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

Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive.

This measure is to be submitted at each visit for patients seen during the measurement period. Merit-based Incentive Payment System (MIPS) eligible clinicians who submit the measure must perform the blood pressure (BP) screening at each patient visit by a MIPS-eligible clinician and may not obtain measurements from external sources.

This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. 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. 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.”

Screen the patient for high blood pressure:

  1. Create a visit note.
  2. On the Overview screen, tap Vitals.

    You may need to swipe left on the second row of tiles to see Vitals.

  3. Record the Systolic, Diastolic, and Position.
  4. Open the Ocular Exam.
  5. Select any diagnosis related to elevated blood pressure from Impressions.
  6. Select any Plan.
  7. Tap Special Plans and select MIPS.
  8. From Popular Plans, select MIPS Quality.
  9. Tap the More tab and select BP.
  10. Select an outcome from the Quality 317 drop-down.
  11. Tap Done.
  12. Document the rest of the exam and Finalize.

Alternatively, code quality with a special plan:

  1. Open the Ocular Exam.
  2. Select a Diagnosis and Plan.
  3. Tap Special Plans and select MIPS.
  4. From Popular Plans, select MIPS Quality.
  5. Tap the More tab.
  6. Select BP.
  7. Select the appropriate procedure from the Quality 317 drop-down.
  8. Tap Done.
  9. Document the rest of the exam and Finalize.

Screen the patient for high blood pressure:

  1. In a patient’s exam record in ExamWRITER, record the office visit.
  2. Click the Exam - Special Tests tab.
  3. Click the yellow Vital Signs button.

    The Vital Signs window opens.

  4. Click your cursor in the Blood Pressure box.

    The Blood Pressure/Pulse window opens.

  5. Record the patient’s Systolic, Diastolic, and Pulse by clicking the appropriate measurements in the slider.

    OR if the patient refuses a BP reading, select the Patient Refused radio button. If this is an emergency situation, select the Urgent or Emergent radio button (G9745).

  6. If the patient has previously been diagnosed with hypertension, select the Active Diagnosis of Hypertension check box (G9744).
  7. If the patient’s BP is ≥120 and ≥80, select the Referred to Alternative/Primary Care Provider check box (G8950).
  8. Click Save/Exit.
  • Claims (ExamWRITER only)
  • EHR (ExamWRITER only)
  • Registry (Eyefinity EHR only)

This topic describes how points are calculated for this measure. To learn more about scoring, go to Scoring.

Benchmarks are displayed here as both a chart and a table. The chart gives you a visual representation and helps you quickly compare benchmarks across different reporting methods. The table lists the specific benchmark criteria for each available reporting method.

 

Submission Method 3rd Decile 4th Decile 5th Decile 6th Decile 7th Decile 8th Decile 9th Decile 10th Decile
Claims (ExamWRITER only) 79.05– 95.66 95.67– 99.08 99.09– 99.77 99.78– 99.99 — — — 100
EHR (ExamWRITER only) 12.47– 17.05 17.06– 19.94 19.95– 22.79 22.80– 25.69 25.70– 28.78 28.79– 33.10 33.11– 40.79 ≥ 40.80
Registry (Eyefinity EHR only) 18.21– 27.75 27.76– 48.04 48.05– 81.63 81.64– 93.85 93.86– 98.92 98.93– 99.92 99.93– 99.99 100

All patient visits for patients aged 18 years or older;

90791, 90792, 92002, 92004, 92012, 92014, 92537, 92538, 92540, 92541, 92542, 92544, 92545, 92546, 92622, 92625, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99236, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99385*, 99386*, 99387*, 99395*, 99396*, 99397*, 99424, 99491, D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7251, G0101, G0402, G0438, G0439

CPT codes listed with an asterisk (*) are noncovered services under the Physician Fee Schedule and will not be counted toward the denominator in claims-based reporting.

OR [EHR reporting only] who were diagnosed with hypertension with one of the following SNOMED codes:

10725009, 10964002, 1201005, 123799005, 123800009, 14973001, 194783001, 194785008, 194788005, 194791005, 19769006, 23130000, 233815004, 233941006, 233942004, 233943009, 233944003, 233945002, 233946001, 234072000, 234073005, 234075003, 237279007, 28119000, 288250001, 31992008, 34742003, 371125006, 38341003, 39018007, 397748008, 398254007, 4210003, 423674003, 428575007, 429198000, 429457004, 46481004, 46764007, 48146000, 48194001, 52698002, 56218007, 57684003, 59621000, 59720008, 65518004, 68267002, 70272006, 73410007, 74451002, 78975002, 81626002, 84094009, 8762007, 89242004

AND [registry reporting only] who was referred to another clinician or specialist during the measurement period:

G9968

Denominator Exclusions

Patient not eligible due to active diagnosis of hypertension:

G9744

OR

Telehealth modifier:

GQ, GT, 95, POS 02, POS 10

If the I10 diagnosis was completed before the exam date, the patient is excluded from the results for Measure 317.

Denominator Exceptions

Documented reason for not screening or recommending a follow-up for high blood pressure:

G9745

Number of visits for patients who were screened for high blood pressure;

AND have a recommended follow-up plan documented, as indicated, if the blood pressure is prehypertensive or hypertensive.

Although the recommended screening interval for a normal BP reading is every 2 years, to meet the intent of this measure, BP screening and follow-up must be performed once per performance period. For patients with Normal blood pressure, a follow-up plan is not required. If the blood pressure is prehypertensive (SBP > 120 and <139 OR DBP >80 and <89) at a Primary Care Provider (PCP) encounter follow up as directed by the PCP would meet the intent of the measure (G8783).

Performance Met

Normal blood pressure reading documented, follow-up not required:

G8783

OR prehypertensive or hypertensive blood pressure reading documented, and the indicated follow-up is documented:

G8950

OR [EHR reporting only] referral to primary care or alternate provider documented with one of the following SNOMED codes:

134403003, 183516009, 183561008, 183856001, 306206005, 306253008, 308470006

Performance Not Met

Blood pressure reading not documented, reason not given:

G8785

OR elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given:

G8952

Measures 236 and 317 are closely related. Refer to the table below to understand how exam procedures and findings impact each measure.

Criteria Measure Notes
  317: Preventive Care & Screening 236: Controlling High BP  
Age 18 and over 18–85  
Procedure code(s) 992xx or 92xxx 992xx  
Diagnosis I10 I10 If the I10 diagnosis was completed before the exam date, the patient is excluded from the results for Measure 317

The conditions above this line affect which options are available below
Active diagnosis of hypertension G9744 (exclusion) — This selection allows BP to be recorded, but restricts other BP check box selections
Patient refused G9745 (exception) — No further coding can be done for 317
Urgent or emergent situation G9745 (exception) — No further coding can be done for 317
BP <120 and <80 G8783 —  
BP ≥120 and ≥80 AND referred to alt. provider G8950 —  
BP ≥120 and ≥80 NOT referred to alt. provider G8952 (not met) —  
Systolic <140 — G8752 Both systolic and diastolic measures required; any not met results in not met
Systolic ≥140 — G8753 (not met)
Diastolic <90 — G8754
Diastolic ≥90 — G8755 (not met)
BP is blank G8785 (not met) G8756 (not met) These codes are overwritten if any of the above are selected