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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 11

•Congenital Hypothyroidism •Postpartum Thyroiditis NOTE: May be considered High Risk at CPA discretion. 345* (SA/CPA) (HR) PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Hypertension and Prehypertension: Hypertension: Consistent readings of >140/>90 mmHg; High blood pressure which may eventually cause health problems and includes chronic hypertension during pregnancy, preeclampsia, eclampsia, chronic hypertension with superimposed preeclampsia, and gestation hypertension. Prehypertension: Consistent readings of 120-139/80-89 mmHg; Being at high risk for developing hypertension based on blood pressure. Presence of condition diagnosed, documented, or reported by physician or someone working under physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information screen (health conditions slider or pregnancy induced health conditions slider) in Crossroads. Document diagnosed condition and treatment plan, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads. 346 (SA/CPA)

PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Renal Disease: Any renal disease including pyelonephritis and persistent proteinuria but excluding urinary tract infections (UTI) involving the bladder.

NOTE: May be considered High Risk at CPA discretion. Presence of renal disease diagnosed, documented, or reported by a physician or someone working under physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information Screen (health conditions slider) in Crossroads. 347 (SA/CPA)

PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Cancer: A chronic disease whereby populations of cells have acquired the ability to multiply and spread without the usual biological restraints. The current condition, or the treatment of the condition, must be severe enough to affect nutritional status.

NOTE: May be considered High Risk at CPA discretion. NOTE: Some cancer treatments may contraindicate breastfeeding. Presence of cancer diagnosed, documented, or reported by a physician or someone working under physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information screen (health conditions slider) in Crossroads. Document condition and treatment plan, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads. 348 (SA/CPA)

PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Central Nervous System Disorders: Conditions which affect energy requirements, ability to feed self, or alter nutritional status metabolically, mechanically, or both. Included, but not limited to: •Cerebral Palsy •Epilepsy •Neural tube defects such as: Spina Bifida and Myelomeningocele •Parkinson’s disease •Multiple sclerosis (MS) NOTE: May be considered High Risk at CPA discretion. Presence of central nervous system disorders diagnosed, documented, or reported by a physician or someone working under physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information screen (health conditions slider) in Crossroads. Document condition and treatment plan, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads.