May 2, 2019
The Controlling High Blood Pressure (CBP) measure for the Healthcare Effectiveness Data and Information Set (HEDIS®) has been updated to assess patients ages 18-85 who had a diagnosis of hypertension and whose blood pressure was adequately controlled (less than 140/90) during the last reading of the year.
Billing blood pressure CPT® Category II codes on each office visit claim along with a hypertensive condition will determine compliance. Previous CBP HEDIS specifications required medical record reviews to confirm the diagnosis and determine if a patient’s blood pressure was under control.
When the correct CPT Category II and ICD-10 codes is added to your claims, medical records will not need to be collected for confirmation. This optimizes time and lessens the need for record retrieval from providers.
To learn more about claims coding to reduce medical record reviews and other measure changes, view the CBP tip sheet.
For more information and/or questions regarding the article above, email ProviderClinicalConsulting@premera.com.