weight assessment and counseling for nutrition and physical activity for children and adolescents
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Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents. Presented by: Healthcare Outcomes and Analysis LA Care Health Plan. September 30, 2010. Presentation Purpose:. Best Practices for documenting record for the new

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weight assessment and counseling for nutrition and physical activity for children and adolescents

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Presented by:

Healthcare Outcomes and Analysis

LA Care Health Plan

September 30, 2010

presentation purpose
Presentation Purpose:
  • Best Practices for documenting record for the new
  • measure “Weight Assessment and Counseling
  • for Nutrition and Physical Activity for
  • Children and Adolescents (WCC)”
  • Proper documentation of WCC visit(s) reflect a better
  • quality of care for patients and a positive feedback for
  • providers’ participation to encourage children and
  • adolescent wellness.
wcc background
WCC - Background:
  • Obesity In Children and Teens
  • The problem of childhood obesity in the
  • United States has grown considerably in recent
  • years.
  • Statistics/Facts:
  • Between 16 and 33 percent of children and
  • adolescents are obese.
  • Obesity is among the easiest medical conditions to
  • recognize but most difficult to treat.
  • Unhealthy weight gain due to poor diet and lack
  • of exercise is responsible for over 30,000 deaths
  • each year.
  • The annual cost to society is estimated at nearly $100 billion.
  • Overweight children are much more likely to become overweight adults unless
  • they adopt and maintain healthier patterns of eating and exercise.
slide4

WCC – Background (contin.):

According to a study conducted by CDC in 2004, 16% of children (over 9 million) 6-19 years of age are overweight or “obese.” This number is three times the population in 1980. 1 In addition to the three-fold increase, obesity has “more than doubled” in both children and adolescents from ages 2-5 and also ages 12-19. Similarly, the population more than tripled in children between 6-11 years old in the past three decades (according to this same study). 2References:1. Obesity In Children and Teens, American Academy of Child and Adolescent Psychiatry, May 20082.Prevalence of overweight and obesity among children and adolescents: United States, CDC, 2004

slide5

WCC – Background (contin.):

  • Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC):
  • Is one of the newest HEDIS measures developed by the National Committee for Quality Assurance (NCQA)
  • The measure consists of three (3) indicators:
  • Body mass index (BMI)
  • Counseling for Nutrition
  • Counseling for Physical Activity
wcc body mass index bmi indicator documentation
WCC - Body Mass Index (BMI) Indicator Documentation:
  • Body Mass Index – documentation in the medical record should include date and BMI percentile &/or value depending upon the child’s age
    • BMI norms vary for children between
    • the ages 3 to 15 years, so the BMI
    • percentile should be recorded, not
    • just the value.
    • For 16-17 years of age, BMI value is
    • acceptable.
slide7

WCC - BMI Indicator Calculation:The formula used to calculate BMI is as follows: Weight in PoundsBMI = ( (Height in inches) x (Height in inches) )x703The pediatric height and weight charts can be found on the CDC website at:http://www.cdc.gov/growthcharts/data/set1clinical/set1color.pdf

wcc counseling for nutrition indicator documentation
WCC - Counseling for Nutrition Indicator Documentation:

2. Counseling for Nutrition

  • Documentation must include a note indicating the date and
  • at least one of the following:
      • Discussion of current nutrition behaviors
      • (e.g., eating and dieting behaviors)
      • Checklist indicating nutrition was assessed
      • Counseling or referral for nutrition education
      • Member received educational materials on nutrition
      • Anticipatory guidance for nutrition
wcc physical activity indicator documentation
WCC - Physical Activity IndicatorDocumentation:
  • Counseling for Physical Activity
  • Documentation must include a note indicating the date
  • and at least one of the following:
      • Discussion of current physical activity behaviors
      • (e.g., exercise routine, participation in sports
      • activities and exam for sports participation)
      • Checklist indicating physical activity was addressed
      • Counseling or referral for physical activity
      • Member received educational materials on physical
      • activity
      • Anticipatory guidance for physical activity
wcc best practices for documentation
WCC – Best Practices for Documentation:
  • BMI Don’ts
    • No BMI or BMI percentile documented in the medical record or plotted on age-growth chart
    • Notation of height and weight only
    • BMI or BMI percentile noted before or after the measurement year
    • Entries on the BMI growth charts without an affiliated date
  • Nutrition and Diet Don’ts
    • No counseling/education on nutrition and diet
    • Counseling/education before or after the measurement year
    • Notation of “health education” or “anticipatory guidance” without any specific mention of nutrition
wcc best practices for documentation contin
WCC – Best Practices for Documentation (contin.):
  • Physical Activity Don’ts
    • No counseling/education on physical activity
    • Notation of “cleared for gym class” alone without any documentation of a discussion
    • Counseling/education before or after the measurement year
    • Notation of “health education” or “anticipatory guidance” without any specific mention of physical activity
wcc best practices for documentation contin1
WCC – Best Practices for Documentation (contin.):
  • Take advantage of any type of member visit, whether it’s for a well-child visit or sick visit to assess and counsel your patient on their BMI, nutrition, and physical activity.
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