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US · guidance

HOPE All Items v1.01, Item J2052

Symptom Follow-up Visit (SFV) (complete only if any response to J2051 Symptom Impact = 2. Moderate or 3. Severe)

activein force · 2025-10-01 – presentcompiled-edition

J2052. Symptom Follow-up Visit (SFV) (complete only if any response to J2051 Symptom Impact = 2. Moderate or 3. Severe)

An in-person Symptom Follow-up Visit (SFV) should occur within 2 calendar days as a follow-up for any moderate

or severe pain or non-pain symptom impact identified during Symptom Impact assessment at Admission or HOPE

Update Visit (HUV).

Enter Code

A. Was an in-person SFV completed?

0. No — Skip to J2052C, Reason SFV Not Completed.

1. Yes

B. Date of in-person SFV — Complete and skip to J2053, SFV Symptom Impact.

Month Day Year

Enter Code C. Reason SFV not completed — Skip to M1190, Skin Conditions.

1. Patient and/or caregiver declined an in-person visit.

2. Patient unavailable (e.g., in ED, hospital, travel outside of service area, expired).

3. Attempts to contact patient and/or caregiver were unsuccessful.

9. None of the above

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
f14bfb64212b1be0428edfc687f2ebdaa757ca3cbd13213bfb6932ab98c405cf
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