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      CMS155v13: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

      Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. There are several rates reported: 

      1. Percentage of patients with height, weight, and body mass index (BMI) percentile documentation

      2. Percentage of patients with counseling for nutrition
      3. Percentage of patients with counseling for physical activity

      Numerator

      Numerator 1: Percentage of patients with height, weight, and body mass index (BMI) percentile documentation

      Patients in the denominator will be added to the numerator if any of the following conditions are met:

      • Vitals: The patient's weight and height are entered in the vitals section of the most recent encounter screen

      • Free Text: in the Physical Exam, Assessment or Plan, the BMI percentile is recorded using any of the following phrases:

        • BMI percentile
        • BMI%
        • BMI %

      Numerator 2: Percentage of patients with counseling for nutrition

      Patients in the denominator will be added to the numerator if either of the following two criteria are met:

      • Clinical Decision Support Rule: the clinician completes the "Screening for Obesity in Children and Adolescents" for the patient.
      • Test in Chart: In the Assessment or Plan fields in the Most Recent Encounter, any of the following terms are used:
        • nutritious
        • nutrition
        • diet
        • weight control

      Numerator 3: Percentage of patients with counseling for physical activity

      Patients in the denominator will be added to the numerator if either of the following two criteria are met:

      • Clinical Decision Support Rule: the clinician completes the "Screening for Obesity in Children and Adolescents" for the patient.

      • Text in Chart: In the Assessment or Plan fields in the Most Recent Encounter, any of the following terms are used:

        • exercise
        • physical activity

      Denominator

      The denominator is the same for all rates, and is split into two different groups: patients between 3 and 11 years and patients between 11 and 17 by the end of the measurement period.

      Patients 3-17 years of age by the end of the measurement period will be added to the denominator is they have at least one outpatient visit with a primary care physician or an obstetrician/gynecologist during the measurement period

      Denominator Exclusions

      Patients who otherwise meet the denominator will be excluded if any of the following is met: 

      • Pregnancy: Identified by an appropriate ICD-10 code assigned to the problem list

      • Exclude patients whose hospice or palliative care overlaps the measurement period:

        • Identified in the patient's Alerts and Directives, located in the demographic screen or the Summary Sheet, in the name, text or comments saved with that alert/directive. The Alert/Directive should include either of the following phrases:

          • palliative

          • hospice