CMS 155v12: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents

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

Encounter Codes Eligible for Denominator

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.

Diagnosis

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

Hospice Care Services

Document Hospice Services as a Procedure

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.

Document Hospice Services in the Assessment Tab

The eligible diagnosis codes for Hospice Services are only available as SNOMED CT codes.

SNOMED CT: 305911006, 170935008

SNOMED codes can be added in the Assessment tab by mapping the code to an active ICD-10 using the Map SNO button.

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

Numerator 1: Documenting Height, Weight, and BMI

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 Column

Numerator 2: Documenting Counseling for Nutrition

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

Numerator 3: Documenting Counseling for Physical Activity

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/2024/cms0155v12