency (less than once a month) of the patient or client's treatment sessio Frequency consultative (less than once per month) Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-12 09:45:45.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0
C22905 Physcial therapy minute duration PTMinDur The duration in minutes related to physical therapy The duration in minutes related to physical therap Mins Numeric Values Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

minute
C06058 Pain problem grade PainProbGrade Grade for the pain problem that indicates whether the person is describing their worst pain problem, their second worst pain problem, or their third worst pain problem Grade for the pain problem that indicates whether the person is describing their worst pain problem, their second worst pain problem, or their third worst pain proble If yes, list pain level number Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-17 09:26:36.973 Physical Therapy Individual Session Therapies Treatment/Intervention Data 255

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C22618 Therapy session minute duration TherSessionMinDur The duration of the patient or client's treatment session in minutes The duration of the patient or client's treatment session in minutes Session duration (total time in minutes) Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-13 12:23:00.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0 minute
C22906 Physical therapy intervention type PTInterventionTyp The type of intervention related to the physical therapy The type of intervention related to the physical therap Intervention Assessment/evaluation;Deep thermal;Balance;Education/training;Postural control;Coordination;Motor control;Facilitation/Handling;Repetitive task practice;Oral-Motor Facilitation;Manual therapy;Joint mobilization/manipulation;Massage;Strengthening functional;Strengthening (PRE);Stretching;Breathing;Aerobic conditioning;Postural drainage;Electrical stimulation NMES;Electrical stimulation Tens;Hot/cold;Biofeedback;Telehealth;Pressure relief;Position changes;Skin check;Energy conservation Assessment/evaluation;Deep thermal;Balance;Education/training;Postural control;Coordination;Motor control;Facilitation/Handling;Repetitive task practice;Oral-Motor Facilitation;Manual therapy;Joint mobilization/manipulation;Massage;Strengthening functional;Strengthening (PRE);Stretching;Breathing;Aerobic conditioning;Postural drainage;Electrical stimulation NMES;Electrical stimulation Tens;Hot/cold;Biofeedback;Telehealth;Pressure relief;Position changes;Skin check;Energy conservation Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C15910 Assessment date and time AssessDateTime The date of participant's injury The date of participant's injury Date Date or Date & Time Adult;Pediatric Supplemental 3.00 2013-07-16 14:01:43.01 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

C22619 Therapy bill unit service value TherapyBillUnitServiceVal The total units of service billed for the patient or client's therapy treatment session The total units of service billed for the patient or client's therapy treatment sessio Units Billed (15 minute incraments) Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-13 12:24:06.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0
C22907 Physical therapy device type PTDeviceTyp The type of device related to the physical therapy The type of device related to the physical therap Equipment BWS system;Treadmill;Stationary bike;Ellipitical;UBE;Seated stepper;Wall rail/furniture;Push toy;Walker;Manual wheelchair;Power wheelchair;Gait Trainer/Weight Supported Walkers;Hoyer/overhead lift;Stander;Other AE Body weight support system;Treadmill;Stationary bike;Ellipitical;Upper body ergometer;Seated stepper;Wall rail/furniture;Push toy;Walker;Manual wheelchair;Power wheelchair;Gait Trainer/Weight Supported Walkers;Hoyer/overhead lift;Stander;Other adaptive equipment Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C19835 Pain indicator PainInd Indicator of pain present Indicator of pain present Pain No;Yes No;Yes Alphanumeric Adult;Pediatric Supplemental 1.00 2015-02-05 00:00:00.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22620 Child Effort Rating - Overall scale ChildEffortScale The scale representing the overall rating for "Child Effort" across the entire session The scale representing the overall rating for "Child Effort" across the entire sessio Child Effort Rating 1;0;2;3;4;5;6 minimal effort;absence of effort;below average effort;Average effort;above average effort;very good effort;superior effort Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-13 12:25:37.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22908 Physical therapy adaptive equipment orthotic session type PTAEOrthoticSessionTyp The type of session related to adaptive equipment or orthotics related to the physical therapy The type of session related to adaptive equipment or orthotics related to the physical therap AE/Orthotic Prescription;Fabrication;Maintenance/repair;Ergonomic intervention;Training;Fitting/Adjustment Prescription;Fabrication;Maintenance/repair;Ergonomic intervention;Training;Fitting/Adjustment Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C21117 Subject name SubjectName Name of subject/participant Name of subject/participan Patient Name or ID# Alphanumeric Adult;Pediatric Supplemental 1.00 2015-06-12 15:16:39.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data 255

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C22621 Pain scale type PainScaleTyp The type of pain scale used to measure the patient or client's pain The type of pain scale used to measure the patient or client's pain Pain scale Faces;FLACC;Visual analog Faces;FLACC;Visual analog Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-13 13:11:56.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22909 Physical therapy position type PTPositionTyp The type of position related to the physical therapy The type of position related to the physical therap Positioning Static seating;Static standing;Dynamic seating;Dynamic standing;Floor position Static seating;Static standing;Dynamic seating;Dynamic standing;Floor position Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C22595 Therapy session type TherSessionTyp The type of session in which the patient or client received therapy The type of session in which the patient or client received therap Session Type Individual;Group;Co-Tx Individual;Group;Co-Tx Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-12 09:33:51.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22629 Therapy factor influence session type TherFacInfSesTyp The type of factor(s) that influenced the treatment session The type of factor(s) that influenced the treatment session Factors influencing session agitation/behavior;disinterest;Fatigue;low arousal;inattention;emotional distress/crying;medical;environment agitation/behavior;disinterest;Fatigue;low arousal;inattention;emotional distress/crying;medical;environment Alphanumeric Adult;Pediatric Supplemental 1.00 2016-07-13 13:56:31.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C22910 Physical therapy assistive technical device type PTAssTechDeviceTyp The type of assistive technical device as related to the physical therapy The type of assistive technical device as related to the physical therap Assistive technical devices Adapted toys/games;Electronic (tablet, PDA);AAC device;Pictures/schedules;Switches;Computer;Modifier;Virtual reality;Video gaming;Pet therapy;Aquatic therapy Adapted toys/games;Electronic (tablet, PDA);Augmentative and alternative communication device;Pictures/schedules;Switches;Computer;Modifier;Virtual reality;Video gaming;Pet therapy;Aquatic therapy Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C22597 Therapy participant count TherPartCt The number of patients participating in the therapy session The number of patients participating in the therapy sessio Session participants # patients Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-12 09:39:26.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0
C22899 Gross Motor Function Classification System (GMFCS) - Level scale GMFCSLevelScl The scale level as reference to the Gross Motor Function Classification System (GMFCS) The scale level as reference to the Gross Motor Function Classification System (GMFCS GMFCS Level Level I;Level II;Level III;Level IV;Level V Children walk at home, school, outdoors and in the community. They can climb stairs without the use of a railing. Children perform gross motor skills such as running and jumping, but speed, balance and coordination are limited.;Children walk in most settings and climb stairs holding onto a railing. They may experience difficulty walking long distances and balancing on uneven terrain, inclines, in crowded areas or confined spaces. Children may walk with physical assistance, a hand held mobility device or used wheeled mobility over long distances. Children have only minimal ability to perform gross motor skills such as running and jumping.;Children walk using a hand-held mobility device in most indoor settings. They may climb stairs holding onto a railing with supervision or assistance. Children use wheeled mobility when traveling long distances and may self-propel for shorter distances.;Children use methods of mobility that require physical assistance or powered mobility in most settings. They may walk for short distances at home with physical assistance or use powered mobility or a body support walker when positioned. At school, outdoors and in the community children are transported in a manual wheelchair or use powered mobility.;Children are transported in a manual wheelchair in all settings. Children are limited in their ability to maintain antigravity head and trunk postures and control leg and arm movements. Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-07 13:11:56.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

C22911 Physical therapy orthoses type PTOrthosesTyp The type of orthoses as related to the physical therapy The type of orthoses as related to the physical therap Orthoses AFO;SMO;FO;HKAFO;TLSO;Serial casting knee;Serial casting ankle;Knee immobilizer;Neuroprosthesis (FES);KAFO;Elastic wraps/suits;Therapeutic taping;Shoe insert off the shelf Ankle foot orthosis;Supramalleolar orthosis;Foot orthosis;Hip knee ankle foot orthosis;Thoraco-lumbo-sacral orthosis;Serial casting knee;Serial casting ankle;Knee immobilizer;Neuroprosthesis (FES);Knee ankle foot orthosis;Elastic wraps/suits;Therapeutic taping;Shoe insert off the shelf Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-08 08:16:44.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Multiple Pre-Defined Values Selected

C22598 Therapist count TherapistCt The number of therapists participating in the treatment session The number of therapists participating in the treatment sessio Session participants # therapist Numeric Values Adult;Pediatric Supplemental 1.00 2016-07-12 09:40:17.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Free-Form Entry

0
C22900 Manual Ability Classification System (MACS) - Level scale MACSLevelScl The scale level related to the Mini-Manual Ability Classification System (MACS) The scale level related to the Mini-Manual Ability Classification System (MACS MACS Level Level I;Level II;Level III;Level IV;Level V Handles objects easily and successfully.;Handles most objects but with somewhat reduced quality and/or speed of achievement.;Handles objects with difficulty, needs help to prepare and/or modify activities.;Handles a limited selection of easily managed objects in adapted situations.;Does not handle objects and has severely limited ability to perform even simple actions. Alphanumeric Adult;Pediatric Supplemental 1.00 2016-12-07 13:36:23.0 Physical Therapy Individual Session Therapies Treatment/Intervention Data

Single Pre-Defined Value Selected

CSV