SELECT Assessment_New.Assessment_Tracker_ID, Assessment_New.Patient_ID, Assessment_New.Agency_ID from #Request.prefix_db_agency#.Assessment_New where Assessment_New.Assessment_ID='#session.cs.AssessmentId#'
'#Form.diagnosis#' /> '#Form.casemix#' /> '#Form.shor_Diagnosis#' /> #Form.ICD# /> #Form.Code_Type# /> #session.cs.AssessmentId# /> #queryass.Assessment_Tracker_ID# /> #queryass.Patient_ID# /> #queryass.Agency_ID# /> '#session.cs.AssessmentId#'M0230/>
Diagnosis Slelect #Form.casemix#
#Form.diagnosis#
Primary? Yes No SEVERITY KEY

0 - Asymptomatic, no treatment needed

1- Symptoms well controlled

2 - Symptoms controlled with difficulty

3 - Symptoms poorly controlled

4 - history of rehospitalizations
Secondary? Yes No
Severity level? 0 1 2
3 4
OnsetExacerbation (O) (E)
Add Case Mix for
ICD10 Z-Code
Add Manifestation for
ICD10 Z-Code 		#form.searchvalue#
If this is a ICD10 Z-Code, and you want to add a case mix diagnosis, click "add cade mix..." now to include that data.
Click "add manifestation" to add a manifestation code.
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