Q9-13: Pulmonary Assessments

Questions 9 – 10: Were pulmonary function tests (PFTs) performed? (if PFTs tests were performed, attach the most recent report)

Indicate if pulmonary function tests (PFTs) were performed since the date of last report. If pulmonary function tests were performed in the current reporting period, report Yes and indicate if a PFT report is attached. If multiple PFTs were performed, attach the most recent report.

If pulmonary function tests were not performed since the date of last report, select No.

For further instructions on how to attach documents in FormsNet3 ^SM, refer to the Training Guide.

Question 11: For children unable to perform a PFT, was oxygen saturation on room air > 95%? (only required to answer if children are 5 years of age or less) (if multiple, report the most recent)

Indicate if oxygen saturation on room air was > 95% since the date of last report. If oxygen saturation is > 95% in the current reporting period, report Yes. If the oxygen saturation of room air was ≤ 95%, report No. If the oxygen saturation was assessed multiple times in the reporting period, report the most recent assessment.

If oxygen saturation was not tested, report Not tested.

This question is only enabled for recipients ≤ 5 years of age.

Questions 12 – 13: Was a 6-minute walk test performed?

A 6-minute walk test is used to assess total distance walked within 6 minutes to determine aerobic capacity and endurance. Indicate if a 6-minute walk test was performed since the date of last report. If Yes, report the total distance walked and specify the unit of measure. If multiple walk tests were performed during the reporting period, report the results of the most recent assessment.

If a walk test was not performed, recipient was unable to walk, or cannot perform the 6-minute walk test due to their current clinical status, report No.

Section Updates:

Question Number	Date of Change	Add/Remove/Modify	Description	Reasoning (If applicable)
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