We need assistance in completing the quality measure for preventive care and screening: Screening for high blood pressure and follow up documented

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Anita Marsh
    • 3044877676
    • Shahid R. Rana, MD
    • Hide
      Thank you for inquiring about CMS22v13 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented eCQM.
      1. CPT Code 99214 is a code within the Encounter to Screen for Blood Pressure value set, and thus can be used to assess measure compliance.
      2. The follow-up requirements differ based on the blood pressure range and which reading it is. However, education alone is insufficient for elevated or hypertensive ranges. For SBP 120-129, if non-pharmacological interventions (meeting the measure requirements specified below) are recommended, an order for follow-up within 6 months must also be documented.
      Please refer to the guidance from the Definition section of the measure:
      3. "Recommended Blood Pressure Follow-Up Interventions:
      -Normal BP: No follow-up required for SBP < 120 mmHg AND DBP < 80 mmHg
      -Elevated BP: Patients with SBP of 120-129 mmHg AND DBP < 80 mmHg:
         -Referral to Alternate/Primary Care Health Care Professional
         OR
         -Follow-up with rescreen within 6 months AND recommend nonpharmacologic interventions
      -First Hypertensive BP Reading: Patients with one elevated reading of SBP >= 130 mmHg
       OR DBP >= 80 mmHg:
         -Referral to Alternate/Primary Care Health Care Professional
          OR
          -Follow-up with rescreen within 4 weeks AND recommend nonpharmacologic interventions
      -Second Hypertensive BP Reading:
         -Second Hypertensive BP Reading: Patients with second elevated reading of
                 SBP of 130-139 mmHg OR DBP of 80-89 mmHg (and not SBP >=140 OR DBP >=90):
                -Referral to Alternate/Primary Care Healthcare Professional
                 OR
                -Nonpharmacologic intervention AND reassessment within 6 months
                   AND an order for a laboratory test or ECG for hypertension
         -Second Hypertensive BP Reading: SBP>=140 or DBP>=90:
                -Referral to Alternate/Primary Care Healthcare Professional
                 OR
                -Nonpharmacologic intervention AND BP-lowering medication
                 AND reassessment within 4 weeks AND an order for a laboratory test or ECG for hypertension
      The 2017 Guideline outlines nonpharmacologic interventions (lifestyle modifications) which must include one or more of the following as indicated:
      -Weight Reduction
      -A “heart-healthy diet,” such as Dietary Approaches to Stop Hypertension (DASH) Eating Plan
      -Dietary Sodium Restriction
      -Increased Physical Activity
      -Moderation in alcohol consumption"
      Show
      Thank you for inquiring about CMS22v13 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented eCQM. 1. CPT Code 99214 is a code within the Encounter to Screen for Blood Pressure value set, and thus can be used to assess measure compliance. 2. The follow-up requirements differ based on the blood pressure range and which reading it is. However, education alone is insufficient for elevated or hypertensive ranges. For SBP 120-129, if non-pharmacological interventions (meeting the measure requirements specified below) are recommended, an order for follow-up within 6 months must also be documented. Please refer to the guidance from the Definition section of the measure: 3. "Recommended Blood Pressure Follow-Up Interventions: -Normal BP: No follow-up required for SBP < 120 mmHg AND DBP < 80 mmHg -Elevated BP: Patients with SBP of 120-129 mmHg AND DBP < 80 mmHg:    -Referral to Alternate/Primary Care Health Care Professional    OR    -Follow-up with rescreen within 6 months AND recommend nonpharmacologic interventions -First Hypertensive BP Reading: Patients with one elevated reading of SBP >= 130 mmHg  OR DBP >= 80 mmHg:    -Referral to Alternate/Primary Care Health Care Professional     OR     -Follow-up with rescreen within 4 weeks AND recommend nonpharmacologic interventions -Second Hypertensive BP Reading:    -Second Hypertensive BP Reading: Patients with second elevated reading of            SBP of 130-139 mmHg OR DBP of 80-89 mmHg (and not SBP >=140 OR DBP >=90):           -Referral to Alternate/Primary Care Healthcare Professional            OR           -Nonpharmacologic intervention AND reassessment within 6 months              AND an order for a laboratory test or ECG for hypertension    -Second Hypertensive BP Reading: SBP>=140 or DBP>=90:           -Referral to Alternate/Primary Care Healthcare Professional            OR           -Nonpharmacologic intervention AND BP-lowering medication            AND reassessment within 4 weeks AND an order for a laboratory test or ECG for hypertension The 2017 Guideline outlines nonpharmacologic interventions (lifestyle modifications) which must include one or more of the following as indicated: -Weight Reduction -A “heart-healthy diet,” such as Dietary Approaches to Stop Hypertension (DASH) Eating Plan -Dietary Sodium Restriction -Increased Physical Activity -Moderation in alcohol consumption"
    • CMS0022v13
    • Not able to meet this measure

      For this measure we were told that the encounter type could only be 99213 or 99212.  Can we use encounter type 99214 for this measure.  This is the code we will use for billing.  Next we were told that if the blood pressure is above 120 we need to go to screenings and choose hypertension education then status ordered.  Will that meet this measure alone or do we have to add the follow up appointment in the screening.  

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Anita J Marsh
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              Updated:
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