The Centers for Disease Control reports that obesity has doubled in children and quadrupled in adolescents in the past 30 years. Obesity predisposes children to a host of chronic illnesses and potentially debilitating conditions such as type 2 diabetes, hypertension, cardiovascular disease, arthritis, certain cancers, and stroke. Several of our quality measures are aligned to track clinical care that can help change activity and nutrition habits for children and their families.
The HEDIS measure for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC) looks for documentation of and evidence of counseling for both nutrition and physical activity in children and teens ages 3-17. The counseling you provide as clinicians counts toward this measure and can help encourage families with children who would benefit from increased activity, better nutrition, and weight loss. Additional details are as follows:
Documentation must include height, weight and BMI percentile during the measurement year. Either of the following meets criteria:
- BMI percentile. Ranges and thresholds do NOT meet criteria. It must be a distinct BMI percentile.
- BMI percentile plotted on age-growth chart.
- Services may be rendered during a visit other than a well-child visit. These services count if the specified documentation is present, regardless of the primary intent of the visit.
- Services specific to an acute or chronic condition do not count toward the “Counseling for nutrition" and “Counseling for physical activity" indicators.
- Use ICD-10 CM BMI percentile codes
Documentation must include a note indicating the date and at least one of the following:
- Discussion of current nutrition behaviors (e.g., eating habits, dieting behaviors) Discussion of appetite alone does NOT meet criteria.
- Checklist indicating nutrition was addressed
- Counseling or referral for nutrition education
- Member received educational materials on nutrition during a face-to-face visit
- Anticipatory guidance for nutrition
- Weight or obesity counseling
Suggestions for documenting nutrition counseling:
- Use ICD-10 CM, CPT codes
- Document current nutrition behaviors (e.g., meal patterns, eating and dieting habits).
Documentation must include a note indicating the date and at least one of the following:
- Discussion of current physical activity behaviors (e.g., exercise routine, participation in sports activities, exam for sports participation).
- Checklist indicating physical activity was addressed
- Counseling or referral for physical activity
- Member received educational materials on physical activity during a face-to-face visit.
- Anticipatory guidance for physical activity
- Weight or obesity counseling
Suggestions for documenting physical activity counseling:
- Use ICD-10 CM, HCPCS codes
- Document physical activity counseling and current physical activity behaviors (e.g., exercise routine, participation in and/or exam for sports activities).
If your practice has an electronic health records (EHR) system, please ensure it is calculating and recording the BMI percentile for your patients after entering the patient’s height and weight. In many EHRs, this is a function that needs to be turned on in order to calculate BMI percentile. In practices that routinely perform well on these measures, the clinical workflow includes obtaining and documenting a BMI percentile at every visit, including sick visits.
BCBSRI’s philanthropic BlueAngel Community Health Grants also support several community organizations working to combat childhood obesity. Read here about the grant recipients or find out how to apply.