Preventive Care
Member Interventions
- Screening and vaccination schedule tools
- Member newsletters
- Text messaging programs with healthy lifestyle tips
BMC HealthNet Plan encourages you to conduct and document age appropriate counseling on an annual basis for nutrition and physical activity. Please use the following codes to document the activities during your patient encounters. Appropriate coding may impact the records requested during future HEDIS reviews.
Description | CPT | ICD-10-CM Diagnosis | HCPCS |
BMI Percentile | Z68.51, Z68.52, Z68.53, Z68.54 | ||
Counseling for Nutrition | 97802-97804 | Z71.3 | G0270, G0271, S9449, S9452, S9470 |
Counseling for Physical Activity | Z02.5 S9451 |
BMI Percentile:
Documentation must include height, weight and BMI percentile. Either of the following meets criteria for BMI percentile:
- BMI percentile
- BMI percentile plotted on age-growth chart
Counseling for nutrition:
- Discussion of current nutrition behaviors (.e.g., eating habits, dieting behaviors)
- Checklist indicating nutrition was addressed
- Counseling or referral for nutrition education
- Member received educational materials on nutrition during face-to face visit
- Anticipatory guidance for nutrition
- Weight or obesity counseling
Counseling for physical activity:
- Discussion of current physical activity behaviors (e.g. exercise routine, participation in sports activities, exam for sports participation)
- Checklist indicating physical activity was addressed
- Counseling or referral for physical activity
- Member received educational materials on physical activity during a face-to-face visit
- Anticipatory guidance for physical activity
- Weight or obesity counseling
Refer Patient to Care Management
Call us at 866-853-5241 or complete the appropriate form to refer a patient to a Care Management program. Our care management staff will evaluate the member and enroll him/her in the most appropriate program based on condition, severity of illness and individual needs.
Clinical Practice Guidelines
- Pediatric Preventive Health Guideline (MHQP)
- Adult Preventative Care Guidelines (From the Massachusetts Health Quality Partners or MHQP) – SCO