This code system http://fhir.org/guides/cqf/cds4cpm/CodeSystem/mypain-questionnaire-codes defines the following codes: Code Display mpq-1000 Please describe the location(s) of any pain you have had in the past 7 days (e.g., lower back and left hip) mpq-1001 In the past 7 days - How intense was your pain at its worst? mpq-1002 In the past 7 days - How intense was your average pain? mpq-1003 In the past 7 days - What is your level of pain right now? mpq-1004 In the past 7 days - How much did pain interfere with your day to day activities? mpq-1005 In the past 7 days - How much did pain interfere with your work? mpq-1006 In the past 7 days - How much did pain interfere with your ability to participate in social activities? mpq-1007 In the past 7 days - How much did pain interfere with your household chores? mpq-1008 How often have Exercises at home (such as those assigned by a therapist) or outside (such as walking, jogging, swimming) you have tried in the past 6 months helped you with your pain? mpq-1009 How often have Sleep positioners or devices (such as additional pillows, padding, etc.) you have tried in the past 6 months helped you with your pain? mpq-1010 How often has Stretching you have tried in the past 6 months helped you with your pain? mpq-1011 How often has Weight loss or changes in your diet you have tried in the past 6 months helped you with your pain? mpq-1012 How often has Setting and reaching activity goals you have tried in the past 6 months helped you with your pain? mpq-1013 How often has Ice or heat therapy you have tried in the past 6 months helped you with your pain? mpq-1014 How often has Physical therapy you have tried in the past 6 months helped you with your pain? mpq-1015 How often has Acupuncture you have tried in the past 6 months helped you with your pain? mpq-1016 How often has Chiropractic treatment you have tried in the past 6 months helped you with your pain? mpq-1017 How often have Pain relievers (such as Advil, Aleve, Aspirin, Ibuprofen, Motrin, Tylenol) you can buy without a prescription from your doctor that you have used in the last 6 months helped with your pain? mpq-1018 How often have Herbal or nutritional pain relievers (such as ginseng or kava kava) that you have used in the last 6 months helped with your pain? mpq-1019 How often have Cremes, lotions, gels or patches applied to the skin (for example Bengay, Tiger Balm or BioFreeze) that you have used in the last 6 months helped with your pain? mpq-1020 How often have prescription Opioid medications (such as hydrocodone, oxycodone, codeine, morphine and fentanyl) helped with your pain in the last 6 months? mpq-1021 How often have prescription Cortisone injections (a shot to relieve inflammation) helped with your pain in the last 6 months? mpq-1022 How often have prescription Non-opioid medications as prescribed by a doctor (such as Celebrex, Cymbalta) helped with your pain in the last 6 months? mpq-1023 How often has Yoga helped with your pain in the last 6 months? mpq-1024 How often has Massage helped with your pain in the last 6 months? mpq-1025 How often has Meditation helped with your pain in the last 6 months? mpq-1026 How often has Relaxation or mindfulness-based training helped with your pain in the last 6 months? mpq-1027 How often has Group or individual therapy for pain helped with your pain in the last 6 months? mpq-1028 How often has Acceptance and commitment therapy helped with your pain in the last 6 months? mpq-1029 How often has Sleep management (such as a sleep study or CPAP) helped with your pain in the last 6 months? mpq-1030 How often has Aromatherapy helped with your pain in the last 6 months? mpq-1031 How often have Crystals helped with your pain in the last 6 months? mpq-1032 How often have Essential oils helped with your pain in the last 6 months? mpq-1033 How often has Music therapy helped with your pain in the last 6 months? mpq-1034 Have you tried any Other new treatments to help with your pain in the last 6 months? Please describe mpq-1035 What are your most important activity goals? For example: I’d like to be able to walk without pain. mpq-1036 What are the biggest barriers to achieving your activity goals? For example: I have a lot of stress from work which makes my pain worse. mpq-1037 DEPRECATED mpq-1038 What type of HEAD pain have you had in the last 7 days? mpq-1039 What type of NECK pain have you had in the last 7 days? mpq-1040 What type of SHOULDERS pain have you had in the last 7 days? mpq-1041 What type of ARMS pain have you had in the last 7 days? mpq-1042 What type of UPPER BACK pain have you had in the last 7 days? mpq-1043 What type of LOWER BACK pain have you had in the last 7 days? mpq-1044 What type of HANDS pain have you had in the last 7 days? mpq-1045 What type of ABDOMEN pain have you had in the last 7 days? mpq-1046 What type of PELVIS pain have you had in the last 7 days? mpq-1047 What type of HIPS pain have you had in the last 7 days? mpq-1048 What type of UPPER LEGS pain have you had in the last 7 days? mpq-1049 What type of KNEES pain have you had in the last 7 days? mpq-1050 What type of LOWER LEGS pain have you had in the last 7 days? mpq-1051 What type of FEET pain have you had in the last 7 days? mpq-1052 What type of EVERYWHERE pain have you had in the last 7 days? mpq-1053 What OTHER pain have you had in the last 7 days? Please describe mpq-1054 How often have Other strategies or methods you have tried in the last 6 months helped with your pain? Please describe mpq-1055 Have you used any Other items you can buy without a prescription from your doctor to help with your pain in the last 6 months? Please describe mpq-1056 How often has Medical marijuana helped with your pain in the last 6 months? mpq-1057 Have you used any Other prescription medications to help with your pain in the last 6 months?: Please describe mpq-1058 How often has Cognitive behavioral therapy helped with your pain in the last 6 months? mpq-1059 Have you tried any Other mind-body techniques or therapies to help with your pain in the last 6 months? Please describe mpq-1060 How often has CBD oil helped with your pain in the last 6 months? mpq-1061 Did the patient view the 4 flat tires video mpq-1062 Did the patient access the US Chronic Pain website mpq-1063 Please indicate your level of agreement with the following statement: Using the MyPAIN tool has helped me begin preparing for a conversation with my provider about managing my pain. mpq-1064 Do you have any other feedback or thoughts to share on your use of MyPAIN? mpq-1065 When did the patient submit their questionnaire response? pain-location Please describe the location(s) of any pain you have had in the past 7 days. my-pain-intensity Thinking about your overall pain, in the past 7 days, please respond to the questions below: my-pain-interference Thinking about your overall pain, in the past 7 days, please respond to the questions below: about-my-treatments My Treatments Questionnaire Grouping Code about-my-goals We'd like to know more about you and your goals mypain-feedback Feedback on your use of MyPAIN
Code system for questions from questionnaire used in MyPAIN and Pain Manager
Please describe the location(s) of any pain you have had in the past 7 days (e.g., lower back and left hip)
In the past 7 days - How intense was your pain at its worst?
In the past 7 days - How intense was your average pain?
In the past 7 days - What is your level of pain right now?
In the past 7 days - How much did pain interfere with your day to day activities?
In the past 7 days - How much did pain interfere with your work?
In the past 7 days - How much did pain interfere with your ability to participate in social activities?
In the past 7 days - How much did pain interfere with your household chores?
How often have Exercises at home (such as those assigned by a therapist) or outside (such as walking, jogging, swimming) you have tried in the past 6 months helped you with your pain?
How often have Sleep positioners or devices (such as additional pillows, padding, etc.) you have tried in the past 6 months helped you with your pain?
How often has Stretching you have tried in the past 6 months helped you with your pain?
How often has Weight loss or changes in your diet you have tried in the past 6 months helped you with your pain?
How often has Setting and reaching activity goals you have tried in the past 6 months helped you with your pain?
How often has Ice or heat therapy you have tried in the past 6 months helped you with your pain?
How often has Physical therapy you have tried in the past 6 months helped you with your pain?
How often has Acupuncture you have tried in the past 6 months helped you with your pain?
How often has Chiropractic treatment you have tried in the past 6 months helped you with your pain?
How often have Pain relievers (such as Advil, Aleve, Aspirin, Ibuprofen, Motrin, Tylenol) you can buy without a prescription from your doctor that you have used in the last 6 months helped with your pain?
How often have Herbal or nutritional pain relievers (such as ginseng or kava kava) that you have used in the last 6 months helped with your pain?
How often have Cremes, lotions, gels or patches applied to the skin (for example Bengay, Tiger Balm or BioFreeze) that you have used in the last 6 months helped with your pain?
How often have prescription Opioid medications (such as hydrocodone, oxycodone, codeine, morphine and fentanyl) helped with your pain in the last 6 months?
How often have prescription Cortisone injections (a shot to relieve inflammation) helped with your pain in the last 6 months?
How often have prescription Non-opioid medications as prescribed by a doctor (such as Celebrex, Cymbalta) helped with your pain in the last 6 months?
How often has Yoga helped with your pain in the last 6 months?
How often has Massage helped with your pain in the last 6 months?
How often has Meditation helped with your pain in the last 6 months?
How often has Relaxation or mindfulness-based training helped with your pain in the last 6 months?
How often has Group or individual therapy for pain helped with your pain in the last 6 months?
How often has Acceptance and commitment therapy helped with your pain in the last 6 months?
How often has Sleep management (such as a sleep study or CPAP) helped with your pain in the last 6 months?
How often has Aromatherapy helped with your pain in the last 6 months?
How often have Crystals helped with your pain in the last 6 months?
How often have Essential oils helped with your pain in the last 6 months?
How often has Music therapy helped with your pain in the last 6 months?
Have you tried any Other new treatments to help with your pain in the last 6 months? Please describe
What are your most important activity goals? For example: I’d like to be able to walk without pain.
What are the biggest barriers to achieving your activity goals? For example: I have a lot of stress from work which makes my pain worse.
What type of HEAD pain have you had in the last 7 days?
What type of NECK pain have you had in the last 7 days?
What type of SHOULDERS pain have you had in the last 7 days?
What type of ARMS pain have you had in the last 7 days?
What type of UPPER BACK pain have you had in the last 7 days?
What type of LOWER BACK pain have you had in the last 7 days?
What type of HANDS pain have you had in the last 7 days?
What type of ABDOMEN pain have you had in the last 7 days?
What type of PELVIS pain have you had in the last 7 days?
What type of HIPS pain have you had in the last 7 days?
What type of UPPER LEGS pain have you had in the last 7 days?
What type of KNEES pain have you had in the last 7 days?
What type of LOWER LEGS pain have you had in the last 7 days?
What type of FEET pain have you had in the last 7 days?
What type of EVERYWHERE pain have you had in the last 7 days?
What OTHER pain have you had in the last 7 days? Please describe
How often have Other strategies or methods you have tried in the last 6 months helped with your pain? Please describe
Have you used any Other items you can buy without a prescription from your doctor to help with your pain in the last 6 months? Please describe
How often has Medical marijuana helped with your pain in the last 6 months?
Have you used any Other prescription medications to help with your pain in the last 6 months?: Please describe
How often has Cognitive behavioral therapy helped with your pain in the last 6 months?
Have you tried any Other mind-body techniques or therapies to help with your pain in the last 6 months? Please describe
How often has CBD oil helped with your pain in the last 6 months?
Did the patient view the 4 flat tires video
Did the patient access the US Chronic Pain website
Please indicate your level of agreement with the following statement: Using the MyPAIN tool has helped me begin preparing for a conversation with my provider about managing my pain.
Do you have any other feedback or thoughts to share on your use of MyPAIN?
When did the patient submit their questionnaire response?
Please describe the location(s) of any pain you have had in the past 7 days.
Thinking about your overall pain, in the past 7 days, please respond to the questions below:
My Treatments Questionnaire Grouping Code
We'd like to know more about you and your goals