QPP Measure #128
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounterNormal Parameters: Age 18 years and older BMI => 18.5 and < 25 kg/m2
Submission Methods: Claims, Electronic Health Record, Registry
Measure Sets: Cardiology, Gastroenterology, Family Medicine, Internal Medicine, Obstetrics Gynecology, Orthopedic Surgery, Otolaryngology, Physical Medicine, Preventive Medicine, Mental Behavioral Health, Vascular Surgery, General Surgery, Urology, Rheumatology, Podiatry, Physical Therapy Occupational Therapy
The following codes apply for this QPP measure:
CPT Codes | |||
| Code | Description | ||
|---|---|---|---|
| 90791 | CPT Code | ||
| 90792 | CPT Code | ||
| 90832 | CPT Code | ||
| 90834 | CPT Code | ||
| 90837 | CPT Code | ||
| 96150 | CPT Code | ||
| 96151 | CPT Code | ||
| 96152 | CPT Code | ||
| 97161 | CPT Code | ||
| 97162 | CPT Code | ||
| 97163 | CPT Code | ||
| 97165 | CPT Code | ||
| 97166 | CPT Code | ||
| 97167 | CPT Code | ||
| 97802 | CPT Code | ||
| 97803 | CPT Code | ||
| 99201 | CPT Code | ||
| 99202 | CPT Code | ||
| 99203 | CPT Code | ||
| 99204 | CPT Code | ||
| 99205 | CPT Code | ||
| 99212 | CPT Code | ||
| 99213 | CPT Code | ||
| 99214 | CPT Code | ||
| 99215 | CPT Code | ||
| 99236 | CPT Code | ||
| 99304 | CPT Code | ||
| 99305 | CPT Code | ||
| 99306 | CPT Code | ||
| 99307 | CPT Code | ||
| 99308 | CPT Code | ||
| 99309 | CPT Code | ||
| 99310 | CPT Code | ||
| 99315 | CPT Code | ||
| 99316 | CPT Code | ||
| 99318 | CPT Code | ||
| 99324 | CPT Code | ||
| 99325 | CPT Code | ||
| 99326 | CPT Code | ||
| 99327 | CPT Code | ||
| 99328 | CPT Code | ||
| 99334 | CPT Code | ||
| 99335 | CPT Code | ||
| 99336 | CPT Code | ||
| 99337 | CPT Code | ||
| 99339 | CPT Code | ||
| 99340 | CPT Code | ||
| 99385 | CPT Code | ||
| 99386 | CPT Code | ||
| 99387 | CPT Code | ||
| 99395 | CPT Code | ||
| 99396 | CPT Code | ||
| 99397 | CPT Code | ||
| 99401 | CPT Code | ||
| 99402 | CPT Code | ||
HCPCS Codes | |||
| Code | Description | ||
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | ||
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | ||
| G0270 | Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes | ||
| G0271 | Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes | ||
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | ||
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | ||
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | ||
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | ||
| G0473 | Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes | ||
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | ||
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | ||
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | ||
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | ||
| G8421 | Bmi not documented and no reason is given | ||
| G8422 | Bmi not documented, documentation the patient is not eligible for bmi calculation | ||
| G8938 | Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible | ||
| G9716 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason | ||
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