Medicare AdvantageDocumentationHigh impact
Every Reading Counts: Your Contribution to Better Blood Pressure Outcomes
Florida Blue·FL · Cardiology, Internal Medicine, Family Medicine +4 more·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jul 29, 2026
Summary
Florida Blue has issued updated guidance on blood pressure management documentation and coding for HEDIS reporting. Providers must now document exact blood pressure readings (no rounding or ranges), utilize specific CPT II codes (3074F-3080F) based on systolic/diastolic thresholds, and assign appropriate ICD-10 codes for hypertensive conditions. This change emphasizes detailed documentation to support quality measure compliance and care management targeting.
Action Required
Effective immediately (July 2026): Billing and clinical teams must implement the following changes: (1) Providers must document exact blood pressure values at all patient visits without rounding, ranges, or averages—update EMR templates and provider encounter forms to enforce this requirement; (2) Billing team must update software to assign CPT II codes 3074F, 3075F, or 3077F for systolic readings and 3078F, 3079F, or 3080F for diastolic readings based on the specified thresholds; (3) Coders must select appropriate ICD-10 codes from the provided reference guide (I10, I11.0, I11.9, I12.0, I12.9, I13.0, I13.10, I13.2, I15, I16, I1A, R03.0) and ensure secondary codes for heart failure and CKD stages are included when applicable; (4) Front-line clinical staff should encourage home blood pressure monitoring during telehealth visits; (5) Non-compliant readings (systolic ≥140 mmHg or diastolic ≥90 mmHg) must be flagged and submitted for HEDIS reporting to support care management outreach. Failure to comply will result in inaccurate HEDIS quality measure reporting and missed opportunities for member care management initiatives. Contact MedicareStarsTeam@bcbsfl.com with questions.