Ambulatory blood pressure monitoring (ABPM) is a diagnostic test used to measure blood pressure when isolated clinic blood pressure measurements are suspected to be inaccurate. ABPM is conducted under the supervision of a physician and does not entail patient intervention; it is not considered a self-monitoring device.
Medicare currently has a National Coverage Determination (NCD) on ABPM that covers the technology only for patients with suspected white coat hypertension. (Section 50-42 of the Coverage Issues Manual [CIM]). The CIM states that the 24-hour measurements collected by the ABPM "…are stored in the device and are later interpreted at the physician's office." However, the reference to the physician's office can be misleading. The intent of our policy was not that ABPM data be interpreted specifically in the setting of a physician's office, but rather that the data be interpreted by a physician, without specification of the setting.
Due to the potentially misleading language cited above, we will make a technical correction to Section 50-42 of the CIM to indicate that a physician is required to perform the interpretation of the data obtained from ABPM. The policy will not specify the setting in which the interpretation is performed.
November 12, 2002
January 16, 2003