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CMS69v14: Preventive Care and Screening: Body Mass Index(BMI)Screening and Follow Up Plan

Note: Applicable for MVP program ONLY, not for Traditional MIPS 

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the measurement period AND who had a follow-up plan documented if BMI was outside of normal parameters

Note: Normal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2

Numerator

Patients with a documented BMI during the encounter or during the measurement period, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during measurement period.

The patient will be added to the numerator they meet either SCENARIO #1 or SCENARIO #2.

SCENARIO #1: Record BMI and it is normal

Within the last 12 months, the clinician has measured the height and weight, and the BMI is determined to be normal.

  • BMI Recorded in Chart: fill out height and weight in the Most Recent Encounter screen. The BMI auto calculates. A BMI between 18.5 and 25 is normal.

SCENARIO #2: Record BMI, it is not normal, and a follow up plan is documented. 

Within the last 12 months, the clinician has measured the height and weight and the BMI is determined to be abnormal, and at any visit within the last six months, a follow up plan is documented. In Amazing Charts, the height and weight must be recorded in the same encounter to calculate the BMI.

  • BMI recorded in the last 12 months at an encounter (either one of the following will count)
    • BMI Recorded in Chart: fill out height and weight in the Most Recent Encounter screen. The BMI auto calculates. A BMI above or below 18.5 and 25 is abnormal.
    • Diagnoses: Overweight or underweight diagnoses added to the patient's problem list
  • Follow up plan documented specific to the BMI

    • Clinical Decision Support: Complete any of the following rules, and record in the Results/Comments of the rule that you created any of the following phrases: "Follow up", "follow- up" or "followup".

      • Healthy Diet and Physical Activity: Counseling Adults with High Risk of CVD Obesity: BMI >= 30

      • Obesity: BMI >= 25 with 1 or more mild-moderate adiposity related complications

      • Obesity: BMI >= 25 no known adiposity-related complications

    • Test in Chart: In the Plan or Assessment, typing any of the following would count:

      • follow up for above normal BMI

      • followup for above normal BMI

      • follow-up for above normal BMI

      • follow up for below normal BMI

      • followup for below normal BMI

      • follow-up for below normal BMI

    • Referral: The clinician refers the patient to another physician, and notes in the Comments section of the referral that the reason for the referral is "weight" or "BMI" related.
       

Denominator

All patients 18 and older on the date of the encounter with at least one eligible encounter during the measurement period

    • An Eligible Encounter must have the appropriate office visit CPT code entered into Amazing Charts (ex: 99213, 99214, etc)

Denominator Exclusions

  • Patients who are pregnant at any time during the measurement period
    • Completed with a diagnosis in the patients 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

Denominator Exceptions

  • Patients who refuse measurement of height and/or weight or refuse follow-up denoted by adding any of the following to the Physical Exam, Assessment or Plan section of the Most Recent Encounter:

    • "Patient refused height and weight measurements"

    • "Patient refused ht and wt measurements"

    • "Patient refused height measurement"

    • "Patient refused weight measurement"

    • "Patient refused ht measurement"

    • "Patient refused wt measurement"

  • Medical Reason(s):Patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status. This may include but is not limited to severely elevated BP when immediate medical treatment is indicated.

    • In the Assessment or Plan section of the Most Recent Encounter, enter any of the following phrases

      • "Urgent Situation. BMI Not Recorded"

      • "Emergent Situation. BMI Not Recorded"

      • "Medical contraindication indicated. BMI Not Recorded"

  • Patients with a documented Medical Reason denoted by adding any of the following to the Assessment or Plan section of the Most Recent Encounter:

    • "Abnormal BMI Intervention not done due to medical reason"

    • "Referral for weight assessment not done due to medical reason"

    • "Abnormal BMI Medication order not done due to medical reason"