Well-child assessment

Percentage of children (three-17 years old) who had an outpatient visit with their primary care provider or OB/GYN and who had evidence of counseling for nutrition and/or physical activity and had a BMI percentile documented in 2021.

Nutrition

Documentation must include the date and at least one of the following:

• Discussion of current nutrition behaviors
• Checklist indicating nutrition was addressed
• Counseling or referral for nutrition education
• Patient received nutrition education materials during visit
• Anticipatory guidance for nutrition
• Weight or obesity counseling

Documentation related to the child’s appetite or an observation such as being well-nourished alone is not indicative of nutrition counseling.

Physical activity

Documentation must include the date and at least one of the following:

• Discussion of current physical activity behaviors
• Checklist indicating physical activity was addressed
• Counseling or referral for physical activity
• Patient received physical activity educational materials during visit
• Anticipatory guidance specific to the child’s physical activity
• Weight or obesity counseling

BMI percentile

Documentation must include the date and at least one of the following:

• Height, weight, and BMI percentile
• BMI may be documented as a percentile or plotted on an age-growth chart

Best practices and yips for talking to patients

• Create a structured field in your electronic health record for routine documentation of well-child assessments to achieve a higher performance on this measure.
• Use a screening or assessment code at the time of the evaluation and management service, which should be billed in addition to the screening or assessment code.

Well-child counseling codes