MDS Section
Section X: Correction Request
Governed reference items for Section X: Correction Request.
Type of Provider (A0200 on existing record to be
modified/inactivated)
Name of Resident (A0500 on existing record to be
modified/inactivated)
GenderSex (A08010 on existing
record to be modified/inactivated)
Sex (A0810 on existing record to be modified/inactivated)
Coding Instructions for X0310, Sex
Birth Date (A0900 on existing record to be
modified/inactivated)
Social Security Number (A0600A on existing record to be
modified/inactivated)
Type of Assessment/Tracking (A0310 on existing record
to be modified/inactivated) (cont.)
Date on Existing Record to Be Modified/Inactivated –
Complete one only
Correction Attestation Section
The items in this section indicate the number of times a record accepted into iQIES has been
Reasons for Modification
The items in this section indicate the possible reasons for the modification request of the record
Reasons for Inactivation
The items in this section indicate the possible reasons for the inactivation request. Check all that
RN Assessment Coordinator Attestation of Completion
(cont.)