DD_DIA_CMS_START
Description:
This table contains data elements submitted for CMS ESRD patient registration forms (CMS-2728).

Primary Key
Column Name Ordinal Position
REGISTRY_DATA_ID 1

Column Information
Name Type Discontinued?
1 REGISTRY_DATA_ID NUMERIC No
The unique identifier for the registry data record.
2 FORM_IDENTIFIER VARCHAR No
The CMS 2728 form identifier.
3 DLYS_REG_FORM_TYPE_C_NAME VARCHAR No
The CMS 2728 form type, such as initial registration or reentitlement.
May contain organization-specific values: Yes
Category Entries:
InitialDialysis
ReentitlementRestartDialysis
ReentitlementDialysisAfterTransplantFailed
SupplementalTraining
4 ADMISSION_DEPARTMENT_ID_EXTERNAL_NAME VARCHAR No
The external name of the department record. This is often used in patient correspondence such as reminder letters.
5 PAT_FIRST_NAME VARCHAR No
The patient's first name.
6 PAT_MIDDLE_INITIAL VARCHAR No
The patient's middle initial.
7 PAT_LAST_NAME VARCHAR No
The patient's last name.
8 DLYS_NAME_SUFFIX_C_NAME VARCHAR No
The patient's name suffix.
May contain organization-specific values: Yes
Category Entries:
Jr
Sr
II
III
IV
V
VI
9 DLYS_PAT_SEX_C_NAME VARCHAR No
The patient's sex assigned at birth.
May contain organization-specific values: No
Category Entries:
F
M
10 PAT_BIRTH_DATE DATETIME No
The patient's date of birth.
11 PAT_HICNUM VARCHAR No
The patient's Medicare health insurance claim number.
12 PAT_MBI_NUM VARCHAR No
The patient's Medicare Beneficiary Identifier number.
13 PAT_SSN VARCHAR No
The patient's Social Security number.
14 MAIL_ADDRESS_STREET_1 VARCHAR No
The first line of the street address of the patient's mailing address.
15 MAIL_ADDRESS_STREET_2 VARCHAR No
The second line of the street address of the patient's mailing address.
16 MAIL_ADDRESS_CITY VARCHAR No
The city of the patient's mailing address.
17 MAIL_ADDRESS_TAX_STATE_C_NAME VARCHAR No
The state of the patient's mailing address.
May contain organization-specific values: Yes
18 MAIL_ADDRESS_COUNTY_2_C_NAME VARCHAR No
The county of the patient's mailing address.
May contain organization-specific values: Yes
19 MAIL_ADDRESS_ZIP_EXT VARCHAR No
The ZIP code extension of the patient's mailing address.
20 PHONE_AREA_CODE NUMERIC No
The area code of the patient's phone number.
21 PHONE_NUMBER VARCHAR No
The patient's phone number, minus the area code.
22 DLYS_PAT_CNTRY_OF_ORG_C_NAME VARCHAR No
The patient's country of origin.
May contain organization-specific values: No
Category Entries:
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of (North Korea)
Korea, Republic of (South Korea)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic (Laos)
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya (Libya)
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
Great Britain
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
23 DLYS_PAT_ETHNICITY_C_NAME VARCHAR No
The patient's ethnicity.
May contain organization-specific values: Yes
Category Entries:
Non-Hispanic or Latino
Hispanic or Latino
24 PAT_TRIBE_CODE NUMERIC No
The patient's tribe code.
25 DLYS_ETH_SELF_REP_C_NAME VARCHAR No
Whether the patient's race and ethnicity were self-reported.
May contain organization-specific values: No
Category Entries:
SelfReported
NotSelfReported
FamilyReported
PatientDeclined
26 ESRD_MEDICARE_APPLY_YN VARCHAR No
Whether the patient is applying for end stage renal disease Medicare coverage.
May contain organization-specific values: No
Category Entries:
No
Yes
27 PRIOR_DLYS_EMPY_STATUS_C_NAME VARCHAR No
The patient's employment status six months prior to renal failure.
May contain organization-specific values: No
Category Entries:
Unemployed
FullTime
PartTime
Homemaker
RetiredAgePref
RetiredDisability
MedicalLeave
Student
Volunteer
28 CURRENT_DLYS_EMPY_STATUS_C_NAME VARCHAR No
The patient's current employment status.
The category values for this column were already listed for column: PRIOR_DLYS_EMPY_STATUS_C_NAME
29 PAT_HEIGHT NUMERIC No
The patient's height.
30 DLYS_HEIGHT_UNIT_C_NAME VARCHAR No
The unit used for the patient's height.
May contain organization-specific values: Yes
Category Entries:
Inch
Centimeter
31 PAT_DRY_WEIGHT NUMERIC No
The patient's dry weight.
32 DLYS_WEIGHT_UNIT_C_NAME VARCHAR No
The unit used for the patient's weight.
May contain organization-specific values: Yes
Category Entries:
Pound
Kilogram
33 DIA_CMS_GFR_METHOD_C_NAME VARCHAR No
The method used to calculate the patient's glomerular filtration rate (GFR).
May contain organization-specific values: Yes
Category Entries:
MDRD
IDMS
OMDRD
BIDMS
34 PRIM_CAUSE_RENAL_FAIL_DX_ID_DX_NAME VARCHAR No
The name of the diagnosis.
35 EPO_RECEIVED_DIA_CMS_YNU_C_NAME VARCHAR No
Whether the patient received exogenous erythropoietin (EPO) or equivalent prior to end stage renal disease therapy.
May contain organization-specific values: Yes
Category Entries:
Yes
No
Unknown
36 EPO_DIA_CMS_DATE_RANGE_C_NAME VARCHAR No
The time range in which exogenous erythropoietin (EPO) or equivalent was administered to the patient prior to end stage renal disease therapy.
May contain organization-specific values: No
Category Entries:
LessThan6Months
6-12Months
GreaterThan12Months
37 NEPH_CARE_RECV_DIA_CMS_YNU_C_NAME VARCHAR No
Whether the patient was under nephrologist care before starting end stage renal disease therapy.
The category values for this column were already listed for column: EPO_RECEIVED_DIA_CMS_YNU_C_NAME
38 NEPH_CARE_DIA_CMS_DATE_RANGE_C_NAME VARCHAR No
The time range in which the patient was under nephrologist care prior to end stage renal disease therapy.
The category values for this column were already listed for column: EPO_DIA_CMS_DATE_RANGE_C_NAME
39 DIET_CARE_RECV_DIA_CMS_YNU_C_NAME VARCHAR No
Whether the patient was under kidney dietician care prior to end stage renal disease therapy.
The category values for this column were already listed for column: EPO_RECEIVED_DIA_CMS_YNU_C_NAME
40 DIET_CARE_DIA_CMS_DATE_RANGE_C_NAME VARCHAR No
The time range in which the patient was under kidney dietician care prior to end stage renal disease therapy.
The category values for this column were already listed for column: EPO_DIA_CMS_DATE_RANGE_C_NAME
41 DIA_CMS_FIRST_ACCESS_C_NAME VARCHAR No
The type of access used for the first outpatient dialysis treatment prior to end stage renal disease therapy.
May contain organization-specific values: Yes
Category Entries:
AVF
Graft
Catheter
Other
PD Catheter
Central Venous Catheter
42 MATURE_AVF_PRESENT_YN VARCHAR No
Whether the patient had a maturing arteriovenous fistula (AVF) present prior to end stage renal disease therapy.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
43 MATURE_AVG_PRESENT_YN VARCHAR No
Whether the patient had a maturing arteriovenous graft (AVG) present prior to end stage renal disease therapy.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
44 DLYS_TRT_LOCATION_C_NAME VARCHAR No
The primary setting in which the patient receives dialysis treatment, such as the patient's home, a dialysis treatment center, skilled nursing facility, or long-term care facility.
May contain organization-specific values: Yes
Category Entries:
Home
Dialysis Facility/ Center
SNF/ Long Term Care Facility
45 DLYS_TRT_TYPE_C_NAME VARCHAR No
The type of dialysis treatment the patient receives, e.g. hemodialysis or peritoneal dialysis.
May contain organization-specific values: Yes
Category Entries:
Hemodialysis
CAPD
CCPD
Other
46 DIALYSIS_SESSIONS_PER_WEEK NUMERIC No
The number of hemodialysis sessions per week prescribed for the patient.
47 DIALYSIS_SESSION_LENGTH_HOURS NUMERIC No
The duration, in hours, of hemodialysis sessions prescribed for the patient.
48 CHRONIC_DIALYSIS_START_DATE DATETIME No
The date the patient began a regular course of dialysis treatments.
49 FACILITY_TREATMENT_START_DATE DATETIME No
The date the patient began receiving dialysis treatments at the current facility.
50 TXP_OPTIONS_PROVIDED_YN VARCHAR No
Whether the patient has been informed of their options for receiving a kidney transplant.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
51 ATTENDING_PROV_ID_PROV_NAME VARCHAR No
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table.
52 ATTENDING_PROV_REMARKS VARCHAR No
Miscellaneous remarks entered by the patient's attending provider.
53 LAB_ALBUMIN_VALUE NUMERIC No
The patient's serum albumin lab value.
54 LAB_ALBUMIN_DATE DATETIME No
The patient's serum albumin lab collection date.
55 LAB_ALBUMIN_LOWER_LIMIT NUMERIC No
The patient's serum albumin lab lower limit value.
56 LAB_ALBUMIN_METHOD_C_NAME VARCHAR No
The patient's serum albumin lab method.
May contain organization-specific values: Yes
Category Entries:
BCG
BCP
57 LAB_CREATININE_VALUE NUMERIC No
The patient's serum creatinine lab value.
58 LAB_CREATININE_DATE DATETIME No
The patient's serum creatinine lab collection date.
59 LAB_HEMOGLOBIN_VALUE NUMERIC No
The patient's hemoglobin lab value.
60 LAB_HEMOGLOBIN_DATE DATETIME No
The patient's hemoglobin lab collection date.
61 LAB_HBA1C_VALUE NUMERIC No
The patient's glycated hemoglobin (HbA1c) lab value that was collected within 45 days prior to the first dialysis treatment or kidney transplant (whichever is more recent).
62 LAB_HBA1C_DATE DATETIME No
The patient's glycated hemoglobin (HbA1C) lab date that was collected within 45 days prior to the first dialysis treatment or kidney transplant (whichever is more recent).
63 LAB_LIPID_TC_VALUE NUMERIC No
The patient's lipid profile total cholesterol lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
64 LAB_LIPID_TC_DATE DATETIME No
The patient's lipid profile total cholesterol lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
65 LAB_LIPID_LDL_VALUE NUMERIC No
The patient's lipid profile LDL cholesterol lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
66 LAB_LIPID_LDL_DATE DATETIME No
The patient's lipid profile LDL cholesterol lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
67 LAB_LIPID_HDL_VALUE NUMERIC No
The patient's lipid profile HDL cholesterol lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
68 LAB_LIPID_HDL_DATE DATETIME No
The patient's lipid profile HDL cholesterol lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
69 LAB_LIPID_TRIGLYCERIDES_VALUE NUMERIC No
The patient's lipid profile triglyceride lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
70 LAB_LIPID_TRIGLYCERIDES_DATE DATETIME No
The patient's lipid profile triglyceride lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
71 TRAINING_DEPARTMENT_ID_EXTERNAL_NAME VARCHAR No
The external name of the department record. This is often used in patient correspondence such as reminder letters.
72 TRAINING_START_DATE DATETIME No
The start date for the patient's dialysis training.
73 TRAINING_END_DATE DATETIME No
The end date for the patient's dialysis training.
74 TRAINING_DLYS_TRT_TYPE_C_NAME VARCHAR No
The type of training given to a patient in preparation for dialysis treatment.
The category values for this column were already listed for column: DLYS_TRT_TYPE_C_NAME
75 DLYS_SELFCARE_STATUS_C_NAME VARCHAR No
Whether the patient is expected to perform self-care at home or in-center after dialysis training.
May contain organization-specific values: No
Category Entries:
Home
Incenter
76 SELF_DIALYZE_YN VARCHAR No
Whether the patient will self-dialyze after completing dialysis training.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
77 TRAINING_PROV_ID_PROV_NAME VARCHAR No
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table.
78 MAIL_ADDRESS_ZIP VARCHAR No
The ZIP code of the patient's mailing address.
79 PAT_NO_SIGN_REASON_C_NAME VARCHAR No
The dialysis patient unable to sign reasons category ID for the CMS Form 2728 abstraction.
May contain organization-specific values: No
Category Entries:
LostToFollowUp
MoveOut
Expired
80 PAT_DEATH_DATE DATETIME No
The date when a dialysis patient died.
81 PRIOR_LAB_VALUES_C_NAME VARCHAR No
The time period when labs were collected for CMS Form 2728 for the abstraction.
May contain organization-specific values: Yes
Category Entries:
Prior Lab Values (Within 45 days prior to the date chronic dialysis began)
Admission Lab Values (Within 15 days before or after the facility treatment start date)
82 LAB_CYSTATIN_C_VALUE NUMERIC No
The patient's Cystatin C lab value.
83 LAB_CYSTATIN_C_DATE DATETIME No
The patient's Cystatin C lab collection date.
84 FIRST_ACSS_CVC_USED_YN VARCHAR No
Indicates whether one lumen of the central venous catheter was used and one needle was placed in an AVF or graft. 'Y' indicates that one lumen of the central venous catheter was used and one needle was placed in an AVF or graft. 'N' or NULL indicates that a central venous catheter is not present or was not used.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
85 FIRST_ACSS_PD_CATH_USED_YN VARCHAR No
Indicates whether the peritoneal dialysis catheter was present during the patient's first chronic dialysis treatment. 'Y' indicates that the peritoneal dialysis catheter was present. 'N' or NULL indicates that a peritoneal dialysis catheter was not present.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN