WellCare of South Carolina wants to ensure that our members have access to quality, cost-effective health care solutions. Our Quality Improvement (QI) program aims to improve patient safety and care so our members can enhance their quality of life by staying healthy or managing their chronic health problems.
HEDIS® is a mandatory process that occurs annually. We've developed a toolkit to help identify required preventive services.
We Need Your Help in Closing the Gap
The pediatric body mass index (BMI) is one of the HEDIS® measures that will require our focus this year. We appreciate the care that you provide to our members, whether they are sick or well. Our members usually receive a height and weight check with each office visit. However, if there is no BMI percentile with the proper code, the Care Gap remains open. We are aware that you are providing the service and we want you to get credit for it. Close the gap by coding the BMI percentile for each office visit that our member receives.
|Pediatric BMI (Ages 3-17)||ICD-10 Code|
|Less than 5th percentile for age||Z68.51|
|5th percentile to less than 85th percentile for age||Z68.52|
|85th percentile to less than 95th percentile for age||Z68.53|
|Greater than or equal to 95th percentile for age||Z68.54|