Wiki Bmi incentive

[aochoa]

CAN ANYBODY TELL ME WHAT HCPCS AND DX CODE I NEED TO USE TO REPORT BMI, FOR THE INCENTIVE PROGRAM FOR MEDICARE??

 

[Melissasuewashburn]

There are many - all depends on the visit

If you are talking about the PQRS incentives then there are 7 different codes that can be used to report the BMI, all depending on the information in that particular visit. They are reported using the same diagnoses as the office visit (there are particular E/M codes that you can report this PQRS measure on). Some of the variables are whether the BMI is normal, above normal, below normal, documented, not documented, with or without a follow up plan, etc. The best bet is to go to http://www.cms.gov/Medicare/Quality...ssessment-Instruments/PQRS/MeasuresCodes.html and download either the individual measures or measure groups files. This will give you the complete information you need to choose the correct codes - the BMI measure is #128 and only has to be reported once per each unique patient.

I hope this helps.

 

[aochoa]

If you are talking about the PQRS incentives then there are 7 different codes that can be used to report the BMI, all depending on the information in that particular visit. They are reported using the same diagnoses as the office visit (there are particular E/M codes that you can report this PQRS measure on). Some of the variables are whether the BMI is normal, above normal, below normal, documented, not documented, with or without a follow up plan, etc. The best bet is to go to http://www.cms.gov/Medicare/Quality...ssessment-Instruments/PQRS/MeasuresCodes.html and download either the individual measures or measure groups files. This will give you the complete information you need to choose the correct codes - the BMI measure is #128 and only has to be reported once per each unique patient.

I hope this helps.

SO I DON'T NEED TO USE THE DX'S FOR BMI (ie. V85.4X) AS LONG AS I USE THE "G" CODE (ie G8417-G8422) WITH THE SAME DIAGNOSIS AS THE OFFICE VISIT?

 

[Melissasuewashburn]

Correct

That is correct. For example at my office (family practice & pain management) we are using the BMI measure for both which means that many times we are reporting it with an office code that only has chronic pain and pain location codes (for the pain management side) and then we might report it on the family practice side with an ear infection, HTN, DM or any other condition that is the patient's reason for being in the office. I believe this would be because the G code is a performance measure so we don't have to have the DX, we just have to show Medicare that we are actually measuring the BMI and if appropriate, if we provided the additional counseling needed (if not then there are still codes to show you screened the BMI, but for some reason didn't provided the counseling).