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? 9