This article is for primary care providers caring for our members
As you know, a controlled blood pressure helps reduce the risk of serious health conditions such as stroke and heart disease. According to the American Heart Association, nearly half of U.S. adults have high blood pressure, with many not even knowing it.
You can help your patients understand the risks of hypertension and the importance of monitoring their blood pressure with some of the best practices below.
Normalizing regular screenings
While lifestyle changes such as healthy diets and exercise can have a positive impact on blood pressure, it’s unlikely that these alone can overcome a genetic predisposition to hypertension, says Dr. Mark Friedberg, an internist and senior vice president of performance measurement and improvement at Blue Cross. Friedberg adds, “people shouldn’t feel guilty or ashamed about having high blood pressure.”
Because hypertension is found in so many people and can develop at a young age, regular screening is critical.
Read more in our Coverage story, High blood pressure basics: Check it, treat it
- Encourage patients to monitor and share blood pressure readings, even at home. Whether through telehealth or in-person, it’s best to capture every blood pressure reading taken using digital reading devices. At any time, your patients can safely and conveniently share their readings and the date they were taken via their patient portal or by phone call.
- Create a daily blood pressure log. This allows you and your patient to better track and manage the progression of their blood pressure.
- Schedule follow-up visits. Having consistent follow-up care ensures that your patient’s medications and other treatment plans are regularly reviewed and adjusted as needed.
- Promote medication adherence. Talk to your patients about the importance of taking their medications as prescribed. Consider prescribing single-pill medications, when possible, to improve adherence and lower patient out-of-pocket costs.
HEDIS®’ measure for blood pressure control
The HEDIS controlling high blood pressure (CBP) measure assesses adults:
- Ages 18–85 with a billed diagnosis of hypertension within the last year, AND
- Whose most recent blood pressure reading is <140/90 mm Hg.
Note: Please code appropriately to account for exclusions from this HEDIS measure. For example, members with the following conditions or circumstances during the measurement year will be excluded: hospice or palliative care; pregnancy; diagnosis of ESRD; frailty; or advanced illness.
When submitting claims for blood pressure, please use the CPT II codes as noted below.
|
CPT II code |
Systolic blood pressure |
|---|---|
|
3074F |
< 130 mm Hg |
|
3075F |
130 - 139 mm Hg |
|
3077F |
≥ 140 mm Hg |
|
CPT II code |
Diastolic blood pressure |
|---|---|
|
3078F |
< 80 mm Hg |
|
3079F |
80 - 89 mm Hg |
|
3080F |
≥ 90 mm Hg |
When reporting on the HEDIS blood pressure control measure, ranges are not acceptable. However, you may document the average blood pressure reading.
Blood pressure resources available to our members
Some of our members may be eligible for resources to help support their blood pressure monitoring and treatment. Members can call Member Service at the number on their ID card to verify their eligibility and benefits.
As always, thank you for the care you give to your patients—our members.
HEDIS®' is a registered trademark of the National Committee for Quality Assurance (NCQA).
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