How To Use CPT Code 93788

CPT 93788 describes the procedure for ambulatory blood pressure monitoring, utilizing report-generating software, worn continuously for 24 hours or longer, with scanning analysis and report. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93788?

CPT 93788 can be used to describe the procedure for ambulatory blood pressure monitoring, where a patient wears a device continuously for 24 hours or longer to automatically measure blood pressure at intervals. The results are recorded and then analyzed using report-generating software to provide a comprehensive report of the patient’s blood pressure patterns.

2. Official Description

The official description of CPT code 93788 is: ‘Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report.’

3. Procedure

1. The provider or a technician fits the patient with an ambulatory blood pressure monitor.
2. The patient wears the device continuously for 24 hours or more while performing their daily activities.
3. The device automatically records blood pressure readings at regular intervals on storage media.
4. The provider scans the recorded data and performs an analysis to identify patterns and trends in the patient’s blood pressure.
5. Based on the analysis, the provider generates a comprehensive report that includes the patient’s blood pressure readings and any significant findings.

4. Qualifying circumstances

Ambulatory blood pressure monitoring using CPT 93788 is typically performed to rule out white coat hypertension, where blood pressure readings are higher in a healthcare setting but normal at home. Patients who exhibit elevated blood pressure or have a suspected white coat hypertension may qualify for this procedure. It is important to note that Medicare coverage for ambulatory blood pressure monitoring is limited to patients with white coat hypertension, and the procedure must be performed for at least 24 hours to meet coverage criteria.

5. When to use CPT code 93788

CPT code 93788 should be used when a provider performs ambulatory blood pressure monitoring using report-generating software and scanning analysis with a report. This code is specifically for the scanning analysis and report generation portion of the procedure and does not include the recording or interpretation of blood pressure readings. It is important to ensure that the monitoring is worn continuously for 24 hours or longer to meet the requirements of this code.

6. Documentation requirements

To support a claim for CPT 93788, the provider must document the following information:

• Prescription for ambulatory blood pressure monitoring
• Duration of monitoring (24 hours or longer)
• Details of the scanning analysis performed
• Findings and any significant patterns or trends in the patient’s blood pressure
• Comprehensive report generated from the analysis

7. Billing guidelines

When billing for CPT 93788, it is important to ensure that the procedure meets the specific requirements of the code. The provider should use report-generating software and perform scanning analysis with a report. It is also important to note that CPT code 93788 should not be reported with other codes for different configurations of ambulatory blood pressure monitoring services. Medicare coverage for ambulatory blood pressure monitoring is limited to patients with white coat hypertension, and the procedure must be performed for at least 24 hours to meet coverage criteria.

8. Historical information

CPT 93788 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2020, where the description was updated to include the utilization of report-generating software.

9. Examples

1. A patient undergoes ambulatory blood pressure monitoring for 24 hours using report-generating software. The provider performs scanning analysis and generates a comprehensive report of the patient’s blood pressure patterns.
2. A patient with suspected white coat hypertension wears an ambulatory blood pressure monitor continuously for 48 hours. The provider performs scanning analysis, interprets the results, and generates a detailed report.
3. A provider prescribes ambulatory blood pressure monitoring for a patient to assess their blood pressure during various daily activities. The patient wears the monitor for 72 hours, and the provider performs scanning analysis to identify any abnormal blood pressure patterns.
4. A patient with elevated blood pressure undergoes ambulatory blood pressure monitoring for 24 hours. The provider uses report-generating software to analyze the recorded data and generates a report with the patient’s blood pressure readings and any significant findings.
5. A provider recommends ambulatory blood pressure monitoring for a patient with suspected white coat hypertension. The patient wears the monitor for 24 hours, and the provider performs scanning analysis to determine if the patient’s blood pressure is elevated only in a healthcare setting.
6. A patient with a history of fluctuating blood pressure wears an ambulatory blood pressure monitor for 48 hours. The provider uses report-generating software to analyze the recorded data and generates a comprehensive report of the patient’s blood pressure patterns.
7. A provider orders ambulatory blood pressure monitoring for a patient to assess the effectiveness of their current blood pressure medication. The patient wears the monitor for 24 hours, and the provider performs scanning analysis to evaluate the patient’s blood pressure control.
8. A patient with suspected white coat hypertension undergoes ambulatory blood pressure monitoring for 72 hours. The provider uses report-generating software to analyze the recorded data and generates a detailed report to confirm the diagnosis.