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	NUMERIC	No
	The patient's dialysis admission facility that is submitting this CMS 2728 form.
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	NUMERIC	No
	The ICD-10 CM code of the patient's primary cause of renal failure.
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	VARCHAR	No
	The patient's attending provider for dialysis treatments.
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	NUMERIC	No
	The patient's dialysis training facility.
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	VARCHAR	No
	The patient's provider for dialysis training.
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