Using CPT II Codes Can Reduce HEDIS® Medical Record Requests for Blood Pressure Readings

The Controlling High Blood Pressure (CBP) HEDIS^® star measure assesses patients 18 to 85 years of age who had a diagnosis of hypertension reported on an outpatient claim and whose blood pressure was adequately controlled (<140/90 mm Hg) as of December 31 of the measurement year.

Per HEDIS specifications, blood pressure CPT^® II codes can establish patient compliance with the CBP measure. We no longer need to review medical records to confirm blood pressure values if CPT II codes are added to claims billed with an office visit, including telehealth, telephone, e-visit, or virtual visit.

Blood pressure readings can be captured during a telehealth, telephone, e-visit, or virtual visit. Please note:

• Patient-reported readings taken with a digital device are acceptable and should be documented in the medical record.
• Providers don’t need to see the reading on the digital device; the patient can verbally report the digital reading.

Read the CBP tip sheet to learn more about the measure and view a chart with blood pressure CPT II codes.

Healthcare Effectiveness Data Information Set. HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).

CPT^® is a registered trademark of the American Medical Association.