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:
|3077F||Systolic is greater than/ equals to 140|
|3074F, 3075F||Systolic is less than 140|
|3080F||Diastolic is greater than/equal to 90|
|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.
1. Patients with ESRD
2. Patients with Nephrectomy or Kidney transplant
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.
2 thoughts on “HEDIS Measure- Controlling High Blood Pressure”
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