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WIC Nutrition Risk Criteria

System Assigned (SA); System or CPA Assigned (SA/CPA); CPA Assigned (CPA); Automatic High Risk* (HR) Code Category [Priority] Risk Criteria/Definition Required Documentation 5

Smoking Pregnant Woman Threshold values: Smoking up to <1 pack per day < 11.3/34 hgb/hct (0-13 weeks) < 10.8/33 hgb/hct (14-26 weeks) < 11.3/34 hgb/hct (27-40 weeks)

Smoking 1 up to 2 packs per day < 11.5/34.5 hgb/hct (0-13 weeks) < 11.0/33.5 hgb/hct (14-26 weeks) < 11.5/34.5 hgb/hct (27-40 weeks)

Smoking 2 packs plus per day < 11.7/35 hgb/hct (0-13 weeks) < 11.2/34 hgb/hct (14-26 weeks) < 11.7/35 hgb/hct (27-40 weeks)

Non-smoking Postpartum Woman Threshold values: Hgb/HCT Age <11.8/36 8 to <12 years old <11.8/36 12 to <15 years old <12.0/36 15 to <18 years old <12.0/36 >18 years old

HR* (High Risk) Values Hgb < 9.9 g/dl HCT < 29.9%

Smoking Postpartum Woman Threshold values: Smoking up to <1 pack per day: < 12.1/37 hgb/hct 8 to <12 years old < 12.1/37 hgb/hct 12 to <15 years old < 12.3/37 hgb/hct 15 to <18 years old < 12.3/37 hgb/hct >18 years old

Smoking 1 up to 2 packs per day: < 12.3/38 hgb/hct 8 to <12 years old < 12.3/38 hgb/hct 12 to <15 years old of iron deficiency anemia, the blood test result must be assessed based on the trimester in which the blood work was taken. Note: Carbon dioxide in cigarettes causes elevated hemoglobin not the nicotine, thus vaping does not affect hemoglobin.

Threshold values based on number cigarettes entered on health information screen, Today drop-list box.