Revisions to CMS guidelines on ABPM reimbursement make it the perfect time to offer 24-hour out-of-office blood pressure measurement to your patients. For more information on reimbursement, see our 2020 ABPM Reimbursement FAQ.
The US reimbursement guidelines for Ambulatory Blood Pressure Monitoring (ABPM) may change after the American Heart Association (AHA) and the American Medical Association (AMA) penned a joint letter to the Center for Medicare and Medicaid Services (CMS) requesting that CMS reconsider the current ABPM guidelines.
Diagnosing and treating hypertension is serious business, and as research shows, ABPM is far superior to other testing available to clinicians. ABPM provides valuable diagnostic information that in-clinic and home blood pressure monitoring systems are incapable of measuring including:
- BP variability and a more accurate estimation of true blood pressure
- Overnight changes in blood pressure (dipper status)
- Morning surges in blood pressure
The US Preventive Services Task Force (USPSTF) Weighs In
According to the Centers for Disease Control and Prevention, 67 million American adults (31%) have high blood pressure – that’s 1 out of every 3 adults. Depending upon the severity of the condition, typically diagnosed by in-office BP measurements, blood pressure medication and/or lifestyle modifications may be prescribed.
Although in-office BP measurements are typically used to diagnose hypertension, several studies have shown that other diagnostic options are far more reliable - specifically, the use of a 24-hour, ambulatory blood pressure monitoring device (ABPM).
Just two months ago the European Society of Hypertension (ESH) released its new guidelines for the management and treatment of arterial hypertension at its annual meeting. ESH remains active in publishing guidance documents and has now released its latest position paper. The topic is Ambulatory Blood Pressure Monitoring (ABPM).
The above title is how author Craig Bowron, MD capped off his recent article “Traditional blood-pressure cuffs not that reliable.” As I was reading the article, I was pleased to see how successful the 15-physician clinic in Minneapolis had been with implementing an Ambulatory Blood Pressure Monitoring (ABPM) program to identify, diagnose and manage their hypertensive patients. One physician was quoted as saying “It’s been breathtaking to see how much difference there can be between office blood pressure readings and what we’ve found with ambulatory [ABP] monitoring”. The practice was able to lower or end treatment on 13% of their patients after ABPM testing revealed that they were being over-treated. Conversely, 18% had their medication added or increased as their ABPM results showed they were under-treated.
Last week, we blogged on the recent report from the Centers for Disease Control and Prevention (CDC) that noted some pretty serious concerns about our national state of health as it relates to hypertension and its potentially deadly effects.
This week, we want to draw your attention to a press release from the American Society of Hypertension urging the CDC to incorporate ambulatory blood pressure monitoring (ABPM) as a way to apply a more "sensitive and specific tool for assessing blood pressure in its national surveys."1
Three months ago, the National Institute for Health and Clinical Excellence (NICE) in the UK released new guidelines for managing hypertension in adults. The new recommendations call for the use of Ambulatory Blood Pressure Monitoring (ABPM) to confirm a diagnosis of hypertension when a patient has a clinic BP reading of 140/90 mmHg or above. One of the major questions raised was how this would be implemented.
Dr. Henry Black, former President of the American Society of Hypertension, presents this very question in his recent video on Medscape News. While Medscape requires a free login account to view their content, we felt this report rather significant and worthy of sharing.
In the video article, Dr. Black points out that the practices of how we measure blood pressure are changing as technology advances and becomes more available. He also explains that while home monitoring is becoming more commonplace, studies of ambulatory blood pressure monitoring (ABPM) are telling us more about its unique prognostic benefits.
That’s just the question Dr. Mark C. van der Wel and colleagues sought the answer to in an article published in the Annals of Family Medicine. As we at SunTech have mentioned in previous posts, two of the most prevalent problems with traditional in-office blood pressure assessment is improper observer technique and the white-coat effect. As a way to overcome this, the authors developed a method of taking a series of in-office automated oscillometric blood pressure readings for 30 minutes by utilizing an ambulatory blood pressure monitor (ABPM) and compared those results with mean daytime ABPM results.
Traditionally, we try not to engage in excessive self-promotion on the SunTech Blog. But last month marked the 24th anniversary of SunTech’s first journey into space, and we’d like to let our readers know about this important and interesting chapter in our history. In the pre-dawn darkness of January 12, 1986, the space shuttle Columbia blasted off from launch pad 39A at the Kennedy Space Center, carrying with it a special version of the SunTech Accutracker II ABPM device. When Columbia landed successfully at Edwards Air Force base after 98 orbits, it may have marked the end of mission STS-61C, but it was just the beginning of SunTech’s foray into space-based research.