Ambulatory Blood Pressure Monitoring
ABPM is a non-invasive diagnostic test that uses a device to track blood pressure over 24-hour cycles. This allows the provider to monitor the patients blood pressure during the patient's daily routine.
CMS has typically only covered ABPM for patient suspected of having "white coat syndrome", which occurs from a patient's anxiety in a clinical setting. However; CMS has expanded coverage to include cases of suspected "masked hypertension", which is the opposite of white coat and occurs when blood pressure measurements in a doctors office are lower than measurements taken outside a clinical setting.
This decision lowers the blood pressure threshold for hypertension from the current policy of 140/90 down to 130/80, aligning with the latest recommendation regarding the diagnostic criteria.
ABPM will continue to be reported using 97384-93790 and DX code R03.0 Elevated blood pressure reading, without diagnosis of hypertension.