2025 CPT code 93790
(Active) Effective Date: N/A Revision Date: N/A Medicine Services and Procedures - Cardiovascular Procedures Medicine Feed
Ambulatory blood pressure monitoring (ABPM) interpretation and report, using automated system for 24 hours or more.
Modifiers 52 (Reduced Services), 76 (Repeat Procedure), 77 (Repeat Procedure by Another Physician), and others may be applicable depending on the specific circumstances.
Medical necessity for ABPM is typically established when a patient presents with suspected white-coat hypertension, inconsistent blood pressure readings, or symptoms suggesting nocturnal hypertension.Documentation should support the clinical indication for the study and justify the need for ABPM over other diagnostic methods.Medicare coverage often requires a minimum 24-hour monitoring period and may be restricted to patients with suspected white-coat hypertension.
The provider or a technician fits the patient with the ABPM device. The patient wears the device for 24 hours or more, performing activities of daily living. Blood pressure results are automatically recorded. The provider reviews the data, considering the patient's medical history and activities, interprets the information, and creates a report.
In simple words: The doctor reviews the results from a 24-hour blood pressure monitor worn by the patient. The doctor interprets this information and provides a report based on the readings and the patient's overall health.
This CPT code encompasses the professional component of ambulatory blood pressure monitoring (ABPM).It includes the interpretation of automatically recorded blood pressure readings obtained over a period of 24 hours or longer using an automated system, and the subsequent generation of a report. The service does not encompass the fitting of the device or the recording and scanning analysis; those services are billed separately.Interpretation involves analysis of the data in conjunction with the patient's medical history and reported activities.
Example 1: A patient presents with suspected white coat hypertension. The physician orders ABPM to obtain a more accurate assessment of blood pressure outside of the clinical setting. Code 93790 is used to bill for the interpretation and reporting of the 24-hour ABPM data., A patient with known hypertension is experiencing fluctuating blood pressure despite medication. ABPM is ordered to evaluate the effectiveness of the current treatment regimen and identify potential contributing factors. Code 93790 is used for the interpretation and reporting of the results., A patient presents with symptoms suggestive of nocturnal hypertension.ABPM is employed to confirm the diagnosis and guide treatment decisions. The physician reviews the data, focusing on nighttime blood pressure readings, and reports the findings using code 93790.
* Patient's medical history, including current medications and relevant past medical conditions.* Detailed description of symptoms.* Ambulatory blood pressure monitoring tracing.* Physician's interpretation and report, including any recommendations or changes to treatment.
** Medicare guidelines require a minimum 24-hour monitoring period for coverage, often restricting coverage to patients with suspected white-coat hypertension.Correct coding necessitates comprehensive documentation and adherence to payer-specific guidelines.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: No Technical Component (TC) modifier is applicable as this code represents the professional component of the service.
- Specialties:Cardiology, Internal Medicine, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center