G. Nutritional Risk Crosswalk

Appendix G.
Nutritional Risk Crosswalk

Nutritional Risk Criteria Worksheet for WIC PC [STUDY YEAR]

This form includes the Nutritional Risk information reported for [STATE AGENCY] in PC [PREVIOUS STUDY YEAR]. To update the worksheet for PC [STUDY YEAR], please follow these steps:

• Review the worksheet to verify all your State agency's codes are included and mapped to the correct FNS Risk Code.

• Indicate any revisions to the codes by selecting "New Code(s) -- Delete PC [PREVIOUS STUDY YEAR] Code" (meaning the PC [PREVIOUS STUDY YEAR] codes are no longer valid) or "Additional Code(s)" (meaning the PC [PREVIOUS STUDY YEAR] code(s) are still valid, but there are additional codes that map to that particular Nutritional Risk). Please keep in mind that WIC PC data may include certification records from as early as May [TWO YEARS PRIOR TO STUDY YEAR] and that all codes in your data will need to be mapped.

• Type any edits or new codes in the Revisions/Additions column.

• Email the completed worksheet to WICPC[STUDY YEAR]@westat.com

When adding and changing codes, please remember, a State agency code cannot correspond to FNS Risk Codes in different categories. On this form, bold lines separate categories. If your State agency has a code that spans multiple categories, please contact Westat for further instructions.

If you will be submitting data using the standard FNS Nutritional Risk Codes, you do not need to complete this worksheet. Please just let us know the data will include the standard FNS Risk Codes.

Westat Contact Information

[NAME]

WICPC[STUDY YEAR]@westat.com

[PHONE]

This information is being collected from State agencies to enable the Food and Nutrition Service (FNS) to prepare biennial reports on WIC participant and program characteristics. This is a mandatory collection authorized under 7 CFR §246.25(b)(3). FNS uses the data from these reports to estimate budgets, submit civil rights reporting, identify needs for research, and to develop and review WIC policies and procedures. Under the Privacy Act of 1974 and the System of Record Notice FNS-8 USDA/FNS Studies and Reports, any personally identifying information obtained will be kept private to the extent of the law. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0609. The time required to complete this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 1320 Braddock Place, Alexandria, VA 22314, ATTN: PRA (0584-0609). Do not return the completed form to this address.

Category/Title	FNS Nutritional Risk Code	PC[PREVIOUS STUDY YEAR] State Agency Code	Revised/ Additional State Agency Codes	Revisions/Additions Please separate each code with a comma (e.g., '102, 105' or 'A5, H7')	Notes
Anthropometric
Low Weight-for-Height	100	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Underweight (women)	101	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Underweight or At Risk of Becoming Underweight	103	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
High Weight-for-Height/Length	110	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Overweight (women)	111	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Obese (children 2–5 years)	113	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Overweight or At Risk of Overweight	114	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
High Weight-for-Length (infants and children younger than 24 months of age)	115	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Short Stature	120	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Short Stature or At Risk of Short Stature (infants, children)	121	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inappropriate Growth/Weight Gain Pattern	130	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Low Maternal Weight Gain	131	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Maternal Weight Loss During Pregnancy	132	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
High Maternal Weight Gain	133	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Failure to Thrive	134	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inadequate Growth	135	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Low Birth Weight/Premature Birth	140	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Low Birth Weight	141	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Preterm or Early Term Delivery	142	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Other Anthropometric Risk	150	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Small for Gestational Age	151	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Low Head Circumference	152	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Large for Gestational Age	153	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Biochemical
Hematocrit or Hemoglobin Below FNS Criteria	200	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Low Hematocrit/Hemoglobin [formerly Anemia]	201	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Other Biochemical Test Results That Indicate Nutritional Abnormality	210	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Elevated Blood Lead Levels	211	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Clinical/Health/Medical
Pregnancy-Induced Conditions	300	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Hyperemesis Gravidarum	301	C15[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Gestational Diabetes	302	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Gestational Diabetes	303	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Preeclampsia	304	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Delivery of Low-Birthweight/Premature Infant	310	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Preterm Delivery	311	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Low Birth Weight	312	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Prior Stillbirth, Fetal, or Neonatal Death	320	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Spontaneous Abortion, Fetal, or Neonatal Loss	321	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
General Obstetrical Risks	330	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Pregnancy at a Young Age	331	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Closely Spaced Pregnancies	332	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
High Parity and Young Age (discontinued)	333	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Lack of Adequate Prenatal Care	334	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Multifetal Gestation	335	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Fetal Growth Restriction	336	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Birth of a Large-for-Gestational-Age Infant	337	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Pregnant Woman Currently Breastfeeding	338	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
History of Birth With Nutrition Related Congenital or Birth Defect	339	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Nutrition-Related Risk Conditions (e.g. Chronic Disease, Genetic Disorder, Infection)	340	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Nutrient Deficiency Diseases	341	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Gastrointestinal Disorders	342	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Diabetes Mellitus	343	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Thyroid Disorders	344	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Hypertension and Prehypertension (Includes Chronic and Pregnancy Induced)	345	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Renal Disease	346	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Cancer	347	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Central Nervous System Disorders	348	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Genetic and Congenital Disorders	349	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inborn Errors of Metabolism	351	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Infectious Diseases (Bronchiolitis added)	352	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Acute	352A	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Chronic	352B	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Food Allergies	353	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Celiac Disease	354	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Lactose Intolerance	355	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Hypoglycemia	356	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Drug-Nutrient Interactions	357	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Eating Disorders	358	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Recent Major Surgery, Trauma, Burns	359	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Other Medical Conditions	360	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Depression	361	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Developmental, Sensory, or Motor Disabilities Interfering With the Ability to Eat	362	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Pre-Diabetes	363	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Substance Abuse (Drugs, Alcohol, Tobacco)	370	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Nicotine and Tobacco Use [formerly, Maternal Smoking]	371	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Alcohol and Illegal Drug Use	372	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Other Health Risks	380	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Dental Problems (Oral Health Conditions)	381	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Fetal Alcohol Spectrum Disorders [formerly, Fetal Alcohol Syndrome]	382	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Neonatal Abstinence Syndrome	383	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Dietary
Failure To Meet Dietary Guidelines for Americans	400	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Failure to Meet Dietary Guidelines for Americans	401	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inappropriate Nutrition Practices	410	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inappropriate Nutrition Practices for Infants	411	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely using a substitute(s) for breast milk or for FDA approved iron-fortified formula as the primary nutrient source during the first year of life	411.01	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely using nursing bottles or cups improperly	411.02	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely offering complementary foods or other substances that are inappropriate in type or timing	411.03	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely using feeding practices that disregard the developmental needs or stage of the infant	411.04	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Feeding foods to an infant that could be contaminated with harmful microorganisms or toxins	411.05	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely feeding inappropriately diluted formula	411.06	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely limiting the frequency of nursing of the exclusively breastfed infant when breast milk is the sole source of nutrients	411.07	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely feeding a diet very low in calories and/or essential nutrients	411.08	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely using inappropriate sanitation in preparing, handling, and storage of expressed breastmilk or formula	411.09	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Feeding dietary supplements with potentially harmful consequences	411.10	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely not providing dietary supplements recognized as essential by national public health policy when an infant’s diet alone cannot meet nutrient requirements	411.11	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inappropriate Nutrition Practices for Children	425	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely feeding inappropriate beverages as the primary milk source	425.01	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely feeding a child any sugar-containing fluids	425.02	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely using nursing bottles, cups, or pacifiers improperly	425.03	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely using feeding practices that disregard the developmental needs or stages of the child	425.04	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Feeding foods to a child that could be contaminated with harmful microorganisms	425.05	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely feeding a diet very low in calories and/or essential nutrients	425.06	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Feeding dietary supplements with potentially harmful consequences	425.07	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely not providing dietary supplements recognized as essential by national public health policy when a child’s diet alone cannot meet nutrient requirements	425.08	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Routinely ingesting nonfood items (pica)	425.09	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inappropriate Nutrition Practices for Women	427	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Consuming dietary supplements with potentially harmful consequences	427.01	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Consuming a diet very low in calories and/or essential nutrients; or impaired caloric intake or absorption of essential nutrients following bariatric surgery	427.02	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Compulsively ingesting nonfood items (pica)	427.03	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Inadequate vitamin/mineral supplementation recognized as essential by national public health policy	427.04	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Pregnant woman ingesting foods that could be contaminated with pathogenic microorganisms	427.05	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Dietary Risk Associated With Complementary Feeding Practices	428	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Other Risks
Regression/Transfer/Presumptive Eligibility	500	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Possibility of Regression	501	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Transfer of Certification	502	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Presumptive Eligibility for Pregnant Women	503	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Breastfeeding Mother/Infant Dyad	600	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Breastfeeding Mother of Infant at Nutritional Risk	601	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Breastfeeding Complications (Women)	602	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Breastfeeding Complications (Infants)	603	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Infant of a WIC-Eligible Mother or Mother at Risk During Pregnancy	700	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Infant Up to 6 Months Old of WIC Mother, or of a Woman Who Would Have Been Eligible During Pregnancy	701	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Breastfeeding Infant of Woman at Nutritional Risk	702	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Infant Born of Woman With Mental Retardation or Alcohol or Drug Abuse During Most Recent Pregnancy	703	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Homelessness/Migrancy	800	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Homelessness	801	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Migrancy	802	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Other Nutritional Risks	900	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Recipient of Abuse	901	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Woman, or Infant/Child of Primary Caregiver With Limited Ability To Make Feeding Decisions and/or Prepare Food	902	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Foster Care	903	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change
Exposure to Environmental Tobacco Smoke	904	[STATE AGENCY CODE FOR PREVIOUS STUDY YEAR]	No Change