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Keep Recording the BMI .... it has great benefits!

  • In conjunction with nutritional history and existing/predisposed chronic conditions, provider can still use comparative BMI over time as springboard for discussion of patient’s overall ‘weight health’
    • potential impact on development of chronic illness
    • need for nutritional evaluation and intervention (high and low BMI)

  • Accurate recording and reporting continue to generate additional incentive income for the practice when BMI is included in claim submitted to the health plan

  • Continues to be HEDIS measure for children and adolescents reflecting the achievement of a quality measure by a practice (BMI percentile)

Importance of Weight Assessment and Counseling for Nutrition and Physical Activity During Pediatric Well-checks

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
  • 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. See the Incentives page of our website.

Sources:

  • Buckeye Health Plan Medical Director Cheryl Morrow-White, M.D. FAAP
  • Buckeye Health Plan Medical Director Peter J. Kambelos, M.D.