Blood pressure coding can reduce HEDIS medical record requests

The Controlling High Blood Pressure, or CBP, HEDIS^® measure — also a Medicare Star Ratings measure — assesses patients ages 18 to 85 who had a diagnosis of hypertension reported on an outpatient claim and whose blood pressure was adequately controlled (<140/90 mm Hg) as of Dec. 31 of the measurement year.

Per HEDIS specifications, blood pressure CPT^® II codes can now establish patient compliance with the CBP measure. We’ll no longer need to review medical records to confirm blood pressure values when you add the CPT II codes to your patients’ claims that are billed as an office visit, including telehealth, telephone, e-visit and virtual visits.

Blood pressure readings can be captured during a telehealth, telephone, e-visit or virtual visit. Keep the following in mind:

• Patient-reported readings taken with a digital device are acceptable and should be documented in the medical record.
• Providers don’t need to see the reading on the digital device; the patient can verbally report the digital reading.

Read the tip sheet to learn more about the measure and view a chart with blood pressure CPT II codes.

HEDIS^®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance.