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

Last updated: June 9, 2017

CMS Measure ID: CMS22v5
Version: 5
NQF Number: None
Measure Description:

Percentage of patients aged 18 years and older seen during the reporting period who were screened for high blood pressure AND a recommended follow-up plan is documented based on the current blood pressure (BP) reading as indicated

Initial Patient Population:

All patients aged 18 years and older before the start of the measurement period with at least one eligible encounter during the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patient has an active diagnosis of hypertension

Numerator Statement:

Patients who were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated if the blood pressure is pre-hypertensive or hypertensive

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Patient Reason(s):

Patient refuses to participate (either BP measurement or follow-up)

OR

Medical Reason(s):

Patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status. This may include but is not limited to severely elevated BP when immediate medical treatment is indicated.

Measure Steward: Centers for Medicare & Medicaid Services (CMS)
Domain: Community/Population Health
Next Version: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
Previous Version: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
Improvement Notation:

Higher score indicates better quality

Guidance:

Both the systolic and diastolic blood pressure measurements are required for inclusion. If there are multiple blood pressures on the same date of service, use the most recent as the representative blood pressure.

Eligible professionals who report the measure must perform the blood pressure screening at the time of a qualifying visit by an eligible professional and may not obtain measurements from external sources.

The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. The documented follow-up plan must be related to the current BP reading as indicated, example: Patient referred to primary care provider for BP management.

Addendum Notes: ICD-10 Value Set addition
Quality ID: 317
High Priority Measure: No
Data Submission Method: Claims,EHR,Registry
Specialty Measure Set: Allergy/Immunology,Internal Medicine,Anesthesiology,Cardiology,Dermatology,Emergency Medicine,Gastroenterology,General Surgery,General Oncology,Hospitalists,Neurology,Obstetrics/Gynecology,Ophthalmology,Orthopedic Surgery,Otolaryngology,Physical Medicine,Preventive Medicine,Rheumatology,Thoracic Surgery,Urology,Vascular Surgery,Mental/Behavioral Health,Plastic Surgery,General Practice/Family Medicine

Specifications

Release Notes

Header

  • Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

Logic

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exclusions

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

Value Set

  • Value set Anti-Hypertensive Pharmacologic Therapy (2.16.840.1.113883.3.600.1476): Added 3 RXNORM codes (1665057, 1719286, 1719290) and deleted 18 RXNORM codes.

    Section: None

    Source: None

  • Value set BP Screening Encounter Codes (2.16.840.1.113883.3.600.1920): Deleted 11 CPT codes (97532, 99218, 99219, 99220, 99224, 99225, 99226, 99234, 99235, 99236, 99340).

    Section: None

    Source: None

  • Value set Followup within one year (2.16.840.1.113883.3.600.1474): Deleted 1 SNOMEDCT code

    (61342007).

    Section: None

    Source: None

  • Value set Diagnosis of hypertension (2.16.840.1.113883.3.600.263): Added 3 ICD10CM codes (I16.0, I16.1, I16.9).

    Section: None

    Source: ICD-10 Addendum

External Resources