Mount Carmel Health Partners HEDIS Tip Sheets - Page 16

  HEDIS Tip Sheet        Controlling Blood Pressure    Definition: Percentage of members ages 18 – 85 who have a diagnosis of hypertension AND whose most recent blood pressure was adequately controlled during the measurement year. Service Needed: Blood pressure measurement between January 1 and December 31 of the measurement year. Coding CPT 2 Systolic BP <130 mmHg. Systolic BP 130-139 mmHg. Systolic BP ≥140 mmHg. Diastolic BP <80 mmHg. Diastolic BP 80-89 mmHg. Diastolic BP ≥90 mmHg. 3074F 3075F 3077F 3078F 3079F 3080F Exclusions: One of the following: • Diagnosis of end stage renal disease (ESRD) or kidney transplant or dialysis documented in the chart on or before December 31 of the measurement year. • Diagnosis of pregnancy during the measurement year. • Hospice care in the measurement year. Chart Review Tips: • Blood pressure measurements may be found in the "Vital Signs" section of the chart. Some practices have them on the recent visit/progress note. • In order to meet the measure, a patient’s most recent blood pressure should be: - less than 140/90 in patients ages 18-59. - less than 140/90 in patients ages 60-85. • If patient meets any of the exclusion criteria, please note for future reference. Member Outreach Tips: Before calling patients solely for the purpose of a blood pressure screening, it may be beneficial to evaluate why patients have not had their blood pressure measured or why they are not controlled: Have they not had a preventive visit? Have they refused measurement? Did the physician start new medications? Supplemental Data Tips When documenting a blood pressure measurement, if a patient has had multiple blood pressures taken on the same day, you may document the lowest systolic (top number) and the lowest diastolic (bottom number), even if they were not calculated together. For example: a patient's blood pressure measurements on 11/20/2020 were calculated as 135/92 and 142/78. You may record the patient’s blood pressure as 135/78.   16