US · guidance
HOPE All Items v1.01, Item J2051
Symptom Impact
J2051. Symptom Impact
Over the past 2 days, how has the patient been affected by each of the following symptoms? Base this on your clinical
assessment (including input from patient and/or caregiver). Symptoms may impact multiple patient activities including, but not
limited to, sleep, concentration, day to day activities, or ability to interact with others.
Coding:
0. Not at all – symptom does not affect the patient, including symptoms well-controlled with current treatment
1. Slight
2. Moderate
3. Severe
9. Not applicable (the patient is not experiencing the symptom)
Enter Code
↓
A. Pain
B. Shortness of breath
C. Anxiety
D. Nausea
E. Vomiting
F. Diarrhea
G. Constipation
H. Agitation
History
HOPE All Items v1.01, effective October 1, 2025 (OMB control number 0938-1153).
Provenance
- Source
- cms.gov
- Retrieved
- 2026-09-17
- Edition
- hope-v1.02
- Content hash
5a44941c552a7cb8586117eb56a4abaaabd9d936e351eaf1fc56fc09e3e5e5c9
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