Pediatric BMI Measures - Message from Medical Director
A message from BHP Medical Director, Peter J. Kambelos, M.D., F.A.C.P.
Importance of Weight Assessment and Counseling for Nutrition and Physical Activity During Pediatric Well-checks
Buckeye Health Plan appreciates your participation in our network as, together, we strive to improve the health of the community, one Ohioan at a time.
I’d like to take this opportunity to emphasize the importance of Weight Assessment and Counseling for Nutrition and Physical Activity during pediatric well-checks and, as a part of that well-check, including documentation and coding of the child’s BMI.
An abnormal BMI can be an early indicator of other health risk factors, such as hyperlipidemia, elevated insulin levels, and high blood pressure. By documenting the child’s BMI, you can, also, close care gaps for your patients and earn incentives as part of the pay for performance program.
A child would be considered obese by BMI criteria if ≥ 95th percentile for age; overweight in the 85th to < 95th percentile for age; normal in the 5th to < 85th percentile for age; and underweight if < 5th percentile for age.
The ICD – 10 codes to apply when reporting a child’s BMI are the following:
- Z68.51 Underweight: BMI less than 5th percentile for age,
- Z68.52 Normal: BMI 5th percentile to less than 85th percentile for age,
- Z68.53 Overweight: BMI 85th to less than 95th percentile for age,
- Z68.54 Obese: BMI greater than or equal to 95th percentile for age.
Buckeye Health Plan offers a Pay-For-Performance (P4P) program for Primary Care Providers (PCP) designed to enhance quality of care through a focus on preventative and screening services. This program supports closing HEDIS-based care gaps for our members, including the Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (BMI Percentile Documentation) HEDIS measure. Please visit the following link to learn more: BHP22-PC-18 - Medicaid - 2022 Measure and Incentive Summary (buckeyehealthplan.com)
Once again, thank you for your participation in our network and for taking such good care of Ohio’s children.
Peter J. Kambelos, M.D., F.A.C.P.,
Buckeye Health Plan