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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 14

NBF [3-6] Infants [1] Child [3] that occurs after lactose ingestion. Lactose Intolerance occurs because of a deficiency in the levels of the lactase enzyme.

physician’s orders, or as self-reported by applicant/participant/caregiver. Document on Health Information screen (health conditions slider). Document symptoms and treatment plan, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads. 356 (SA/CPA) PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Hypoglycemia: Occurs when the level of glucose in the blood drops below standard levels. Presence of hypoglycemia 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) in Crossroads. 357 (SA/CPA) PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Drug Nutrient Interactions: Use of prescription or over-the- counter drugs or medications that have been shown to interfere with nutrient intake, absorption, distribution, metabolism, or excretion, to an extent that nutritional status is compromised.

*High Risk Assigned for Infants. 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) in Crossroads. Document identified interaction on Care Plan Summary – Nutrition Assessment in Crossroads. 358 (CPA) PG [1] BF [1] NBF [3-6] Eating Disorders: Characterized by severe disturbances in a person’s eating behaviors and related thoughts and emotions. Eating Disorders include, but are not limited to •Anorexia Nervosa (AN) •Bulimia Nervosa (BN) •Binge-Eating Disorder (BED) Presence of eating disorder diagnosed, documented, or reported by a physician or someone working under a physician’s orders, or as self-reported by applicant/participant/caregiver. Must document type of eating disorder and impact on nutritional status on participant’s Care Plan Summary Screen, Nutrition Assessment field, in Crossroads. Manually assign on Assigned Risk Factors screen in Crossroads. 359 (SA/CPA) PG [1] BF [1] NBF [3-6] Infants [1] Child [3] Recent Major Surgery, Physical Trauma, Burns: Major surgery (including cesarean sections), physical trauma or burns severe enough to compromise nutritional status. Any occurrence: •Within the past two (<2) months, may be self-reported •More than two (>2) months previous must have the continued need for nutritional support diagnosed by a physician or a health care provider working under the orders of a physician. Must be documented on the Health Information screen (health conditions slider) in Crossroads. Document type of surgery (ex. C-section) on Major Surgery sticky note and additional information, if applicable, on Care Plan Summary – Nutrition Assessment in Crossroads. 360 (CPA) PG [1] BF [1] NBF [3-6] Other Medical Conditions: Diseases or conditions with nutritional implications that are not included in any of the other medical conditions. Current condition, or treatment for the condition, Presence of medical condition(s) diagnosed, documented, or reported by a physician or someone