For beneficiaries with suspected masked hypertension, which is defined as average office blood pressure between 120 mm Hg and 129 mm Hg for systolic blood pressure or between 75 mm Hg and 79 mm Hg for diastolic blood pressure on two separate clinic/office visits with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are ≥130/80 mm Hg.For beneficiaries with suspected white coat hypertension, which is defined as an average office blood pressure of systolic blood pressure greater than 130 mm Hg but less than 160 mm Hg or diastolic blood pressure greater than 80 mm Hg but less than 100 mm Hg on two separate clinic/office visits with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries under the following circumstances:.At least 2 documented BP measurements taken outside the clinic Clinic blood pressure >140/90 mm Hg at 3 separate clinic visits with 2 measurements made at each visit.We have an ICD-10 code to use for that, R03.0, elevated blood-pressure reading, without diagnosis of hypertension. The name “white coat syndrome” was coined to describe this phenomenon of a patient’s blood pressure being measured higher in the doctor’s office than their typical blood pressure. Some patients get nervous when they go to the doctor’s office, and their nervousness can cause their blood pressure to measure higher in the office than typical for the patients in other situations. More patients may be eligible for the test now that CMS has expanded the range of BP readings.
CMS has changed the range of blood pressures that are covered. This test measures blood pressure at regular intervals over a 24 hour period, and is covered to evaluate white coat hypertension, possible drug resistant hypertension, and other hypertensive conditions.
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