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Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)

HEDIS Measure

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)

Line of business: Commercial Medicaid

Data Collection Method: Administrative and Hybrid

Measure Description

The percentage of members 3–17 years of age who had an outpatient visit with a PCP or OB/GYN and who had evidence of the following during the measurement year:

  • BMI percentile documentation
  • Counseling for nutrition.
  • Counseling for physical activity.

Numerator Compliance

BMI
Documentation must include height, weight and BMI percentile during the measurement year from the same data source, by one of the following:

BMI percentile documented as a value (e.g., 85th percentile). BMI percentile plotted on an age-growth chart.

Member-collected biometric values are compliant.
NOTE: Ranges and thresholds do not meet criteria for this indicator.

Documentation of >99% or <1% meet criteria because a distinct BMI percentile is evident (i.e., 100% or 0%).

NUTRITION COUNSELING
Documentation must include a note indicating the date and at least one of the following:

  • Discussion of current nutrition behaviors (e.g., eating habits, dieting behaviors).
  • Checklist indicating nutrition was addressed.
  • Counseling or referral for nutrition education.
  • Member received educational materials on nutrition during a face-to-face visit.
  • Anticipatory guidance for nutrition.
  • Weight or obesity counseling.

PHYSICIAL ACTIVITY
Documentation must include a note indicating the date and at least one of the following:

  • Discussion of current physical activity behaviors (e.g., exercise routine, participation in sports activities, exam for sports participation).
  • Checklist indicating physical activity was addressed.
  • Counseling or referral for physical activity.
  • Member received educational materials on physical activity during a face-to-face visit.
  • Anticipatory guidance specific to the child’s physical activity.
  • Weight or obesity counseling.

Best Practices

  • Take advantage of every visit, including sick visits, to capture BMI percentile and nutrition and physical activity assessments/anticipatory guidance
  • Document weight and obesity counseling, if applicable, to comply for both Nutrition and Physical Activity sub-measures
  • Member-reported biometric values (body mass index, height and weight) are acceptable.
  • Encourage patients to maintain the relationship with a PCP to promote consistent and coordinated health care
  • Educate patients on the importance of having at least one ambulatory or preventive care visit during each measurement year
  • Consider offering extended practice hours to increase care access
  • Remind patients of their appointment by making calls or sending texts
  • Make outreach calls and/or send letters to advise members of the need for a visit
  • Partner with Horizon Healthy Journey Program to assist with targeted outreach activities

NOTE: Services rendered for eating disorders may be used to meet criteria for the Counseling for Nutrition and Counseling for Physical Activity indicators if the specified documentation is present.

Referral to the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) may be used to meet criteria for the Counseling for Nutrition indicator.

Quality Value Set Directory Coding Tips

BMI Percentile

ICD10CM

  • Z68.51
  • Z68.52
  • Z68.53
  • Z68.54

LOINC

  • 59574-4
  • 59575-1
  • 59576-9

Nutrition Counseling

CPT

  • 97802
  • 97803
  • 97804

HCPCS

  • G0270
  • G0271
  • G0447
  • S9449
  • S9452
  • S9470

ICD10CM

  • Z71.3

SNOMED CT US Edition

  • 11816003
  • 61310001
  • 183059007
  • 183060002
  • 183061003
  • 183062005
  • 183063000
  • 183065007
  • 183066008
  • 183067004
  • 183070000
  • 183071001
  • 226067002
  • 266724001
  • 275919002
  • 281085002
  • 284352003
  • 305849009
  • 305850009
  • 305851008
  • 306163007
  • 306164001
  • 306165000
  • 306626002
  • 306627006
  • 306628001
  • 313210009
  • 370847001
  • 386464006
  • 404923009
  • 408910007
  • 410171007
  • 410177006
  • 410200000
  • 429095004
  • 431482008
  • 443288003
  • 609104008
  • 698471002
  • 699827002
  • 699829004
  • 699830009
  • 699849008
  • 700154005
  • 700258004
  • 705060005
  • 710881000
  • 14051000175103
  • 428461000124101
  • 428691000124107
  • 441041000124100
  • 441201000124108
  • 441231000124100
  • 441241000124105
  • 441251000124107
  • 441261000124109
  • 441271000124102
  • 441281000124104
  • 441291000124101
  • 441301000124100
  • 441311000124102
  • 441321000124105
  • 441331000124108
  • 441341000124103
  • 441351000124101
  • 445291000124103
  • 445301000124102
  • 445331000124105
  • 445641000124105

Physical Activity Counseling

HCPCS

  • G0447
  • S9451

ICD10CM

  • Z02.5
  • Z71.82

SNOMED CT US Edition

  • 103736005
  • 183073003
  • 281090004
  • 304507003
  • 304549008
  • 304558001
  • 310882002
  • 386291006
  • 386292004
  • 386463000
  • 390864007
  • 390893007
  • 398636004
  • 398752005
  • 408289007
  • 410200000
  • 410289001
  • 410335001
  • 429778002
  • 710849009
  • 435551000124105