0. Presented by: Healthcare Outcomes and Analysis LA Care Health Plan
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
September 30, 2010
Presented by:
Healthcare Outcomes and Analysis
LA Care Health Plan

1. Presentation Purpose:
Best Practices for documenting record for the new
measure “Weight Assessment and Counseling
for Nutrition and Physical Activity for
Children and Adolescents (WCC)”
Proper documentation of WCC visit(s) reflect a better
quality of care for patients and a positive feedback for
providers’ participation to encourage children and
adolescent wellness.

2. WCC - Background: Obesity In Children and Teens
The problem of childhood obesity in the
United States has grown considerably in recent
years.
Statistics/Facts:
Between 16 and 33 percent of children and
adolescents are obese.
Obesity is among the easiest medical conditions to
recognize but most difficult to treat.
Unhealthy weight gain due to poor diet and lack
of exercise is responsible for over 30,000 deaths
each year.
The annual cost to society is estimated at nearly $100 billion.
Overweight children are much more likely to become overweight adults unless
they adopt and maintain healthier patterns of eating and exercise.

3. WCC – Background (contin.):
According to a study conducted by CDC in 2004, 16% of children (over 9 million) 6-19 years of age are overweight or “obese.” This number is three times the population in In addition to the three-fold increase, obesity has “more than doubled” in both children and adolescents from ages 2-5 and also ages Similarly, the population more than tripled in children between 6-11 years old in the past three decades (according to this same study). 2 References: 1. Obesity In Children and Teens, American Academy of Child and Adolescent Psychiatry, May Prevalence of overweight and obesity among children and adolescents: United States, CDC, 2004

4. WCC – Background (contin.):
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (WCC):
Is one of the newest HEDIS measures developed by the National Committee for Quality Assurance (NCQA)
The measure consists of three (3) indicators:
Body mass index (BMI)
Counseling for Nutrition
Counseling for Physical Activity

5. WCC - Body Mass Index (BMI) Indicator Documentation:
Body Mass Index – documentation in the medical record should include date and BMI percentile &/or value depending upon the child’s age
BMI norms vary for children between
the ages 3 to 15 years, so the BMI
percentile should be recorded, not
just the value.
For years of age, BMI value is
acceptable.

6. WCC - BMI Indicator Calculation: The formula used to calculate BMI is as follows: Weight in Pounds BMI = ( (Height in inches) x (Height in inches) )x703 The pediatric height and weight charts can be found on the CDC website at:

7. WCC - Counseling for Nutrition Indicator Documentation:
Documentation must include a note indicating the date and
at least one of the following:
Discussion of current nutrition behaviors
(e.g., eating and dieting behaviors)
Checklist indicating nutrition was assessed
Counseling or referral for nutrition education
Member received educational materials on nutrition
Anticipatory guidance for nutrition

8. WCC - Physical Activity Indicator Documentation:
Counseling for Physical Activity
Documentation must include a note indicating the date
and at least one of the following:
Discussion of current physical activity behaviors
(e.g., exercise routine, participation in sports
activities and exam for sports participation)
Checklist indicating physical activity was addressed
Counseling or referral for physical activity
Member received educational materials on physical
activity
Anticipatory guidance for physical activity

9. WCC – Best Practices for Documentation:
BMI Don’ts
No BMI or BMI percentile documented in the medical record or plotted on age-growth chart
Notation of height and weight only
BMI or BMI percentile noted before or after the measurement year
Entries on the BMI growth charts without an affiliated date
Nutrition and Diet Don’ts
No counseling/education on nutrition and diet
Counseling/education before or after the measurement year
Notation of “health education” or “anticipatory guidance” without any specific mention of nutrition

10. WCC – Best Practices for Documentation (contin.):
Physical Activity Don’ts
No counseling/education on physical activity
Notation of “cleared for gym class” alone without any documentation of a discussion
Counseling/education before or after the measurement year
Notation of “health education” or “anticipatory guidance” without any specific mention of physical activity

11. WCC – Best Practices for Documentation (contin.):
Take advantage of any type of member visit, whether it’s for a well-child visit or sick visit to assess and counsel your patient on their BMI, nutrition, and physical activity.

12. For questions, please contact: Carina Yapyuco, RN cyapyuco@lacare
For questions, please contact: Carina Yapyuco, RN Theresa Colom, LVN