PACIO Personal Functioning and Engagement Implementation Guide
1.0.0 - STU1 United States of America flag

This page is part of the PACIO Personal Functioning and Engagement Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Personal Functioning and Engagement Mental Functions Value Set - XML Representation

Draft as of 2024-01-05

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="pfe-mental-functions-vs"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Include these codes as defined in <a href="http://loinc.org"><code>http://loinc.org</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href="https://loinc.org/11332-4/">11332-4</a></td><td style="color: #cccccc">History of Cognitive function Narrative</td></tr><tr><td><a href="https://loinc.org/44250-9/">44250-9</a></td><td style="color: #cccccc">Little interest or pleasure in doing things in last 2 weeks</td></tr><tr><td><a href="https://loinc.org/44255-8/">44255-8</a></td><td style="color: #cccccc">Feeling down, depressed, or hopeless in last 2 weeks</td></tr><tr><td><a href="https://loinc.org/45482-7/">45482-7</a></td><td style="color: #cccccc">Comatose [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/46473-5/">46473-5</a></td><td style="color: #cccccc">Cognitive, behavioral, and psychiatric symptoms demonstrated at least one time per week [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/46589-8/">46589-8</a></td><td style="color: #cccccc">Cognitive functioning [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/46592-2/">46592-2</a></td><td style="color: #cccccc">Frequency of behavior problems [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/52731-7/">52731-7</a></td><td style="color: #cccccc">Repetition of three words # [BIMS]</td></tr><tr><td><a href="https://loinc.org/52732-5/">52732-5</a></td><td style="color: #cccccc">Temporal orientation - current year [BIMS]</td></tr><tr><td><a href="https://loinc.org/52733-3/">52733-3</a></td><td style="color: #cccccc">Temporal orientation - current month [BIMS]</td></tr><tr><td><a href="https://loinc.org/52735-8/">52735-8</a></td><td style="color: #cccccc">Recall - sock [BIMS]</td></tr><tr><td><a href="https://loinc.org/52736-6/">52736-6</a></td><td style="color: #cccccc">Recall - blue [BIMS]</td></tr><tr><td><a href="https://loinc.org/52737-4/">52737-4</a></td><td style="color: #cccccc">Recall - bed [BIMS]</td></tr><tr><td><a href="https://loinc.org/54597-0/">54597-0</a></td><td style="color: #cccccc">Comatose during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54605-1/">54605-1</a></td><td style="color: #cccccc">Brief Interview for Mental Status (BIMS) should be conducted [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54609-3/">54609-3</a></td><td style="color: #cccccc">Temporal orientation - current day of the week [BIMS]</td></tr><tr><td><a href="https://loinc.org/54614-3/">54614-3</a></td><td style="color: #cccccc">Brief Interview for Mental Status - summary score [BIMS]</td></tr><tr><td><a href="https://loinc.org/54615-0/">54615-0</a></td><td style="color: #cccccc">Should staff assessment for mental status be conducted [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54616-8/">54616-8</a></td><td style="color: #cccccc">Short-term memory OK during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54617-6/">54617-6</a></td><td style="color: #cccccc">Long-term memory OK during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54624-2/">54624-2</a></td><td style="color: #cccccc">Cognitive skills for daily decision making during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54628-3/">54628-3</a></td><td style="color: #cccccc">Inattention in last 7 days [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/54629-1/">54629-1</a></td><td style="color: #cccccc">Disorganized thinking in last 7 days [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/54632-5/">54632-5</a></td><td style="color: #cccccc">Acute onset mental status change [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/54634-1/">54634-1</a></td><td style="color: #cccccc">Should resident mood interview be conducted [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54636-6/">54636-6</a></td><td style="color: #cccccc">Little interest or pleasure in doing things in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54637-4/">54637-4</a></td><td style="color: #cccccc">Little interest or pleasure in doing things in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54638-2/">54638-2</a></td><td style="color: #cccccc">Feeling down, depressed or hopeless in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54639-0/">54639-0</a></td><td style="color: #cccccc">Feeling down, depressed or hopeless in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54640-8/">54640-8</a></td><td style="color: #cccccc">Trouble falling or staying asleep, or sleeping too much in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54641-6/">54641-6</a></td><td style="color: #cccccc">Trouble falling or staying asleep, or sleeping too much in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54642-4/">54642-4</a></td><td style="color: #cccccc">Feeling tired or having little energy in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54643-2/">54643-2</a></td><td style="color: #cccccc">Feeling tired or having little energy in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54644-0/">54644-0</a></td><td style="color: #cccccc">Poor appetite or overeating in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54645-7/">54645-7</a></td><td style="color: #cccccc">Poor appetite or overeating in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54646-5/">54646-5</a></td><td style="color: #cccccc">Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54647-3/">54647-3</a></td><td style="color: #cccccc">Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54648-1/">54648-1</a></td><td style="color: #cccccc">Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54649-9/">54649-9</a></td><td style="color: #cccccc">Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54650-7/">54650-7</a></td><td style="color: #cccccc">Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54651-5/">54651-5</a></td><td style="color: #cccccc">Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54652-3/">54652-3</a></td><td style="color: #cccccc">Thoughts that you would be better off dead, or of hurting yourself in some way in last 2 weeks.presence [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54653-1/">54653-1</a></td><td style="color: #cccccc">Thoughts that you would be better off dead, or of hurting yourself in some way in last 2 weeks.frequency [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54654-9/">54654-9</a></td><td style="color: #cccccc">Mood interview total severity score [Reported PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54658-0/">54658-0</a></td><td style="color: #cccccc">Little interest or pleasure in doing things in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54659-8/">54659-8</a></td><td style="color: #cccccc">Little interest or pleasure in doing things in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54660-6/">54660-6</a></td><td style="color: #cccccc">Feeling or appearing down, depressed or hopeless in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54661-4/">54661-4</a></td><td style="color: #cccccc">Feeling or appearing down, depressed, or hopeless in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54662-2/">54662-2</a></td><td style="color: #cccccc">Trouble falling or staying asleep, or sleeping too much in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54663-0/">54663-0</a></td><td style="color: #cccccc">Trouble falling or staying asleep, or sleeping too much in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54664-8/">54664-8</a></td><td style="color: #cccccc">Feeling tired or having little energy in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54665-5/">54665-5</a></td><td style="color: #cccccc">Feeling tired or having little energy in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54666-3/">54666-3</a></td><td style="color: #cccccc">Poor appetite or overeating in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54667-1/">54667-1</a></td><td style="color: #cccccc">Poor appetite or overeating in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54668-9/">54668-9</a></td><td style="color: #cccccc">Indicating that (s)he feels bad about self, is a failure, or has let self or family down in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54669-7/">54669-7</a></td><td style="color: #cccccc">Indicating that (s)he feels bad about self, is a failure, or has let self or family down in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54670-5/">54670-5</a></td><td style="color: #cccccc">Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54671-3/">54671-3</a></td><td style="color: #cccccc">Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54672-1/">54672-1</a></td><td style="color: #cccccc">Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that (s)he has been moving around a lot more than usual in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54673-9/">54673-9</a></td><td style="color: #cccccc">States that life isn't worth living, wishes for death, or attempts to harm self in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54674-7/">54674-7</a></td><td style="color: #cccccc">States that life isn't worth living, wishes for death, or attempts to harm self in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54675-4/">54675-4</a></td><td style="color: #cccccc">Being short-tempered, easily annoyed in last 2 weeks.presence [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54676-2/">54676-2</a></td><td style="color: #cccccc">Being short-tempered, easily annoyed in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54677-0/">54677-0</a></td><td style="color: #cccccc">Staff assessment of resident mood total severity score [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/54682-0/">54682-0</a></td><td style="color: #cccccc">Physical behavioral symptoms directed toward others during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54683-8/">54683-8</a></td><td style="color: #cccccc">Verbal behavioral symptoms directed toward others during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54684-6/">54684-6</a></td><td style="color: #cccccc">Other behavioral symptoms not directed toward others during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54685-3/">54685-3</a></td><td style="color: #cccccc">Overall presence of behavioral symptoms during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54686-1/">54686-1</a></td><td style="color: #cccccc">Put the resident at significant risk for physical illness or injury during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54687-9/">54687-9</a></td><td style="color: #cccccc">Significantly interfere with the resident's care during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54688-7/">54688-7</a></td><td style="color: #cccccc">Significantly interfere with the resident's participation in activities or social interactions during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54689-5/">54689-5</a></td><td style="color: #cccccc">Put others at significant risk for physical injury during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54690-3/">54690-3</a></td><td style="color: #cccccc">Significantly intrude on the privacy or activity of others during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54691-1/">54691-1</a></td><td style="color: #cccccc">Significantly disrupt care or living environment during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54692-9/">54692-9</a></td><td style="color: #cccccc">Rejection of care - presence and frequency in last 7 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54693-7/">54693-7</a></td><td style="color: #cccccc">Wandering - presence and frequency in last 7 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54694-5/">54694-5</a></td><td style="color: #cccccc">Wandering places resident at significant risk of getting to a potentially dangerous place in last 7 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54695-2/">54695-2</a></td><td style="color: #cccccc">Wandering significantly intrudes on the privacy or activities of others in last 7 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54696-0/">54696-0</a></td><td style="color: #cccccc">Change in behavioral or other symptoms in last 7 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/54904-8/">54904-8</a></td><td style="color: #cccccc">Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that (s)he has been moving around a lot more than usual in last 2 weeks.frequency [Observed PHQ-9 CMS]</td></tr><tr><td><a href="https://loinc.org/57242-0/">57242-0</a></td><td style="color: #cccccc">Standardized depression screening was conducted [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/58104-1/">58104-1</a></td><td style="color: #cccccc">When confused within the last 14 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/72106-8/">72106-8</a></td><td style="color: #cccccc">Total score [MMSE]</td></tr><tr><td><a href="https://loinc.org/72172-0/">72172-0</a></td><td style="color: #cccccc">Total score [MoCA]</td></tr><tr><td><a href="https://loinc.org/83248-5/">83248-5</a></td><td style="color: #cccccc">Should brief interview for mental status be conducted during 3 day assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/85073-5/">85073-5</a></td><td style="color: #cccccc">Functional cognition [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/85629-4/">85629-4</a></td><td style="color: #cccccc">Comatose during 3 day assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/85631-0/">85631-0</a></td><td style="color: #cccccc">Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said during 3 day assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/85634-4/">85634-4</a></td><td style="color: #cccccc">Is there evidence of an acute change in mental status from the patient's baseline during 3 day assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/85651-8/">85651-8</a></td><td style="color: #cccccc">Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject during 3 day assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/86495-9/">86495-9</a></td><td style="color: #cccccc">When anxious within the last 14 days [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/86527-9/">86527-9</a></td><td style="color: #cccccc">Conditions related to intellectual disability and developmental disability status [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/86597-2/">86597-2</a></td><td style="color: #cccccc">Potential indicators of psychosis during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/93159-2/">93159-2</a></td><td style="color: #cccccc">How often do you feel lonely or isolated from those around you [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/93414-1/">93414-1</a></td><td style="color: #cccccc">Altered level of consciousness in last 3 day [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95743-1/">95743-1</a></td><td style="color: #cccccc">Memory/recall ability during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/95812-4/">95812-4</a></td><td style="color: #cccccc">Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said during assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95813-2/">95813-2</a></td><td style="color: #cccccc">Is there evidence of an acute change in mental status from the patient's baseline during assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95814-0/">95814-0</a></td><td style="color: #cccccc">Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject during assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95815-7/">95815-7</a></td><td style="color: #cccccc">Altered level of consciousness during assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95855-3/">95855-3</a></td><td style="color: #cccccc">Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity during assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95856-1/">95856-1</a></td><td style="color: #cccccc">LCDS v4.00 - Altered level of consciousness during assessment period [CMS Assessment]</td></tr><tr><td><a href="https://loinc.org/95857-9/">95857-9</a></td><td style="color: #cccccc">Level of consciousness - Alert (normal) during assessment period [CAM.CMS]</td></tr><tr><td><a href="https://loinc.org/95858-7/">95858-7</a></td><td style="color: #cccccc">Level of consciousness - Vigilant or lethargic or stupor or coma during assessment period [CAM.CMS]</td></tr></table></li></ul></div>
  </text>
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       value="http://hl7.org/fhir/us/pacio-pfe/ValueSet/pfe-mental-functions-vs"/>
  <version value="1.0.0"/>
  <name value="PFEMentalFunctionsVS"/>
  <title
         value="Personal Functioning and Engagement Mental Functions Value Set"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2024-01-05T17:17:38+00:00"/>
  <publisher value="HL7 International / Patient Care"/>
  <contact>
    <name value="HL7 International / Patient Care"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/patientcare"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="patientcare@lists.HL7.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="PACIO project"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/patientcare"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="info@pacioproject.org"/>
    </telecom>
  </contact>
  <description
               value="This value set includes LOINC codes that represent patient observations regarding individual's mental functioning."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright
             value="This material contains content from LOINC (http://loinc.org). LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc."/>
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        <code value="11332-4"/>
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      <concept>
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      <concept>
        <code value="44255-8"/>
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      <concept>
        <code value="45482-7"/>
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      <concept>
        <code value="46473-5"/>
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      <concept>
        <code value="46589-8"/>
      </concept>
      <concept>
        <code value="46592-2"/>
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      <concept>
        <code value="52731-7"/>
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      <concept>
        <code value="52732-5"/>
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      <concept>
        <code value="52733-3"/>
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        <code value="52735-8"/>
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      <concept>
        <code value="52736-6"/>
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      <concept>
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      <concept>
        <code value="54597-0"/>
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      <concept>
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      <concept>
        <code value="54609-3"/>
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      <concept>
        <code value="54614-3"/>
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      <concept>
        <code value="54615-0"/>
      </concept>
      <concept>
        <code value="54616-8"/>
      </concept>
      <concept>
        <code value="54617-6"/>
      </concept>
      <concept>
        <code value="54624-2"/>
      </concept>
      <concept>
        <code value="54628-3"/>
      </concept>
      <concept>
        <code value="54629-1"/>
      </concept>
      <concept>
        <code value="54632-5"/>
      </concept>
      <concept>
        <code value="54634-1"/>
      </concept>
      <concept>
        <code value="54636-6"/>
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      <concept>
        <code value="54637-4"/>
      </concept>
      <concept>
        <code value="54638-2"/>
      </concept>
      <concept>
        <code value="54639-0"/>
      </concept>
      <concept>
        <code value="54640-8"/>
      </concept>
      <concept>
        <code value="54641-6"/>
      </concept>
      <concept>
        <code value="54642-4"/>
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