Preventive Care

BMC HealthNet Plan provides ongoing support and education to members to promote healthy lifestyle choices.

Member Interventions

BMC HealthNet Plan encourages members to pursue healthy lifestyles through physical activity, healthy eating, and keeping up-to-date on all necessary screenings and vaccinations. Tools developed to support members include:


  • 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
 

CPT

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.

Refer a SCO Member
Refer An ACO Member
Refer a MCO Member
Refer a QHP Member

Clinical Practice Guidelines

BMC HealthNet Plan adopts, endorses and implements these evidence-based guidelines from national sources, professional organizations, or developed by regional collaborative groups. Guidelines serve as a means of establishing standards among medical and behavioral health providers to improve health outcomes. They are not intended to replace clinical judgment. 

 

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