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  2. CQM-6748

Follow-Up clarification regarding CMS-22 (Preventative Care and Screening for High Blood Pressure and Follow-Up Documented)

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
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    • Jason Shropshire
    • 919-933-6615
    • UNC Health
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      Thank you for your question on CMS22v12: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented. Per the measure specifications, a patient diagnosed with hypertension would qualify for the denominator exclusion.

      For patients with elevated blood pressure readings, the numerator criteria include a referral to an alternate/primary care health professional OR a follow-up with a re-screen and recommendations of nonpharmacologic interventions.
      In order to receive credit for a referral to an Alternate/Primary Care Healthcare Professional, you need an intervention order (i.e., order and referral). Instructing the patient to follow up with their PCP would not qualify the patient to meet the numerator.
      Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading
      ["Intervention, Order": "Referral to Primary Care or Alternate Provider"] Referral
        where Referral.reason in "Finding of Elevated Blood Pressure or Hypertension"


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      Thank you for your question on CMS22v12: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented. Per the measure specifications, a patient diagnosed with hypertension would qualify for the denominator exclusion. For patients with elevated blood pressure readings, the numerator criteria include a referral to an alternate/primary care health professional OR a follow-up with a re-screen and recommendations of nonpharmacologic interventions. In order to receive credit for a referral to an Alternate/Primary Care Healthcare Professional, you need an intervention order (i.e., order and referral). Instructing the patient to follow up with their PCP would not qualify the patient to meet the numerator. Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading ["Intervention, Order": "Referral to Primary Care or Alternate Provider"] Referral   where Referral.reason in "Finding of Elevated Blood Pressure or Hypertension"
    • CMS0022v12
    • See description below

      I am part of a team that is assisting a specialty clinic that will be reporting Quality Measures as part of their MIPS requirements for CY24. I have a question concerning the follow-up documentation required for patients with abnormal BP readings (>120/80) for CMS 22-Preventative Care and Screening for High Blood Pressure and Follow-Up Documented. Per the measure criteria for patients to be included in the numerator during a patient visit, they are screened for high blood pressure AND have a recommended follow-up plan documented, as indicated if the blood pressure is elevated or hypertensive. With a documented diagnosis of Elevated Blood Pressure Reading or Hypertension, and documentation Patient was instructed to follow up with a Primary Care Provider due to elevated blood pressure in the chart and the After Visit Summary (AVS) provided to the patient would this meet the follow-up criteria for the measure?

            edave Mathematica EC eCQM Team
            jshropsh Jason Shropshire
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