Controlling High Blood Pressure and Submitting Compliant Readings
Tips when scheduling members to close CBP care gaps:
- When scheduling appointments, have staff ask patients to avoid caffeine and nicotine for at least an hour before their scheduled appointment time.
- If possible, update your scheduling app and/or your reminder text message campaigns to include reminders about abstaining from caffeine and nicotine prior to appointment time as well as a reminder to arrive early to avoid a sense of rushing.
Tips for lower BP readings during the appointment:
- Ask the patient if they tend to get nervous at appointments and have higher readings as a result. If they do, take their blood pressure at both the start and end of the appointment and document the lower reading.
- Readings can also vary arm to arm. If slightly elevated in one arm, try the other and document the lower reading.
Getting credit for adequately controlled blood pressure readings:
- Submit readings via Category II CPT® codes on claims.
CAT II: 3078F-3080F
Diastolic 80 to 89
CAT II: 3079F
Diastolic greater than/equal to 90
CAT II: 3080F
Diastolic less than 80
CAT II: 3078F
CAT II: 3074F, 3075F, 3077F
Systolic greater than/equal to 140
CAT II: 3077F
Systolic less than 140
CAT II: 3074F, 3075F
- Ensure readings are carefully and appropriately documented within your electronic medical record system.
- If you have questions on how to submit readings, speak to your care or practice consultant.
- Also, be sure to adequately code patients who meet the exclusion criteria:
- Palliative care
- Enrolled in hospice
- Frailty and/or advanced illness
- Living in long-term care
- Optional exclusions:
- Dialysis (ESRD), kidney transplant, nephrectomy
- Female members with a diagnosis of pregnancy
- Non-acute inpatient admissions
February 2023 Provider Newsletter - Maine