ED Coding and Reimbursement Alert

Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

• Updated Instructions, Numerator Definition (Recommended BP Follow-Up, Recommended Lifestyle Modifications, Second Hypertensive BP Reading Interventions, and Recommended Blood Pressure Follow-Up Interventions), Numerator Note, Numerator Option (G8784)
• Deleted Denominator Coding, CPT^® 97532, 99218, 99219, 99220, 99224, 99225, 99226, 99234, 99235,99236, 99281, 99282, 99283, 99284, 99285, Numerator Option (G8951)
• Update 12/18/2015 Version 10.1: Added Denominator Coding, CPT^® 99281, 99282, 99283, 99284, 99285

Measure 317 Instructions:
Report this measure a minimum of once per reporting period for patients seen during the reporting period. Eligible professionals who report the measure must perform the blood pressure screening at the time of a qualifying visit and may not obtain measurements from external sources.

Eligible professionals who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated.

This measure requires reporting both systolic and diastolic blood pressure measurements. If there are multiple blood pressures on the same date of service, use the most recent as the representative blood pressure. The documented follow-up plan must be related to the current BP reading as indicated.

For example: “Patient referred to primary care provider for BP management.”

Measure Reporting via Claims:
CPT^® or HCPCS codes and patient demographics identify patients who are included in the measure’s denominator. Quality-data codes report the numerator of the measure.

When reporting the measure via claims, submit the listed CPT^® or HCPCS codes, and the appropriate quality-data code. Report all measure-specific coding on the claim(s) representing the eligible encounter.

Measure Reporting via Registry: 

CPT^® or HCPCS codes and patient demographics identify patients who are included in the measure’s denominator. The listed numerator options report the numerator of the measure.