Measure: Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if most recent BMI was outside of normal parameters | ||
| Measure Type | High Priority Measure | Scoring |
| Process | No | A higher percentage indicates better quality |
| Denominator | All patients 18 and older on the date of the encounter with at least one eligible encounter during the measurement period |
| Numerator | Patients with a documented BMI during the encounter or during the measurement period, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the measurement period |
| Denominator Exceptions |
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| Denominator Exclusions |
|
Denominator
Patients who meet the following criteria will be included in the denominator:
Age is ≥ 18 years at the beginning of the Measurement Period
AND
- Have at least one eligible encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator
CPT: 90791, 90792, 90832, 90834, 90837, 96156, 96158, 96159, 97161, 97162, 97163, 97165, 97166, 97167, 97802, 97803, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99236, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99339, 99340, 99385, 99386, 99387, 99395, 99396, 99397, 99401, 99402
HCPCS: G0101, G0108, G0270, G0271, G0402, G0438, G0439, G0447, G0473
Note: Telephone encounters are not eligible for the denominator.
Denominator Exceptions
A patient will be counted as an exception if there is a medical reason or urgent medical situation for not documenting their BMI or for not providing a BMI follow up plan if BMI was out of the normal range. A patient who refuses to have their height or weight measured will also be counted as an exception.
The reason for the exception must be documented on the day of the eligible encounter.
Document Reason BMI Was Not Obtained
- Go to Encounter > Flowsheets/Labs > Standard
- From the BMI – Adult flowsheet, click Add Column
- Select Emergent situation, Has a terminal illness, Medical reason, or Physical disability from the No BMI obtained due to list
- Click OK to save
Document Reason BMI Follow Up Plan Was Not Provided
- Go to Encounter > Flowsheets/Labs > Standard
- From the BMI – Adult flowsheet, click Add Column
- Select a Value from the BMI Management Plan not done due to list
- Click OK to save
Patient Refused Height or Weight Measurement
- Go to Encounter > Flowsheets/Labs > Standard
- From the BMI – Adult flowsheet, click Add Column
- Select Patient Refused from the No BMI obtained due to list
- Click OK to save
Denominator Exclusions
A patient will be excluded from this measure if they meet any of the following conditions:
- Has an active diagnosis of pregnancy at any time during the Measurement Period
- Is in hospice care at any time during the Measurement Period
- Is receiving palliative care at any time during the Measurement Period
Pregnancy Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible pregnancy diagnosis codes can be located here.
Hospice Care Services
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.
Palliative Care
Palliative care services can be documented using the FACIT-Pal Questionnaire flowsheet, as an order, or as a diagnosis.
FACIT-Pal Questionnaire Flowsheet
Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
Click Add New Flowsheet
Select the FACIT-Pal Questionnaire flowsheet and click Add
Click Add Column
Populate the patient’s responses to the questions as appropriate
Click OK to save
Palliative Care Services Order
Go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
HCPCS: G9054
Order Status must be marked as Complete.
Palliative Care Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis code for palliative care is:
ICD-10: Z51.5
Numerator
A patient will be counted in the numerator if their BMI was documented during the eligible encounter or during the Measurement Period. If the patient’s BMI is outside of the normal range (as defined by this measure), a BMI follow up plan must be provided to the patient during the eligible encounter or during the Measurement Period.
This measure defines Normal BMI Parameters as: Age 18 years and older BMI ≥ 18.5 and < 25 kg/m2
Note
If more than one BMI is documented during the Measurement Period, and any of the documented BMI assessments is outside of normal parameters, documentation of an appropriate follow-up plan will be used to determine if performance has been met.
Document BMI
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 and click Add/Retake Vitals
Documenting BMI Follow Up Plan
The BMI follow up plan can be documented in any of the following ways:
As a referral in the BMI – Adult flowsheet
As an active or resolved diagnosis
As a procedure
As a prescription for medication
The BMI follow up plan must be provided on the day of the eligible encounter or during the Measurement Period.
Document Referral Created for BMI Follow Up in the BMI – Adult Flowsheet
- Go to Encounter > Flowsheets/Labs > Standard
- From the BMI – Adult flowsheet, click Add Column
- Select a Value from the BMI Referral to list
- Click OK to save
Note
This action does not create a referral in Sevocity. Referrals are created from the Referrals tab in the chart or from the Orders/Referrals tab in an encounter
Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis codes for BMI follow up plan are:
Above Normal BMI Follow Up
ICD-10: Z71.3, Z71.82
Below Normal BMI Follow Up
ICD-10: Z71.3
BMI Management Procedure
To document a BMI follow up plan as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
Above Normal BMI Follow Up
CPT: 43644, 43645, 43659, 43770, 43771, 43772, 43773, 43774, 43842, 43843, 43845, 43846, 43847, 43848, 43886, 43888, 97802, 97803, 97804, 98960, 99078, 99401, 99402
HCPCS: G0270, G0271, G0447, G0473, S9449, S9451, S9452, S9470
Below Normal BMI Follow Up
CPT: 97802, 97803, 97804, 98960, 99078, 99401, 99402
HCPCS: G0270, G0271, S9449, S9452, S9470
Order Status must be marked as Pending or Complete.
Medication
To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription. A comprehensive list of eligible BMI management medications can be located here.
eCQI Reference
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