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

Compare Versions of: "Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan"

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

Compare 2025 version to

Table Options
Measure Information 2025 Performance Period
Title Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
CMS eCQM ID CMS69v13
CBE ID* Not Applicable
MIPS Quality ID 128
Measure Steward Centers for Medicare & Medicaid Services (CMS)
Description

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

Measure Scoring Proportion measure
Measure Type Process
Stratification

None

Risk Adjustment

None

Rationale

BMI Above Normal Parameters

“Obesity is a chronic, multifactorial disease with complex psychological, environmental (social and cultural), genetic, physiologic, metabolic and behavioral causes and consequences. The prevalence of overweight and obese people is increasing worldwide at an...

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Clinical Recommendation Statement

All adults should be screened annually using a BMI measurement. BMI measurements >= 25 kg/m2 should be used to initiate further evaluation of overweight or obesity after taking into account age, gender, ethnicity, fluid status, and muscularity; therefore, clinical evaluation and judgment...

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Improvement Notation

Higher score indicates better quality

Definition

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

BMI - Body mass index (BMI) is a number calculated using the Quetelet index: weight divided by height squared (W/H2) and is commonly used to classify weight categories. BMI can be calculated using:

Metric Units: BMI...

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Guidance

BMI Measurement Guidance:

- Height and Weight - An eligible clinician or their staff is required to measure both height and weight. Both height and weight must be measured during the measurement period. Self-reported values cannot be used.

- The BMI may be documented in the medical record...

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Initial Population

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

Denominator

Equals Initial Population

Denominator Exclusions

Patients who are pregnant at any time during the measurement period.

Patients receiving palliative or hospice care at any time during the measurement period.

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 the measurement period

Numerator Exclusions

Not Applicable

Denominator Exceptions

Patients with a documented medical reason for not documenting BMI or for not documenting a follow-up plan for a BMI outside normal parameters (e.g., elderly patients 65 years of age or older for whom weight reduction/weight gain would complicate other underlying health conditions such as...

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Telehealth Eligible No
Next Version No Version Available
Previous Version

Header

  • Updated the eCQM version number.

    Measure Section:

    eCQM Version Number

    Source of Change:

    Annual Update

  • Changed all references from NQF to CBE to identify the consensus-based entity role.

    Measure Section:

    CBE Number

    Source of Change:

    Annual Update

  • Updated copyright.

    Measure Section:

    Copyright

    Source of Change:

    Annual Update

  • Added a statement to the Guidance to clarify that if a patient meets exception criteria, then the clinician must document the exception on the date of the qualifying encounter.

    Measure Section:

    Guidance

    Source of Change:

    Measure Lead

  • Updated Guidance to remove any instances of 'Eligible Professional(s)' to align with other eCQMs.

    Measure Section:

    Guidance

    Source of Change:

    Measure Lead

  • Updated the Guidance to indicate the Numerator actions must occur during the measurement period to align with measure intent and measure logic.

    Measure Section:

    Guidance

    Source of Change:

    Measure Lead

  • Updated grammar, wording, and/or formatting to improve readability and consistency.

    Measure Section:

    Multiple Sections

    Source of Change:

    Annual Update

  • Updated references and measure header to reflect current evidence and new or updated literature.

    Measure Section:

    Multiple Sections

    Source of Change:

    Measure Lead

Logic

  • Changed alias name from 'Pregnancy' to 'Is Pregnant during Day of Measurement Period' in Denominator Exclusions to align with the CQL Style Guide and to provide clarity.

    Measure Section:

    Denominator Exclusions

    Source of Change:

    Measure Lead

  • Updated the version number of the Palliative Care Exclusion Library to v4.0.000 and the library name from 'PalliativeCareExclusionECQM' to 'PalliativeCareQDM.'

    Measure Section:

    Definitions

    Source of Change:

    Annual Update

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'

    Measure Section:

    Definitions

    Source of Change:

    Annual Update

  • Updated the version number of the Hospice Library to v6.0.000 and the library name from 'Hospice' to 'HospiceQDM.'

    Measure Section:

    Definitions

    Source of Change:

    Annual Update

  • Updated the timing logic in the 'High BMI Interventions Performed' and 'Low BMI Interventions Performed' definitions to align with measure intent.

    Measure Section:

    Definitions

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-6165

  • Updated logic to remove the use of relevant period in the negation rationale for the 'Medical Reason or Patient Reason for Not Performing BMI Exam' exception definition to align with CQL standards.

    Measure Section:

    Definitions

    Source of Change:

    Measure Lead

  • Updated logic definition of 'Has Normal BMI' to ensure that patients with BMI values of 24.91 to 24.99 are properly captured in the measure logic.

    Measure Section:

    Definitions

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-5940

  • Renamed value set to 'Payer Type' to more accurately reflect the contents and intent of the value set.

    Measure Section:

    Definitions

    Source of Change:

    Standards/Technical Update

  • Changed alias name from 'Pregnancy' to 'Is Pregnant during Day of Measurement Period' in definitions to align with the CQL Style Guide and to provide clarity.

    Measure Section:

    Definitions

    Source of Change:

    Measure Lead

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section:

    Definitions

    Source of Change:

    Standards/Technical Update

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'

    Measure Section:

    Functions

    Source of Change:

    Annual Update

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • The value set used for the pregnancy exclusion was replaced with existing 'Pregnancy' value set (OID: 2.16.840.1.113883.3.526.3.378) that is stewarded by the American Heart Association to harmonize value sets across measures.

    Measure Section:

    Terminology

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-5976

  • Removed value set Pregnancy Obstetric or Maternal Diagnoses (2.16.840.1.113883.3.600.1.1623) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Follow Up for Above Normal BMI (2.16.840.1.113883.3.600.1.1525): Added 3 CPT codes (99403, 99404, 43775) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Follow Up for Below Normal BMI (2.16.840.1.113883.3.600.1.1528): Added 2 CPT codes (99403, 99404) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584): Added 2 SNOMED CT codes (170935008, 170936009) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 SNOMED CT code (385765002) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Medications for Above Normal BMI (2.16.840.1.113883.3.526.3.1561): Added 13 RxNorm codes based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Palliative Care Encounter (2.16.840.1.113883.3.464.1003.101.12.1090): Added 3 SNOMED CT codes (305686008, 305824005, 441874000) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set (2.16.840.1.114222.4.11.3591): Renamed to Payer Type based on recommended value set naming conventions.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

Last Updated: Aug 01, 2024