will apply to all services performed on or after the above revision date which
will become the new effective date.
services referred to in this policy that were performed before the revision
date, contact customer service for the rules that would apply.
Automated ambulatory blood
pressure monitoring is an outpatient procedure using fully or semi-automated
devices to measure ambulatory blood pressure at frequent intervals during the
day and night in an effort to determine the variability of a patient`s blood
pressure due to environmental stresses and to aid in the management of difficult
to control high blood pressure.
The use of automated or
semi-automated blood pressure monitoring has not been proven to be a
substantially more appropriate alternative to intermittent home self-monitoring.
Therefore, coverage is limited.