Weight Assessment and Counseling for Nutrition & Physical Activity for Children/Adolescents (WCC)
Date: 04/01/22
WCC Key Points
- Measure consists of three components:
- Body Mass Index (BMI) Percentile
- Nutrition Counseling/Education
- Physical Activity Counseling/Education
- All members ages 3-17
- All three components may occur during a well visit, sick visit, or telehealth visit.
Coding Summary
WCC Component & ICD-10 Code
- BMI <5th percentile - Z68.51
- BMI 5th to <85th percentile - Z68.52
- BMI 85th to <95th percentile - Z68.53
- BMI > or = to 95th percentile - Z68.54
- Nutritional Counseling - Z71.3
- Physical Activity Counseling - Z71.82, Z02.5
BMI Percentile
Documentation must include height, weight, and BMI percentile during the measurement year.
Either of the following meets criteria for BMI percentile:
- BMI percentile
- BMI percentile plotted on an age-growth chart
Ranges and thresholds do not meet criteria for this indicator. A distinct BMI percentile is required.
Coding: To improve HEDIS scores, add the appropriate ICD-10 informational codes Z68.51-Z68.54 below to claim:
BMI Percentile and ICD-10 Code
- BMI <5th percentile - Z68.51
- BMI 5th to <85th percentile - Z68.52
- BMI 85th to <95th percentile - Z68.53
- BMI > or = to 95th percentile - Z68.54
Nutritional Counseling
Coding: To improve HEDIS scores, add ICD-10 informational code Z71.3 to claim.
Acceptable Documentation
- Discussion of current nutrition behaviors (e.g., eating habits, dieting behaviors)
- Documentation of quality/type of diet (e.g., “diet good,” “diet regular,” “diet well balanced,” “balanced meals”)
- Member/parent/guardian received educational materials on nutrition during a face-to-face visit (e.g., 5-2-1-0)
- Anticipatory guidance for nutrition (e.g., 5-2-1-0)
- Weight or obesity counseling (Note: Weight or obesity counseling counts for both Nutrition and Physical Activity Counseling.)
- Providing referrals to food and nutrition programs if needed (e.g., WIC)
- Counseling or referral for nutrition education (e.g., “counseled on healthy eating habits”)
- Checklist indicating nutrition was addressed (must be marked: circled, checked, or underlined)
Unacceptable Documentation
- Documentation of appetite alone without discussion of nutrition factors (e.g., “appetite good,” “eats well”)
- A physical exam finding or observation alone (e.g., “well nourished”)
- Sending member educational material via email or directing to a website to research information on their own
- Notation of “health education” or “anticipatory guidance” without specific mention of nutrition
- Documentation of healthy behaviors without specific mention of nutrition (e.g., “healthy lifestyle,” “caffeine: soda approximately 16 ounces a day”)
- Diet prescribed specific to an acute or chronic condition (e.g., ADA diet that was provided specifically to manage the diabetes, the BRAT diet for gastroenteritis)
- Questionnaires filled out by the parent with no indication that provider discussed or reviewed
- Checklist not marked in any way
Physical Activity Counseling
Coding: To improve HEDIS scores, add ICD-10 informational code Z71.82 to claim. Sports physical code Z02.5 may also be used. A sports physical alone does not qualify as WCV/WCC.
Acceptable Documentation
- Discussion of current physical activity behaviors like exercise routine, participation in sports activities (e.g., “no sports,” “physical activity: WNL,” “Physical activity: active, plays sports”)
- A sports physical exam completed during visit
- Member received educational materials on physical activity during a face-to-face visit (e.g., 5-2-1-0)
- Anticipatory guidance specific to the child’s physical activity (e.g., “encourage opportunities for physical activity,” “regular exercise 3 times a week,” “exercise education,” 5-2-1-0)
- Weight or obesity counseling (Note: Weight or obesity counseling counts for both Nutrition and Physical Activity Counseling.)
- Counseling or referral for physical activity
- Bike safety and water safety discussion with specific mention of physical activity recommendations
- Checklist indicating physical activity was addressed (must be marked: circled, checked, or underlined)
Unacceptable Documentation
- Documentation of “plays with peers” without any other mention of physical activity
- Notation of “cleared for gym class” alone without documentation of discussion
- Sending member educational material via email or directing to a website to research information on their own
- Notation of “health education” or “anticipatory guidance” without specific mention of physical activity
- Notation solely related to screen time (computer or television) without specific mention of physical activity
- Services specific to an acute or chronic condition do not meet criteria (e.g., referral to physical therapy for an injury, sports contraindicated until injury/illness is resolved)
- Notation of anticipatory guidance related solely to safety (e.g., wears helmet, water safety) without specific mention of physical activity recommendations
- Checklist not marked in any way
Printable version of this guide.