New HEDIS CBP measure specifications eliminate need for medical record reviews

The controlling high blood pressure HEDIS^® measure has been updated to assess patients ages 18 to 85 who had a diagnosis of hypertension and whose blood pressure was adequately controlled (less than 140/90) during the last reading of the year.

Previous CBP HEDIS, or Healthcare Effectiveness Data and Information Set, specifications required medical record reviews to determine if a patient’s blood pressure was under control. Now, Blood Pressure CPT Category II results codes will determine compliance.

When you add the correct CPT Category II and ICD-10 codes to your claims, you won’t need to include medical records for confirmation. This optimizes time and reduces record keeping for providers.

To learn more about claims coding to reduce medical record reviews and other measure changes, view the CBP tip sheet here. Questions about HEDIS compliance? Go to bcbsm.com/providers for additional resources.

HEDIS^® is a registered trademark of the National Committee for Quality Assurance.