A
DiraChart MDS item reference
A0100Section Av1.20.1Manual page A-3
Facility Provider Numbers
Item Rationale
Quick coding
Answer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Instruction / group heading
B
CMS Certification Number (CCN) – If A0410 = 3
C
State Provider Number (optional). This number is
Item-specific instructions
Coding Guidance
Review what the item asks, how to choose the response, and what should be verified before submission.
Coding Instructions
•
Enter the facility provider numbers:
A. National Provider Identifier (NPI).
B. CMS Certification Number (CCN) – If A0410 = 3
(federal required submission), then A0100B
(facility CCN) must not be blank.
C. State Provider Number (optional). This number is
assigned by the State survey agency and provided to
the intermediary. When known, enter the State
Provider Number in A0100C. Completion of this is
not required; however, your State may require the
completion of this item.
MDS item matrixAssessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
15 relationships5 groups+
Assessment Applicability
See where this item applies across Nursing Home, Swing Bed, discharge, required-use, OBRA, and program or policy columns.
Nursing Home Subsets
Swing Bed Subsets
Shared NH/SB Subsets
OBRA Stand Alone Assessments
OBRA Admission A=01, B=99, F=99, G=^, H=0
MDS Item Matrix v1.20.1 v4
OBRA Quarterly A=02, B=99, F=99, G=^, H=0
MDS Item Matrix v1.20.1 v4
OBRA Annual / Sig Chg A=03, B=99, F=99, G=^, H=0 A= 04, B=99, F=99, G=^, H=0
MDS Item Matrix v1.20.1 v4
OBRA Discharge A=99, B=99, F=10, 11, G=1, 2, H=0
MDS Item Matrix v1.20.1 v4
Program and Policy Use
Official CMS source
Verify in the CMS Source
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Reference details
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