Column 9 - Race/Ethnicity American Indian or Native White Asian Native Hawaiian/Pacific Islander Black or African American Two or more races Hispanic/Latino Column 10 Documented Vision Loss (Items 5 and 8 are intentionally not used and they are unavailable as an option) – Low Vision Diagnosed Progressive Loss Legally Blind Further Testing Needed (1 year only) Light Perception Only Documented Functional Vision Loss Totally Blind Column 11 -Cortical Vision Impairment 2. Unknown 0. No 1. Yes Column 12 -Documented Hearing Loss (Item 8 is intentionally not used and it is unavailable as an option) Mild Profound Moderate Diagnosed Progressive Loss Moderately Severe Further Testing Needed (1 year only) Severe Documented Functional Hearing Loss Column 13 - Central Auditory Processing Disorder 0. No 2. Unknown 1. Yes Column 14 - Auditory Neuropathy 0. No 2. Unknown 1. Yes Column 15 - Cochlear Implant 0. No 2. Unknown 1. Yes Column 16 - Other Impairments or Conditions-Orthopedic/Physical 0. No 1. Yes
Column 9 - Race/Ethnicity American Indian or Native Asian Black or African American Hispanic/Latino White Native Hawaiian/Pacific Islander Two or more races Column 10 – Documented Vision Loss (Items 5 and 8 are intentionally not used and they are unavailable as an option) Low Vision Legally Blind Light Perception Only Totally Blind Diagnosed Progressive Loss Further Testing Needed (1 year only) Documented Functional Vision Loss Column 11 -Cortical Vision Impairment 0. No 1. Yes 2. Unknown Column 12 -Documented Hearing Loss (Item 8 is intentionally not used and it is unavailable as an option) Mild Moderate Moderately Severe Severe Profound Diagnosed Progressive Loss Further Testing Needed (1 year only) Documented Functional Hearing Loss Column 13 - Central Auditory Processing Disorder 0. No 1. Yes 2. Unknown Column 14 - Auditory Neuropathy 0. No 1. Yes 2. Unknown Column 15 - Cochlear Implant 0. No 1. Yes 2. Unknown Column 16 - Other Impairments or Conditions-Orthopedic/Physical 0. No 1. Yes
2017childcountcodesheet_Oct_12_2017-14_39_06.docx