HEDIS® Measure: Check and Document Body Mass Index

Posted September 12, 2019 

Maintaining a healthy weight is one of the keys to reducing the risk of high blood pressure, high blood cholesterol and type 2 diabetes. Reducing the risk of these factors may decrease the risk of heart disease and stroke. Measuring and documenting your patients’ Body Mass Index (BMI) according to Healthcare Effectiveness Data and Information Set (HEDIS) standards may help you care for their long-term health.

A healthy weight as determined by a person’s BMI is one of 90 HEDIS measurements. The National Committee for Quality Assurance (NCQA) collects HEDIS data. The goal of collecting data is to provide information on the performance of the health care system. Blue Cross and Blue Shield of Illinois (BCBSIL) collects HEDIS data from BCBSIL independently contracted providers for an annual audit to measure and improve the quality of care our members receive.

You can help us collect HEDIS data and better care for our members by measuring and documenting your patients’ BMI at least once every two years. BMI may help you identify patients who have an increased risk of morbidity. To make this process easier, we have an adult BMI tip sheet available on our website with ICD-10 Z codes and charting tips.

Please measure and report BMI using the appropriate ICD-10 Z codes during our members’ office visit. This may help you avoid a request for medical records later.

The HEDIS Adult BMI Assessment measures the BMI of 18- to 74-year-olds. The member had to have seen their provider at an outpatient visit and had a documented BMI in the past two years. 

Note: When these services are paid by BCBSIL, the Z code must be used as a secondary code and is non-reimbursable.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

The material presented here is for informational/educational purposes only, is not intended to be medical advice or a definitive source for coding claims and is not a substitute for the independent medical judgment of a physician or other health care provider. Health care providers are encouraged to exercise their own independent medical judgment based upon their evaluation of their patients’ conditions and all available information, and to submit claims using the most appropriate code(s) based upon the medical record documentation and coding guidelines and reference materials. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.