HEDIS Measure- Controlling High Blood Pressure

Definition: The percentage of patients that are ages 18 to 85 years old, who have had a diagnosis of hypertension (HTN) and whose blood pressure was adequately controlled (<140/90 mm Hg) during the measurement period.

What is Accepted:

DOCUMENT YOUR EFFORTS! Blood pressure and DX of HTN (high blood pressure).

DX code:  I10

Medical Billing and coding:

Code	Description
3077F	Systolic is greater than/ equals to 140
3074F, 3075F	Systolic is less than 140
3080F	Diastolic is greater than/equal to 90
3079F	Diastolic 80-89
3078F	Diastolic less than 80
93784,93788,93790,99091,99453,99454,99457	Remote  Blood Pressure Monitoring codes
98966, 98967,98968,99441,99442,99443	Telephone visits
95, GT	Telemedicine Modifiers/ POS 02 (place of service)

Patients that have BP adequately controlled include:

+Patients 18 to 85 years old who had a diagnosis of HTN and whose BP was adequately controlled during the measuring period

+ Patients who had a most recent BP reading during the measurement period year or had a BP measurement after the second diagnosis of HTN.

If no BP is recorded during the measuring period year, than it is assumed that BP is not controlled.

Exclusions:

1. Patients with ESRD

2. Patients with Nephrectomy or Kidney transplant

3.Pregnant patient

4.Nonacute inpatient stay

5. Patients aged 66 to 80 years old with frailty and advanced illness

6. Patients 81 years old and above with frailty

What is not accepted in this measure:

– If BP was taken on same day as a diagnostic test or procedure  was done or for a change of diet or medication regiment

– If BP was taken a day before or on the same day of any test or procedure

– BP taken during an acute inpatient stay or at the emergency department.