2025 CPT code 93786
(Active) Effective Date: N/A Medicine - Cardiovascular Feed
Ambulatory blood pressure monitoring using automated software, worn continuously for 24 hours or longer; recording only.
Modifiers may be applicable. Modifier 51 is used for multiple procedures and modifier 76 indicates repeat procedures.
Medical necessity for this code must be established based on the patient's clinical presentation.Examples include suspected white coat hypertension, masked hypertension, or evaluation of antihypertensive treatment efficacy.
A healthcare professional or technician fits the patient with the ambulatory blood pressure monitor. The patient wears the device and continues with normal daily activities. The device automatically records the blood pressure readings.
In simple words: A small device is worn for a day or more to automatically check your blood pressure at regular intervals. The results are recorded and used by your doctor to get a better understanding of your blood pressure patterns.
This code represents the recording of ambulatory blood pressure measurements over a 24-hour period or longer using a device worn by the patient. The device automatically records blood pressure at predetermined intervals. This service includes only the recording of blood pressure, not the analysis, interpretation, or report generation.
Example 1: A patient presents with elevated blood pressure readings in the clinic, but denies symptoms of hypertension at home. Ambulatory blood pressure monitoring is ordered to evaluate for white coat hypertension., A patient with diagnosed hypertension is not responding well to medication. Ambulatory blood pressure monitoring is ordered to assess the efficacy of the current treatment regimen., A pregnant patient has elevated blood pressure. Ambulatory blood pressure monitoring is used to evaluate for gestational hypertension.
Documentation should include the medical reason for the monitoring, the duration of the monitoring period, and any symptoms experienced by the patient during the monitoring period.
** CPT 93786 covers only the recording of the blood pressure.Analysis and interpretation require a separate code.Medicare coverage requires a diagnosis of white coat hypertension. Medicare will only pay for ambulatory blood pressure monitoring with one of these diagnosis codes attached. I10 is essential hypertension.R85.1 is abnormal finding of blood pressure measurement without diagnosis of hypertension. This code will often not get paid by medicare unless it meets the criteria above. This test needs to be conducted over 24 hours to get paid by medicare. The monitor and equipment is provided by a Durable Medical Equipment vendor (DME) and requires a separate claim from the technical placement of the monitor.The recording of blood pressure code 93786 should be billed along with the interpretation codes 93784 - 93790.
- Revenue Code: T2D - OTHER TESTS - OTHER
- Modifier TC rule: Not applicable
- Specialties:Cardiology, Internal Medicine, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Home