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Hints for HEDIS® (and more)

Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Pediatrics, Internal Medicine +2 more·Physician
Effective date
Sep 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

This policy provides updated HEDIS quality measure documentation requirements for weight assessment and counseling in children/adolescents ages 3-17. It specifies compliant documentation standards for BMI percentile, nutrition counseling, and physical activity counseling during the measurement year.

Action Required

Action needed
Immediately: Providers and clinical staff must update documentation practices for pediatric patients ages 3-17 to ensure HEDIS compliance. Document BMI percentile (not just BMI value), specific nutrition counseling discussions, and physical activity counseling in progress notes and encounter forms. Use the specified ICD-10, CPT, and HCPCS codes when billing for nutrition and physical activity counseling services.

Affected Billing Codes

Z68.51
Z68.52
Z68.53
Z68.54
97802
97803
97804
G0270
G0271
G0447
S9449
S9452
S9470
Z71.3
S9451
Z02.5
Z71.82