CMS 155v11: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/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:

  • 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 by the end of the measurement period 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 the measurement period

Numerator 3: Patients who had counseling for physical activity during the measurement period

Denominator Exceptions None
Denominator Exclusions
  • Patients who have a diagnosis of pregnancy during the measurement period
  • Patients who are in hospice care for any part of the measurement period

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

  • Age is 3 years to 17 years at the end of the Measurement Period

    AND

  • Have at least one eligible encounter during the Measurement Period finalized by the EC

    AND

  • EC must be a primary care provider 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, 98966, 98967, 98968, 99441, 99442, 99443

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 for any part of the Measurement Period.

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

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

CPT: 99377, 99378

HCPCS: G0182

Order Status must be marked as Pending or Complete.

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

HCPCS: G9996, G9473, G9474, G9475, G9476, G9477, G9478, G9479, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5010, S9126, T2042, T2043, T2044, T2045, T2046

Order Status must be marked as Complete.

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 and BMI percentile are 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
  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
  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/ec/2023/cms155v11

 

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