Provider Central

This article is for primary care providers caring for our members

Controlling high blood pressure is crucial to prevent cardiovascular events, and accurate documentation plays a key role in effective management.

Reminder: For your hypertensive patients (ages 18-85), a blood pressure of less than 140/90 mm Hg is the recognized benchmark for adequate control under HEDIS.

By accurately and consistently documenting blood pressure readings, you enhance patient care through proactive health management, ensure compliance with HEDIS measures, and reduce administrative burden on your practice.

Easy steps for quality care and reporting

1. Back to basics: Remind support staff to check for measurement accuracy
   • After rooming the patient, allow them to sit quietly for a few minutes before taking their blood pressure.
   • Check for proper cuff size on the patient.
   • Support the patient’s arm at heart level, ensure feet are flat on the floor and legs are uncrossed.
   • Retake high readings later in the visit, consider using the other arm.
     
     
2. Document blood pressure numbers
   • Check for missing codes: Review for existing blood pressure readings and ensure the correct CPT II code has been submitted.
     

     CPT II code	Systolic blood pressure	CPT II code	Diastolic blood pressure
     3074F	< 130 mm Hg	3078F	< 80 mm Hg
     3075F	130 - 139 mm Hg	3079F	80 - 89 mm Hg
     3077F	≥ 140 mm Hg	3080F	≥ 90 mm Hg

   • Record exact numbers: Document all blood pressure readings with dates and don’t round results. 
   • Use the lowest reading: For multiple readings on the same day, document the lowest systolic and diastolic results. 
   • Address elevated readings: If your patient has elevated reading, schedule a follow-up visit to re-check blood pressure, discuss lifestyle changes, and medication adherence if applicable. Note: a telephone visit may be helpful for this follow-up, and you can:
     • Incorporate at-home readings: Encourage patients to check their readings at home and share those with you. Document patient-reported readings from their digital devices in the medical record.
   • Code elevated readings appropriately: Use ICD-10 code R03.0 for elevated readings without a hypertension diagnosis.

Encourage patients to monitor their blood pressure at home and bring a log of their readings to appointments or encourage them to send to you via portal message. Here’s how patients can order a home monitor:

• Medicare Advantage
  Either members or their doctors can email hhit@bcbsma.com  or call our Engagement Specialists at 1-888-376-0644.

• Federal Employee Program (FEP)
  Members can sign up for the Hypertension Management Program.

• Commercial
  Members can purchase a digital blood pressure monitor with their health financial account.

By following these practices, you can help us improve blood pressure control, reduce risks, and enhance patients’ quality of life.

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