CMS 155v7: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Measure: Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported:

  • Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
  • Percentage of patients with counseling for nutrition
  • Percentage of patients with counseling for physical activity
Measure Type High Priority Measure Scoring
Process No A higher percentage indicates better quality
Denominator Patients 3-17 years of age with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period
Numerator

Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period

Numerator 2: Patients who had counseling for nutrition during a visit that occurs during the measurement period

Numerator 3: Patients who had counseling for physical activity during a visit that occurs during the measurement period

Denominator Exceptions None
Denominator Exclusions

Patients:

  • Who have a diagnosis of pregnancy during the measurement period
  • Whose hospice care overlaps the measurement period

Patients who meet the following criteria will be included in the denominator:

  • Age must be ≥ 3 years and < 17 years at the beginning of the Measurement Period

    AND

  • Must have at least one encounter during the Measurement Period finalized by the EC/EP

    AND

  • Encounter must be with a primary care physician or an obstetrician/gynecologist

CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99401, 99402, 99403, 99404, 99411, 99412, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99384, 99382, 99381, 99383, 99394, 99392, 99391, 99393

A patient will be excluded from the measure if they have an active diagnosis of pregnancy during the Measurement Period or were in hospice care during the measurement year.

Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for pregnancy can be located here.

  1. Go to Encounter > Flowsheets/Labs > Standard Flowsheets
  2. From the BMI – Pediatric flowsheet, click Add Column
  3. Select Pregnant from the Patient excluded due to following reason list
  4. Click OK to save

To document hospice care services as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

SNOMED CT: 385763009, 385765002

Order Status must be marked as Complete.

SNOMED CT codes must be added as a Favorite in Preferences > Form Data > Orders to be accessible from the Orders/Referrals tab.

Three separate actions are required for the numerator. A patient will be counted in the numerator if during the Measurement Period:

  • Their height, weight, and BMI was documented
  • They received counseling for nutrition
  • They received counseling for physical activity

BMI is calculated based on the patient height and weight as entered in the Vitals tab of an encounter.

To document height and weight, go to Encounter > Vitals > click Add/Retake Vitals

  1. Go to Encounter > Flowsheets/Labs > Standard Flowsheets
  2. From the BMI – Pediatric flowsheet, click Add Column
  3. Select the Done checkbox for Nutrition Counseling
  4. Click OK to save

  1. Go to Encounter > Flowsheets/Labs > Standard Flowsheets
  2. From the BMI – Pediatric flowsheet, click Add Column
  3. Select the Done checkbox for Physical Activity Counseling
  4. Click OK to save

https://ecqi.healthit.gov/ecqm/ep/2019/cms155v7

 

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