Description
Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period.
Guidance
In reference to the numerator element, only blood pressure readings performed by a clinician or a remote monitoring device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by a remote monitoring device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the remote monitoring device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record.
Do not include BP readings taken during an acute inpatient stay or an ED visit.
If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed "not controlled".
If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
Initial Population
Patients 18-85 years of age by the end of the measurement period who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
Date of birth information can be entered in DrChrono in the patient chart under the Demographics tab with the Patient's Date of Birth.
AND
A Patient encounter during the performance period (CPT or HCPCS)
CPT
99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99455, 99456, 99483
HCPCS
G0162, G0299, G0300, G0402, G0438, G0439, G0463, G0493, G0494, S0271, S0311, S9123, S9124, T1000, T1001, T1002,T1003, T1004, T1005, T1015, T1019, T1020, T1021, T1022, T1030, T1031
CPT and HCPCS codes can be entered into the billing section for the encounter. Below is an example from the appointment window.
AND
A diagnosis of essential hypertension starting before or continuing into or starting during the first 6 months of the measurement period.
Denominator
Equals initial population
Denominator Exclusions
Patients with evidence of end-stage renal disease (ESRD), dialysis, or renal transplant before or during the measurement period. Also, exclude patients with a diagnosis of pregnancy during the measurement period.
Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients 66 and older by the end of the measurement period who are living long-term in a nursing home at any time on or before the end of the measurement period.
Exclude patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
- Advanced illness with two outpatient encounters during the measurement period or the year prior
- OR advanced illness with one inpatient encounter during the measurement period or the year prior
- OR taking dementia medications during the measurement period or the year prior
Exclude patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period.
Exclude patients receiving palliative care for any part of the measurement period.
Denominator Exceptions
None
Numerator
Patients whose most recent blood pressure is adequately controlled (systolic blood pressure less than 140 mmHg and diastolic blood pressure less than 90 mmHg) during the measurement period.
Blood pressure can be documented in the Vitals section of the appointment window or clinical note.
The vitals are saved with the visit, and can also be seen in the Physical Exam section of the patient's CQMs tab in their chart with the relevant LOINC codes.
Numerator Exclusions
None