Primary Care Coding Alert

Question: How should I bill Medicare for monitoring a patient's blood pressure for 24 hours?


New Mexico Subscriber

Answer: The entire process of monitoring and interpreting a patient's blood pressure over a 24-hour period includes three codes: 93786 (Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; recording only), 93788 (- scanning analysis with report) and 93790 (- physician review with interpretation and report).

If your physician requests the test but does not conduct it, you should only code for the patient's visit (selecting from 99212-99215, Office or other outpatient visit for the evaluation and management of an established patient ...)

Caution: Medicare only accepts 796.2 (Elevated blood pressure reading without diagnosis of hypertension) as the diagnosis for blood pressure monitoring tests. Be sure this diagnosis applies before submitting it in hopes of gaining reimbursement.