479 - Coding For BMI And Associated Counseling During Well Visits In An Academic Pediatric Primary Care Setting

Comprehensive coding that incorporates BMI status draws attention to the patient’s medical problem and can trigger appropriate workup and treatment. Documenting dietary and exercise counseling is important in recognizing the work that providers do, and may improve health system revenue capture.


Objective:

To increase the frequency of correct coding of BMI status, exercies and nutritional counseling by 50% from baseline.


Design/Methods:

We conducted a quality improvement project using multiple PDSA cycles. We randomly reviewed charts pre (March-June 2021) and post (October 2021- February 2022) intervention to capture data for correct coding of BMI categories, documentation of nutrition and exercising counseling for patients 2-12 years old at well child visits. We performed 3 PDSA cycles consisting of the following:1. Education and demonstration of comprehensive coding.2. Introduction of EMR Smart Sets with a check list for well visits.3. Email reminders for reinforcement.


Results:

At baseline 52% (34/64) had BMI coding, 41% (27/64) exercise counseling and 47% (31/64) nutrition counseling. After the three interventions, coding for BMI improved to 81% (104/129), exercise counseling 80% (103/129) and nutrition counseling 86% (111/129). There was a 50% increase in coding from baseline after the above interventions.


Conclusion(s):

Verbal reminders, e-mails as well as EMR tools such as Smart Sets increased the frequency of coding for BMI and associated counseling. Our work is applicable across healthcare because optimizing coding provides benefits including optimizing patient care, record keeping, and revenue collection.