Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-up

eCQM / NQF #: CMS69v7 / 0421
Measure: Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter

Normal Parameters:

• Age 18 and older: BMI => 18.5 and < 25 kg/m2
Numerator: Patients with a documented BMI during the encounter or during the previous twelve months, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter.
Denominator: All patients 18 and older on the date of the encounter with at least one eligible encounter during the measurement period.
Denominator Exclusions: Patients who are pregnant Patients receiving palliative care Patients who refuse measurement of height and/or weight or refuse follow-up.
Denominator Exceptions: Patients with a documented Medical Reason: *Elderly Patients (65 or older) for whom weight reduction/weight gain would complicate other underlying health conditions such as the following examples: *Illness or physical disability *Mental illness, dementia, confusion *Nutritional deficiency, such as Vitamin/mineral deficiency *Patients in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status
Domain: Community/Population Health

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient, age 18 and older, at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominators:

If one of the following is documented, the patient will not be included in the denominators:

Required Data Elements for the Numerator:

If the BMI is outside of the normal parameters, at least ONE of the following must be documented within the 6 months prior to or during the first BMI Encounter of the measurement period:

BMI Measurement Guidance:

•  Height and Weight - An eligible professional or their staff is required to measure both height and weight. Both height and weight must be measured within six months of the current encounter and may be obtained from separate encounters. Self-reported values cannot be used.

•  The BMI may be documented in the medical record of the provider or in outside medical records obtained by the provider.

•  If the most recent documented BMI is outside of normal parameters, then a follow-up plan is documented during the encounter or during the previous six months of the current encounter.

•  If more than one BMI is reported during the measurement period, the most recent BMI will be used to determine if the performance has been met.

Additional Information:

•  There is no diagnosis associated with this measure

•  This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period.

•  This measure may be reported by eligible professionals who perform the quality actions described in the measure based on the services provided at the time of the qualifying visit and the measure-specific denominator coding.

•  The SNOMED codes required for Overweight, Underweight, MUST be attached to either:- the procedure code indicating Follow-Up Intervention
- the same procedure code where the SNOMED for Follow-up or Referral Intervention are attached.  (Note:  the BMI office encounter code can not be used)
- a procedure, other than the office encounter code, when prescribing the medication intervention

•  When using a SNOMED code for Patient, Medical or Other reason not performed:
- it MUST be attached to the same procedure as the Under/Overweight SNOMED code
- the procedure code must also be marked as "Procedure Not Performed"
- the procedure code can not be the BMI office encounter code

•  When using a SNOMED code for Follow-Up Intervention or Referral, it must be attached to the same procedure code as the Under/Overweight SNOMED code  (Note:  the BMI office encounter code can not be used)

•  The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes.