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Measure: CMS155

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

Measure Versions

eMeasure Code Measure Year Full Version Number Title
CMS155v12 2024 12.0.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
CMS155v11 2023 11 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
CMS155v10 2022 10.0.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
CMS155v9 2021 9.2.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
CMS155v8 2020 8.1.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
CMS155v7 2019 7.2.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
CMS155v6 2018 6.1.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
CMS155v5 2017 5.0.000 Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Description

Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported. - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity

Guidance

The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.

Patient Group Definitions

Group Description Instructions Links
Initial PopulationPatients 3-17 years of age with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement periodWebchart Instructions
DenominatorEquals Initial PopulationWebchart Instructions
Denominator ExclusionsPatients who have a diagnosis of pregnancy during the measurement period. Exclude patients who are in hospice care for any part of the measurement period.Webchart Instructions
NumeratorNumerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period Numerator 2: Patients who had counseling for nutrition during the measurement period Numerator 3: Patients who had counseling for physical activity during the measurement periodWebchart Instructions
Numerator ExclusionsNot ApplicableWebchart Instructions
Denominator ExceptionsNone

Details

Full eMeasure Code eMeasure Identifier Measure Year Version NQF # GUID
CMS155v10 155 2022 10.0.000 Not Applicable 0b63f730-25d6-4248-b11f-8c09c66a04eb
Steward Developer Endorsed By
National Committee for Quality Assurance National Committee for Quality Assurance
Scoring Method Measure Type Stratification Risk Adjustment
Proportion PROCESS Report a total score, and each of the following strata: Stratum 1 - Patients age 3-11 Stratum 2 - Patients age 12-17 None

Rate Aggregation

None

Improvement Notation

Higher score indicates better quality

Rationale

Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017). Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention, 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (Centers for Disease Control and Prevention, 2016). The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014). Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).

Clinical Recommendation Statement

U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)
 
American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - 

- Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. 
- Assess barriers to healthy eating and physical activity. 
- Provide anticipatory guidance for nutrition and physical activity.

Definition

None

Transmission Format

TBD

Applicable Value Sets

Category Value Set OID
Diagnosis Pregnancy 2.16.840.1.113883.3.526.3.378
Encounter, Performed Encounter Inpatient 2.16.840.1.113883.3.666.5.307
Encounter, Performed Home Healthcare Services 2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed Office Visit 2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed Preventive Care - Established Office Visit, 0 to 17 2.16.840.1.113883.3.464.1003.101.12.1024
Encounter, Performed Preventive Care Services - Group Counseling 2.16.840.1.113883.3.464.1003.101.12.1027
Encounter, Performed Preventive Care Services-Individual Counseling 2.16.840.1.113883.3.464.1003.101.12.1026
Encounter, Performed Preventive Care- Initial Office Visit, 0 to 17 2.16.840.1.113883.3.464.1003.101.12.1022
Encounter, Performed Telephone Visits 2.16.840.1.113883.3.464.1003.101.12.1080
Intervention, Order Hospice care ambulatory 2.16.840.1.113762.1.4.1108.15
Intervention, Performed Counseling for Nutrition 2.16.840.1.113883.3.464.1003.195.12.1003
Intervention, Performed Counseling for Physical Activity 2.16.840.1.113883.3.464.1003.118.12.1035
Intervention, Performed Hospice care ambulatory 2.16.840.1.113762.1.4.1108.15
Patient Characteristic Ethnicity Ethnicity 2.16.840.1.114222.4.11.837
Patient Characteristic Payer Payer 2.16.840.1.114222.4.11.3591
Patient Characteristic Race Race 2.16.840.1.114222.4.11.836
Patient Characteristic Sex ONC Administrative Sex 2.16.840.1.113762.1.4.1
Physical Exam, Performed BMI percentile 2.16.840.1.113883.3.464.1003.121.12.1012
Physical Exam, Performed Height 2.16.840.1.113883.3.464.1003.121.12.1014
Physical Exam, Performed Weight 2.16.840.1.113883.3.464.1003.121.12.1015

References

CITATIONCenters for Disease Control and Prevention. (2016). Childhood obesity causes & consequences. Retrieved from https://www.cdc.gov/obesity/childhood/causes.html
CITATIONFinkelstein, E. A., Graham, W. C. K., & Malhotra, R. (2014). Lifetime direct medical costs of childhood obesity. Pediatrics, 133(5), 854-862.
CITATIONFryar, C. D., Carroll, M. D., & Ogden, C. L. (2014). Prevalence of overweight and obesity among children and adolescents: United States, 1963-1965 through 2011-2012. Health E-Stats. Retrieved from https://www.cdc.gov/nchs/data/hestat/obesity_child_11_12/obesity_child_11_12.htm
CITATIONHagan, J. F., Shaw, J. S., & Duncan, P. M. (eds.). (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents, 4th ed. Elk Grove Village, IL: American Academy of Pediatrics.
CITATIONHales, C.M., Carroll, M.D., Fryar C.D., et al. (2017). Prevalence of obesity among adults and youth: United States, 2015-2016. NCHS Data Brief. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db288.pdf
CITATIONU.S. Preventive Services Task Force. (2017). Screening and interventions for overweight in children and adolescents: Recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality.  https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/obesity-in-children-and-adolescents-screening1?ds=1&s=obesity

Disclaimer

The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

Copyright

This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2020 National Committee for Quality Assurance. All Rights Reserved. 

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2020 American Medical Association. LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. ICD-10 copyright 2020 World Health Organization. All Rights Reserved.

Source: https://ecqi.healthit.gov/ecqm/measures/cms155v1