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Comprehensive Diabetes Care: Controlling High BP <140/90

Advantage MD, EHP, Priority Partners, and USFHP. Members 18-75 years of age.

Percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had the following:

  • BP* was adequately controlled (systolic and diastolic both <140/90 mm HG) during the measurement year.

* Uses last BP of the year.

Best Practice and Measure Tips

BP reading must be the last BP result performed within the measurement year. See CBP Measure for tips.

Measure Exclusions

Required Exclusions:

  • Palliative Care
  • Hospice
  • Fraility
  • Fraility and Advanced Illness
  • Living in Long Term Care

Optional Exclusion: Members without a diagnosis of diabetes in any setting and a diagnosis of polycystic ovarian syndrome, gestational diabetes or steroid-induced diabetes during the measurement year or the year prior.

Measure Codes

  • Outpatient Codes
    • CPT: 99201-99205, 99211-99215, 99241-99245, 99347 -99350, 99381-99387, 99391-99397, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99455, 99456, 99483, 99341-99345
    • HCPCS: G0402, G0438, G0439, G0463, T1015
  • Non-Acute Inpatient
    • CPT: 99304-99310, 99315, 99316, 99318, 99324-99328, 99334-99337
  • Remote BP Monitoring
    • CPT: 93784, 93788, 93790, 99091
  • Diastolic Less than 80
    • CPT-CAT-II: 3078F
  • Diastolic 80-89
    • CPT-CAT-II: 3079F
  • Diastolic Greater than/Equal to 90
    • CPT-CAT-II: 3080F
  • Systolic Less than 130
    • CPT-CAT-II: 3074F
  • Systolic 131-140
    • CPT-CAT-II: 3075F
  • Systolic Greater than/Equal to 140
    • CPT-CAT-II: 3077F