HCPCS G8755: Most Recent Diastolic Blood Pressure ≥ 90 mmHg - OpenPayer

Summary & Overview

HCPCS G8755: Most Recent Diastolic Blood Pressure ≥ 90 mmHg

HCPCS Level II code G8755 represents a documented clinical outcome where the most recent diastolic blood pressure is greater than or equal to 90 mmHg. As an indicator tied to blood pressure control, this code is used in outpatient settings to flag elevated diastolic readings that may require clinical follow-up. Nationally, such measures are central to quality reporting, population health management, and performance measurement for hypertension control.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how G8755 is defined and applied, what it signals clinically, and why it matters for payer quality programs and reporting. The publication outlines typical sites of service, common contexts for use, and where this measure fits within broader hypertension management initiatives.

This summary provides benchmarks and context for clinical teams, coding professionals, and payers regarding documentation expectations and the role of this outcome-oriented code in quality measurement. Information on modifiers, taxonomies, and diagnosis coding is not available in the input and will be addressed separately when provided.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG8755HCPCS Level IIblood pressurehypertensionquality measureoutpatientvital signsperformance measure

Billing Code Overview

HCPCS Level II code G8755 denotes a recorded clinical measurement indicating the most recent diastolic blood pressure is greater than or equal to 90 mmHg. This code is a performance/outcome descriptor tied to blood pressure control metrics and reflects a hypertensive-range diastolic value.

Service type: Blood pressure measurement and documentation of an elevated diastolic value
Typical site of service: Outpatient clinical settings where vital signs are measured, such as primary care clinics, cardiology clinics, community health centers, and ambulatory care locations

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with a history of hypertension and type 2 diabetes presents to a primary care clinic for a routine chronic disease management visit. Nursing staff obtain vital signs at triage; the most recent automated or manual blood pressure measurement records a diastolic blood pressure of 94 mmHg. The clinician reviews the measurement, documents it in the medical record, assesses current antihypertensive therapy, and documents counseling regarding lifestyle and medication adherence. The documented finding of a most recent diastolic blood pressure ≥ 90 mmHg is used for quality reporting, population health registries, and may impact performance measures for blood pressure control.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or intensity for the visit is substantially greater than typical for the service provided and additional documentation supports the increase.
`23`	Unusual anesthesia	Use when an otherwise non-anesthesia service requires anesthesia due to unusual circumstances.

Related Codes

HCPCS-G9806-CERVICAL-CYTOLOGY-HPV-TEST

HCPCS G9806: Cervical Cytology or HPV Test

HCPCS-G2003-MODERATE-POST-DISCHARGE-IN-HOME-VISIT-NEW-PATIENT

HCPCS G2003: Moderate Post-Discharge In-Home Visit for New Patients

HCPCS-G9759-HISTORY-PREOPERATIVE-POSTERIOR-CAPSULE-RUPTURE

HCPCS G9759: History of Preoperative Posterior Capsule Rupture

HCPCS-G0239-GROUP-RESPIRATORY-THERAPY-MUSCLE-STRENGTH-ENDURANCE

HCPCS G0239: Group Respiratory Therapy for Muscle Strength and Endurance

HCPCS-G9585-OPIOID-RISK-SCREENING-NOT-DONE

HCPCS G9585: Opioid Risk Screening Not Completed

HCPCS-G8981-CHANGING-MAINTAINING-BODY-POSITION-ASSESSMENT

HCPCS G8981: Changing & Maintaining Body Position Functional Assessment

HCPCS-G9321-CT-AND-CARDIAC-NUCLEAR-IMAGING-PRIOR-STUDY-COUNT

HCPCS G9321: Prior CT and Cardiac Nuclear Imaging Study Count

HCPCS-G9562-OPIOID-THERAPY-QUARTERLY-FOLLOW-UP-EVALUATION

HCPCS G9562: Follow-Up Evaluation During Opioid Therapy, Quarterly

HCPCS-G9316-RISK-ASSESSMENT-PATIENT-COMMUNICATION

HCPCS G9316: Patient-Specific Risk Assessment and Communication

HCPCS-G9805-HOSPICE-SERVICES-MEASUREMENT-PERIOD

HCPCS G9805: Hospice Services During Measurement Period

Showing 1–10 of 1996

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care providers commonly document blood pressure and manage hypertension.
`207R00000X`	Internal Medicine	Internists frequently assess and treat elevated diastolic blood pressure.
`208D00000X`	Cardiovascular Disease (Cardiology)	Cardiologists manage complex hypertension and assess cardiovascular risk.
`163W00000X`	Nurse Practitioner	Nurse practitioners often obtain vitals and document BP in outpatient visits.
`367A00000X`	Physician Assistant	Physician assistants commonly perform clinic visits and document blood pressure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I10`	Essential (primary) hypertension	Primary diagnosis for patients with persistently elevated diastolic blood pressure and the most common reason for BP documentation.
`I15.0`	Renovascular hypertension	Secondary cause of elevated diastolic BP; considered when BP is resistant to treatment.
`I11.9`	Hypertensive heart disease without heart failure	Elevated diastolic BP contributes to hypertensive cardiac changes; relevant for risk stratification.
`E11.9`	Type 2 diabetes mellitus without complications	Common comorbidity that increases cardiovascular risk in patients with elevated diastolic BP.
`I12.9`	Hypertensive chronic kidney disease with stage unspecified chronic kidney disease	Elevated diastolic BP can indicate or worsen hypertensive kidney disease; used when kidney involvement is present.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M visit code used when evaluating and documenting elevated diastolic blood pressure in an established patient.
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, typically 25 minutes	Use when the visit requires moderate to high complexity medical decision making related to uncontrolled blood pressure and comorbidities.
`99406`	Smoking and tobacco use cessation counseling intermediate, greater than 3 minutes up to 10 minutes	Often provided as part of lifestyle counseling when addressing hypertension risk factors.
`99407`	Smoking and tobacco use cessation counseling intensive, greater than 10 minutes	Use when extended counseling on tobacco cessation is provided during hypertension management.
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Ordered as part of cardiovascular risk assessment when elevated diastolic BP suggests target organ effects.