AdministrativeCommercialFebruary 1, 2019

HEDIS® 2019: Controlling High Blood Pressure (CBP)

One of the measures Anthem Blue Cross and Blue Shield (Anthem) reports on is the Controlling High Blood Pressure (CBP) measure. This measure focuses on the percentage of members who are 18 to 85 years of age who had a diagnosis of hypertension and whose blood pressure (BP) was adequately controlled (<140/90 mm Hg) during the measurement year (2018).

 

What’s new for 2019?

 

  • The Controlling High Blood Pressure (CBP) measure is no longer strictly a hybrid measure, which means that we review both medical records and claims. We can now use claims data to confirm both the diagnosis of hypertension as well as the blood pressure reading (CPT II codes).

  • If you submit a claim using CPT II codes to document the blood pressure reading, we can now use that information, eliminating the need to request the medical record from you.

  • Compliant BP is defined as <140/90 mm Hg for all members.

  • Blood pressure readings taken from remote monitoring devices that are electronically submitted directly to the Provider can be utilized for the measure.


What do we need from you?

 

We need the last 2 office visit notes from 2018 with the blood pressure documented. Also, if the member was diagnosed with end stage renal disease, renal dialysis, renal transplant or pregnancy in 2018 please send that documentation as well.

 

Common chart deficiencies:

 

  • Recheck elevated blood pressures readings and document all BP readings in the medical record.

 

For more information on HEDIS visit the Anthem Provider Portal online at Anthem.com. Click on Providers > Click Polices and Guidelines > Select your State>Scroll down and click View Med Policies and UM Guideline >Click Health & Wellness > Scroll down to Quality Improvement and Standards> and then scroll down on the page to HEDIS Information.

 

Thank you for your continued cooperation and support of HEDIS.

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).