Source anchor
CMS MDS 3.0 RAI Manual v1.20.1 is the governed baseline currently attached to this lookup item.
Error message
MDS Lookup
Pain Intensity
Steps for Assessment
Matrix review
5 matrix group(s) are already attached for review on this item.
Answer coverage
5 governed answer row(s) are attached for this item.
Answer Codes
Code 1
Mild
if resident indicates that their pain is “mild.”
Code 2
Moderate
if resident indicates that their pain is “moderate.”
Code 3
Severe
if resident indicates that their pain is “severe.”
Code 4
Very severe, horrible
if resident indicates that their pain is “very severe or horrible.”
Code 9
Unable to answer
if resident is unable to answer, chooses not to respond, does not respond or gives a nonsensical response. If the Verbal Descriptor Scale i...
What this item is
Steps for Assessment
When to use it
Use this item when the facility is completing content tied to Section J and needs to stay anchored to v1.20.1.
Reminders
- Current source status: Published.
- Item locator: Manual page J-17
- CMS exact locator: Manual page J-17
- This item has 5 governed answer row(s) attached.
Source awareness
This page is grounded in CMS MDS 3.0 RAI Manual v1.20.1. Review the exact text and locators before treating the item as final reference content.
Source & Review
Manual
CMS MDS 3.0 RAI Manual v1.20.1
Status
Published
Effective start
2025-10-01
Item locator
Manual page J-17
CMS exact locator
Manual page J-17
Full CMS Text
Steps for Assessment
1. You may use either the Numeric Rating Scale item (J0600A) or the Verbal Descriptor
Scale item (J0600B) to interview the resident about pain intensity. For each resident, try to use the same scale used on prior assessments.
2. If the resident is unable to answer using one scale, the other scale should be attempted.
3. Record either the Numeric Rating Scale item or the Verbal Descriptor Scale item. Leave
the response for the unused scale blank.
4. Read the question and item choices slowly. While reading, you may show the resident the
response options (the Numeric Rating Scale or Verbal Descriptor Scale) clearly printed on a piece of paper, such as a cue card. Use large, clear print. For the Numeric Rating Scale, say, “Please rate your worst pain over the last 5 days with zero being no pain, and ten as the worst pain you can imagine.” For Verbal Descriptor Scale, say, “Please rate the intensity of your worst pain over the last 5 days.” 5. The resident may provide a verbal response, point to the written response, or both. Coding Instructions for J0600A. Numeric Rating Scale (00-10) Enter the two digit number (00-10) indicated by the resident as corresponding to the intensity of their worst pain over the last 5 days, where zero is no pain, and 10 is the worst pain imaginable. Enter 99 if unable to answer. If the Numeric Rating Scale is not used, leave the response box blank. Coding Instructions for J0600B. Verbal Descriptor Scale
Code 1, mild: if resident indicates that their pain is “mild.”
Code 2, moderate: if resident indicates that their pain is “moderate.”
Code 3, severe: if resident indicates that their pain is “severe.”
Code 4, very severe, horrible: if resident indicates that their pain is “very severe or
horrible.” Code 9, unable to answer: if resident is unable to answer, chooses not to respond, does not respond or gives a nonsensical response. If the Verbal Descriptor Scale is not used, leave the response box blank. Examples for J0600A. Numeric Rating Scale (00-10)
1. The nurse asks Resident T to rate their pain on a scale of 0 to 10. Resident T states that they
are not sure, because they have shoulder pain and knee pain, and sometimes it is really bad, and sometimes it is OK. The nurse reminds Resident T to think about all the pain they had over the last 5 days and select the number that describes their worst pain. They report that their pain is a “6.” Coding: J0600A would be coded 06.
Rationale: The resident said their pain was 6 on the 0 to 10 scale. Because a 2-digit
number is required, it is entered as 06.
2. The nurse asks Resident S to rate their pain, reviews use of the scale, and provides the 0 to 10
visual aid. Resident S says, “My pain doesn’t have any numbers.” The nurse explains that the numbers help the staff understand how severe their pain is and repeats that the “0” end is no pain and the “10” end is the worst pain imaginable. Resident S replies, “I don’t know where it would fall.” Coding: Item J0600A would be coded 99, unable to answer. The interviewer would go on to ask about pain intensity using the Verbal Descriptor Scale item (J0600B).
Rationale: The resident was unable to select a number or point to a location on the 0-10
scale that represented their level of pain intensity. Examples for J0600B. Verbal Descriptor Scale
1. The nurse asks Resident R to rate their pain using the verbal descriptor scale. They look at
the response options presented using a cue card and say their pain is “severe” sometimes, but most of the time it is “mild.” Coding: J0600B would be coded 3, severe.
Rationale: The resident said their worst pain was “Severe.”
2. The nurse asks Resident U to rate their pain, reviews use of the verbal descriptor scale, and
provides a cue card as a visual aid. Resident U says, “I’m not sure whether it’s mild or moderate.” The nurse reminds Resident U to think about their worst pain over the last 5 days. Resident U says, “At its worst, it was moderate.”
Coding: Item J0600B would be coded 2, moderate.
Rationale: The resident indicated that their worst pain was “Moderate.”
Matrix Applicability
Nursing Home Subsets
NC - Comprehensive
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
NQ - Quarterly
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
ND - Discharge
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
NP - PPS 5 Day
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
Program and Policy Use
Care Area Triggers
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
Swing Bed Subsets
SP - PPS 5 Day
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Stand Alone Assessments
OBRA Admission A=01, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Quarterly A=02, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Annual / Sig Chg A=03, B=99, F=99, G=^, H=0 A= 04, B=99, F=99, G=^, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
OBRA Discharge A=99, B=99, F=10, 11, G=1, 2, H=0
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4
D/C Items (Only when A0310F = 10 or 11)
A0310G=1 PDC
Marker: x
applies
Locator: MDS Item Matrix v1.20.1 v4