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

Last updated: May 18, 2016

CMS Measure ID: CMS69v3
Version: 3
NQF Number: 0421
Measure Description:

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous six months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous six months of the current encounter

Normal Parameters:
Age 65 years and older BMI => 23 and < 30 kg/m2
Age 18 – 64 years BMI => 18.5 and < 25 kg/m2

Initial Patient Population:

There are two (2) Initial Patient Populations for this measure:

Initial Patient Population 1: All patients 18 through 64 years on the date of the encounter with at least one eligible encounter during the measurement period NOT INCLUDING encounters where the patient is receiving palliative care, refuses measurement of height and/or weight, the 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, or there is any other reason documented in the medical record by the provider explaining why BMI measurement was not appropriate.

Initial Patient Population 2: All patients 65 years of age and older on the date of the encounter with at least one eligible encounter during the measurement period NOT INCLUDING encounters where the patient is receiving palliative care, refuses measurement of height and/or weight, the 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, or there is any other reason documented in the medical record by the provider explaining why BMI measurement was not appropriate.

Denominator Statement:

Equals Initial Patient Population

Denominator Exclusions:

Patients who are pregnant.

Numerator Statement:

Patients with a documented BMI during the encounter or during the previous six months, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the previous six months of the current encounter.

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: Centers for Medicare & Medicaid Services
National Quality Strategy Domain: Community, Population and Public Health
Next Version: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Measure Score: Proportion
Score Type: Process
Improvement Notation:

Higher score indicates better quality

Guidance:

  • There is no diagnosis associated with this measure.
  • This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period.
  • This measure may be reported by eligible professionals who perform the quality actions described in the measure based on the services provided at the time of the qualifying visit and the measure-specific denominator coding.

BMI Measurement Guidance:

  • Height and Weight - An eligible professional or their staff is required to measure both height and weight. Both height and weight must be measured within six months of the current encounter and may be obtained from separate encounters. Self-reported values cannot be used.
  • The BMI may be documented in the medical record of the provider or in outside medical records obtained by the provider.
  • If the most recent documented BMI is outside of normal parameters, then a follow-up plan is documented during the encounter or during the previous six months of the current encounter.
  • The documented follow-up plan must be based on the most recent documented BMI, outside of normal parameters, example: Patient referred to nutrition counseling for BMI above normal parameters. (See Definitions for examples of a follow-up plan treatments).
  • If more than one BMI is reported during the measurement period, the most recent BMI will be used to determine if the performance has been met.

Specifications

External Resources