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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.


Presented by healthcare outcomes and analysis la care health plan

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


Presented by healthcare outcomes and analysis la care health plan

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.


Presented by healthcare outcomes and analysis la care health plan

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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For questions, please contact: Carina Yapyuco, RNcyapyuco@lacare.orgTheresa Colom, LVNtcolom@lacare.org