Mount Carmel Health Partners HEDIS Tip Sheets | Page 9

HEDIS Tip Sheet
Body Mass Index (BMI)
Definition: Percentage of members ages 18 – 74 who had an outpatient visit AND a BMI documented during the
measurement year or year prior.
Service Needed: Outpatient visit and calculated BMI during the measurement year or year prior.
Coding:
ICD-10-CM
BMI 19 or Less
BMI 20.0-20.9
BMI 21.0-21.9
BMI 22.0-22.9
BMI 23.0-23.9
BMI 24.0-24.9
BMI 25.0-25.9
BMI 26.0-26.9
BMI 27.0-27.9
BMI 28.0-28.9
BMI 29.0-29.9
BMI 30.0-30.9
BMI 31.0-31.9
Z68.1
Z68.20
Z68.21
Z68.22
Z68.23
Z68.24
Z68.25
Z68.26
Z68.27
Z68.28
Z68.29
Z68.30
Z68.31
BMI 32.0-32.9
BMI 33.0-33.9
BMI 34.0-34.9
BMI 35.0-35.9
BMI 36.0-36.9
BMI 37.0-37.9
BMI 38.0-38.9
BMI 39.0-39.9
BMI 40.0-44.9
BMI 45.0-49.9
BMI 50.0-59.9
BMI 60.0-69.9
BMI 70 or greater
Z68.32
Z68.33
Z68.34
Z68.35
Z68.36
Z68.37
Z68.38
Z68.39
Z68.41
Z68.42
Z68.43
Z68.44
Z68.45
Exclusions:
• Diagnosis of pregnancy during the measurement year or year prior.
• Hospice care in the measurement year.
Chart Review Tips:
• BMIs may be found with the "Vital Signs" in the chart or in the recent the office visit/progress note.
• If the patient meets the exclusion criteria, please note for future reference.
• BMI results may be used from a Specialist's Consult note.
Member Outreach Tips:
• Encourage patients to schedule an appointment with their PCP if they have not had a BMI calculated during the
measurement year or year prior.
• Before calling patients solely for the purpose of a BMI screening, it may be beneficial to evaluate why a BMI has not
been calculated within the measurement year or year prior. Have they not had a preventive visit? Have they
refused a weight measurement? Is the BMI not calculated and in the chart?
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