Clinical Medical Policy Department Clinical Affairs Division DESCRIPTION
|
|
- Frederica O’Neal’
- 6 years ago
- Views:
Transcription
1 Ambulatory Blood Pressure Monitoring (ABPM) [For the list of services and procedures that need preauthorization, please refer to go to Comunicados a Proveedores, and click Cartas Circulares.] Medical Policy: MP-ME Original Effective Date: February 18, 2009 Revised: April 24, 2017 Next Revision: April, 2018 This policy applies to products subscribed by the following corporations, MCS Life Insurance Company (Commercial), and MCS Advantage, Inc. (Classicare) and, provider s contract; unless specific contract limitations, exclusions or exceptions apply. Please refer to the member s benefit certification language for benefit availability. Managed care guidelines related to referral authorization, and precertification of inpatient hospitalization, home health, home infusion and hospice services apply subject to the aforementioned exceptions. DESCRIPTION Ambulatory Blood Pressure Monitoring (ABPM) is a medical device worn by the patient that takes Blood Pressure (BP) measurements over a 24 to 48 hour period, usually every 15 to 20 minutes during the daytime and every 30 to 60 minutes during sleep. These blood pressures are recorded on the device, and the average day (diurnal) or night (nocturnal) blood pressures are determined from the data by a computer. The percentage of BP readings exceeding the upper limit of normal can also be calculated (UpToDate /Kaplan, 2017). Ambulatory Blood Pressure Monitoring (ABPM) is being increasingly recommended for routine clinical practice (UpToDate /Kaplan, 2017). It provides valuable diagnostic information that in-clinic and home blood pressure monitoring systems are incapable of measuring including: Blood Pressure (BP) variability and a more accurate estimation of true blood pressure; Overnight changes in blood pressure (i.e., Dipper Status); and Morning surges in BP. In general, ABPM is recognized in the medical community as a valuable tool for supporting the management of appropriate pharmacologic treatment as well as the assessment of White Coat Hypertension (WCH); Resistant Hypertension; Masked Hypertension; Hypotensive symptoms with hypertensive medications (STM, 2016), all further defined under the Indications Section. COVERAGE Benefits may vary between groups and contracts. Please refer to the appropriate member certificate and subscriber agreement contract for applicable diagnostic imaging, DME, laboratory, machine tests, benefits, and coverage. 1
2 INDICATIONS, (MCS) considers medically necessary, for Both the Commercial and Classicare (Advantage) lines of business (LOB), the use of Ambulatory Blood Pressure Monitoring (ABPM) when ordered by a physician for the evaluation of Both Pediatric and Adult patients with Any of the following conditions: 1. Suspected White Coat Hypertension (WCH) defined as: a. Office blood pressure > 140/90 mmhg on a least three separate clinic/office visits with two separate measurements made at each visit; b. At least two documented separate blood pressure measurements taken outside the office which are < 140/90mm Hg; and c. No evidence of end-organ damage. 2. Resistant hypertension that is refractory to medication. 3. Hypotensive symptoms and/or syncopal events that are thought to be related to antihypertensive medications. 4. Episodic hypertension suspected when office blood pressure measurements are normal and symptoms suggest episodic hypertension secondary to an existing condition. 5. Suspected nocturnal hypertension. 6. When there is a large discrepancy between clinic and home BP measurements. 7. Management of isolated systolic hypertension in patients age 60 or older. 8. Autonomic Dysfunction. LIMITATIONS 1. The information obtained by ABPM is necessary in order to determine the appropriate management of the patient. ABPM is not covered for any other uses. 2. In the rare circumstance that ABPM needs to be performed more than once in a patient, the qualifying criteria described above must be met for each subsequent ABPM test. 3. The ABPM must be performed for at least 24 hours to meet coverage criteria. 2
3 4. ABPM is designated as an outpatient service; patients admitted to a hospital or residing in institutions, such as Skilled Nursing Facilities (SNFs), who receive ABPM, are not qualified for coverage. CODING INFORMATION FOR BOTH THE COMMERCIAL and CLASSICARE (ADVANTAGE) LOB CPT Codes (List may not be all inclusive) CPT Codes Description Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; recording only Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; scanning analysis with report Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; review with interpretation and report Current Procedural Terminology (CPT ) 2017 American Medical Association: Chicago, IL. ICD-10 Codes (List may not be all inclusive) ICD-10 Codes I10 Essential (primary) hypertension Description I11.0 Hypertensive heart disease with heart failure I11.9 Hypertensive heart disease without heart failure I12.0 Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease I12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney dis ease I13.10 Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease I13.11 Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney dis ease, or end stage renal disease I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease I15.0 Renovascular hypertension I15.1 Hypertension secondary to other renal disorders I15.2 Hypertension secondary to endocrine disorders 3
4 I15.8 Other secondary hypertension I15.9 Secondary hypertension, unspecified I95.1 Orthostatic hypotension N26.2 Page kidney R03.0 Elevated blood-pressure reading, without diagnosis of hypertension R55 Syncope and collapse REFERENCES 1. American Academy of Family Physicians (AAFP) (2005, February 1). Management of Hypertension in Older Persons. American Family Physician Volume 71, Issue 3, Pages Accessed April 13, Available at URL address: 2. American Academy of Family Physicians (AAFP) (2003, June 1). Automated Ambulatory Blood Pressure Monitoring: Clinical Utility in the Family Practice Setting. American Family Physician. Volume 67, Issue 11, Pages Accessed April 13, Available at URL address: 3. American Academy of Pediatrics (AAP) (2004, August 1). Supplement Article: The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Used Topic: ABPM. Pediatrics: Volume 114, Supplement Number 2, Pages Accessed April 13, Available at URL address: or 4. American Diabetes Association (ADA) (2013, August). Ambulatory Blood Pressure Monitoring (ABPM). Diabetes Care: Volume 36, Supplement 2, Pages S307 - S311. DOI: /dcS Accessed April 13, Available at URL address: and at URL address: 5. American Heart Association (AHA) (2014). Update: AHA Scientific Statement Update: Ambulatory Blood Pressure Monitoring in Children and Adolescents. Hypertension: 63: DOI: /HYP Page Accessed April 13, Available at URL address: and at URL address: 6. American Heart Association (AHA) (2013, December). Ambulatory Blood Pressure Measurement What Is the International Consensus? Page 990. Hypertension: 62: DOI: /HYPERTENSIONAHA Accessed April 13, Available at URL address: and at URL address: 4
5 7. Brown, M. (2014, January). Is there a role for Ambulatory Blood Pressure Monitoring (ABPM) in pregnancy? Clinical and Experimental Pharmacology and Physiology: 41 (1), DOI: / Accessed April 17, Available at URL address: 8. Centers for Medicare and Medicaid Services (CMS) (2016). Medicare Claims Processing Manual (CPM) Chapter 32- Billing Requirements for Special Services: Section Ambulatory Blood Pressure Monitoring (ABPM) Billing Requirements for Special Services. Rev. 3556, done 07/01/2016. Accessed April 17, Available at URL address: Guidance/Guidance/Manuals/downloads/clm104c32.pdf 9. Centers for Medicare and Medicaid Services (CMS) (2003). National Coverage Determination (NCD) for Ambulatory Blood Pressure Monitoring (20.19). Version Number 2. Effective Date of this Version: 7/1/2003. Implementation Date: 7/1/2003. Accessed April 17, Available at URL address: European Society of Hypertension (ESH) with the European Society of Cardiology (ESC) (2013, July) ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the Management of Arterial Hypertension of ESH and of ESC. Journal of Hypertension Volume 31, Number 7, Pages Accessed April 17, Available at URL address: Journal of the American Medical Association (JAMA) (2014). Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA: Volume 311, Number Accessed April 17, Available at URL Address: National Heart, Lung, and Blood Institute (NIH) (2005). The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. NIH Publication No Originally printed September 1996 ( ). Revised: May Page 17 (Ambulatory Blood Pressure Monitoring). Accessed April 17, Available at URL address: and at URL address: National Heart, Lung, and Blood Institute (NIH) (2004, August). Complete Report - The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7). NIH Publication No Page 19. Accessed April 17, Available at URL address: f, and at URL address: or at URL address: 5
6 14. Segura, J.; Banegas, J.; & Ruilope, L. (2014, January). Usefulness of ambulatory blood pressure monitoring (ABPM) in daily clinical practice: Data from the Spanish ABPM registry. Clinical and Experimental Pharmacology and Physiology Volume 41, Issue 1, Pages DOI: / Accessed April 17, Available at URL address: and at URL address: SunTech Medical, Inc. (STM) (2016). Ambulatory Blood Pressure Monitoring (ABPM). Accessed April 17, Available at URL address: UpToDate /Kaplan, N. (2017). Ambulatory blood pressure monitoring and white coat hypertension in adults. Literature review current through: March This topic last updated: October 13, Accessed April 17, Available at URL address: UpToDate /Flynn, J. (2017). Ambulatory blood pressure monitoring in children. Literature review current through: March This topic last updated: March 23, Accessed April 17, Available at URL address: =2~ WebMD LLC. / Matthew, A. & Yang, e. (2017). Hypertension Differential Diagnoses Updated: March 23, Accessed April 17, Available at URL address: POLICY HISTORY DATE ACTION COMMENT February 18, 2009 Origination of Policy February 18, 2010 Revised Ambulatory Blood Pressure Monitoring is revised to add the contraindications and limitations. February 18, 2011 Yearly Revision Experimental/Experimental list added. January 12, 2012 Yearly Revision References Updated. February 25, 2013 Revised References Updated. Added new reference, number 6. To the Indications Section: Added Indication # 8. February 21,2014 Revised To the Coding section: A new ICD-10 Codes (Preview Draft) section was added to the policy. April 10, 2014 Revised References Updated. Added new references, numbers 1-3, 5-11, 13-16, 18-23, 26-32, and 34. To the Descriptions Section: Deleted: The percentage of patients presenting hypertension 6
7 signs has increased and as a result patients are exposed to organ damage, higher risks for strokes, heart disease, heart attacks, and kidney failure. Deleted: High blood pressure usually has no symptoms and controlling hypertension can become challenging. Therefore, the physician along with the patient must work together to find the best way to lower blood pressure. The only way to find out the blood pressure (BP) is too high is to check it with a pressure monitor. The higher the BP is the more often should be check. Deleted: Blood Pressure (BP) as recorded in the office setting is the standard technique recommended for the measurement of BP in routine medical care. The standard technique for the auscultatory method of BP measurement in the office setting requires a properly calibrated and validated instrument; the patient seated quietly for at least five minutes in a chair rather than on the examination table, with feet on the floor and arm supported at heart level. At least two measurements should be made on each of two or more office visits. The mean of those readings should be recorded and given to the patient along with the goals for blood pressure management. Deleted: Office or clinic blood pressure measurements have limitations; blood pressure fluctuates throughout the day and specific ranges are associated with normal, hypertension and hypotension. On the other hand, some patients, elevated blood pressure may only be detected in the physician office and this pattern can be in response to the medical environment (condition known as white coat hypertension). Because of this, the numbers of measurements obtained in the office may not always reflect a patient s true average blood pressure. Deleted: Ambulatory blood pressure monitoring (ABPM) is a noninvasive method of measuring regular blood pressure readings, regularly over a 24-hour period, as patients conduct their normal activities. A special, automatic blood pressure monitor is used, and patients are asked to keep a diary or log of their activities. These 24-hour measurements are stored in the device and are later interpreted by the physician. Deleted: ABPM devices consist of an inflatable cuff with pressure regulators and valves to measure BP, a cuff microphone or sound transducer and microprocessor to detect and interpret BP sounds, mechanisms for programming and recording BP readings, and an inflation bulb for semiautomatic devices. There are various types of devices including: fully automated, which inflate at pre-programmed intervals; semiautomated, which are patient-activated; and transtelephonic, which allow the use of telephones to transmit measured automatic digital readings to a computer-assisted receiver. The devices are lightweight and quiet and use auscultatory or oscillometric methods, or both. Added: Hypertension, or high blood pressure, is a chronic condition defined by elevated blood pressure in the arteries. Normal blood pressure at rest is usually 100 to 140 mm Hg systolic and 60 to 90 mm Hg diastolic. Because hypertension is asymptomatic, it can be detected only by screening. Simple blood-pressure cuff tests are routinely performed as part of most physical exams. However, office assessments of blood pressure may not be very accurate: the manual cuffs require subjective assessment, many people develop temporary blood pressure elevations in doctor s offices (i.e., white coat hypertension ), and definitive changes in blood pressure occur throughout the day due to the circadian rhythm. One possible approach to obtaining reliable blood pressure measurements is through continuous Ambulatory Blood Pressure Monitoring 7
8 (ABPM). Added: Ambulatory Blood Pressure Monitoring (ABPM) is a noninvasive, fully-automated technique in which blood pressure is recorded over an extended period of time, typically 24 hours. The APBM device is a wearable blood pressure cuff or finger-cuff with a monitor. During a typical ABPM session, the device will inflate the cuff and measure blood pressure every 15 to 30 minutes over a 24-hour period, including both awake and asleep hours, preferably on a workday. The total number of readings usually varies between 50 and 100. Blood pressure data are stored in a monitor and then downloaded and analyzed using device-specific computer software. In general, ABPM devices consist of a standard blood-pressure cuff attached to a small computer, which the user wears at the waist or on a shoulder strap. The patient wears the device continuously for 24 hours, during which the monitor collects information on blood pressure multiple times (ECRI, 2013). To entire medical policy: Changed the word member to the word patient. June 27, 2015 Revised To the References Section: References updated. Deleted obsolete, unavailable and non-used references for 2015 revision. Added new references, numbers 5, 11, and 15. To the Description Section: Deleted entire previous information. Added: Ambulatory Blood Pressure Monitoring (ABPM) is determined using a device worn by the patient that takes Blood Pressure (BP) measurements over a 24- to 48-hour period, usually every 15 to 20 minutes during the daytime and every 30 to 60 minutes during sleep. These blood pressures are recorded on the device, and the average day (diurnal) or night (nocturnal) blood pressures are determined from the data by a computer. The percentage of BP readings exceeding the upper limit of normal can also be calculated (UpToDate /Kaplan, 2015). Added: Ambulatory Blood Pressure Monitoring (ABPM) is being increasingly recommended for routine clinical practice (UpToDate /Kaplan, 2015). It provides valuable diagnostic information that in-clinic and home blood pressure monitoring systems are incapable of measuring including: Blood Pressure (BP) variability and a more accurate estimation of true blood pressure; Overnight changes in blood pressure (i.e., Dipper Status); and Morning surges in BP. In general, ABPM is recognized in the medical community as a valuable tool for supporting the management of appropriate pharmacologic treatment as well as the assessment of: White Coat Hypertension (WCH); Resistant Hypertension; Masked Hypertension; and Hypotensive symptoms with hypertensive medications (STM, 2015), all further defined under the Indications Section. To the Indications Section: Restructured coverage statement as follows: For Both the Commercial and Classicare (Advantage) Lines of Business (LOB):, (MCS) considers medically necessary the use of Ambulatory Blood Pressure Monitoring (ABPM) when ordered by a physician for the evaluation of Both Pediatric and 8
9 Adult patients with Any of the following conditions. To the Experimental/Investigational/Unproven Section: Deleted entire section, based on content of Limitation #1 (i.e., ABPM is not covered for any other uses). To the Limitations Section: Revised and restructured content of Limitation #4 as follows: ABPM is designated as an outpatient service; patients admitted to a hospital or residing in institutions, such as Skilled Nursing Facilities (SNFs), who receive ABPM, are not qualified for coverage. Deleted Limitation #5: A physician is required to perform the interpretation of the data obtained through ambulatory blood pressure monitoring. There are no requirements regarding the setting in which the interpretation is performed. To the Coding Information: Clarification was made that Coding Information applies to Both LOB. To the ICD-9-CM Codes Section, added codes: and To the ICD-10 Codes Section, added codes: I95.89 and I95.9. November 23, 2015 Revised To the coding section: Eliminate ICD-9 codes since they are no longer valid for diagnosis classification. Add new section of ICD-10 codes which are the valid diagnosis classification system since October 1, March 30, 2016 Revised References were Updated. April 24, 2017 Revised References were Updated. To the References Section: New Reference #12 was added to the Policy. To the Description section: Phrase determined using was deleted and a new phrase was added to the first paragraph. To the References Section: Reference #8 and 16 were deleted from this Policy. This document is for informational purposes only. It is not an authorization, certification, explanation of benefits, or contract. Receipt of benefits is subject to satisfaction of all terms and conditions of coverage. Eligibility and benefit coverage are determined in accordance with the terms of the member s plan in effect as of the date services are rendered., (MCS) medical policies are developed with the assistance of medical professionals and are based upon a review of published and unpublished information including, but not limited to, current medical literature, guidelines published by public health and health research agencies, and community medical practices in the treatment and diagnosis of disease. Because medical practice, information, and technology are constantly changing, Medical Card System, Inc., (MCS) reserves the right to review and update its medical policies at its discretion., (MCS) medical policies are intended to serve as a resource to the plan. They are not intended to limit the plan s ability to interpret plan language as deemed appropriate. Physicians and other providers are solely responsible for all aspects of medical care and treatment, including the type, quality, and levels of care and treatment they choose to provide. 9
Direct Current Therapy for Treatment of Hemorrhoids
Direct Current Therapy for Treatment of Hemorrhoids [For the list of services and procedures that need preauthorization, please refer to www.mcs.com.pr go to Comunicados a Proveedores, and click Cartas
More informationClinical Medical Policy Department Clinical Affairs Division DESCRIPTION
Prothrombin Time/International Normalized Ratio (PT/INR) Monitor for Home Anticoagulation Management [For the list of services and procedures that need preauthorization, please refer to www.mcs.com.pr.
More informationEndovenous Radiofrequency and Laser Ablation
Endovenous Radiofrequency and Laser Ablation [For the list of services and procedures that need preauthorization, please refer to www.mcs.com.pr go to Comunicados a Proveedores, and click Cartas Circulares.]
More informationAmbulatory BP Monitoring: Getting the Diagnosis of Hypertension Right. Anthony J. Viera, MD, MPH, FAHA Professor and Chair
Ambulatory BP Monitoring: Getting the Diagnosis of Hypertension Right Anthony J. Viera, MD, MPH, FAHA Professor and Chair Objectives Review limitations of office BP in making a correct diagnosis of hypertension
More informationWelch Allyn ABPM 6100S. Comprehensive blood pressure monitoring that brings patient comfort home.
Welch Allyn ABPM 6100S Comprehensive blood pressure monitoring that brings patient comfort home. Features and Benefits of the Welch Allyn ABPM 6100S Pictorial application instructions, artery markers and
More informationMEDICAL POLICY No R1 MEDICAL MANAGEMENT OF OBESITY
MEDICAL MANAGEMENT OF OBESITY Effective Date: May 10, 2017 Review Dates: 8/11, 12/11, 2/12, 2/13, 2/14, 2/15, 2/16, 2/17 Date Of Origin: August 10, 2011 Status: Current Note: This medical policy does not
More informationMEDICAL POLICY SUBJECT: AUTOMATED AMBULATORY BLOOD PRESSURE MONITORING
MEDICAL POLICY SUBJECT: AUTOMATED AMBULATORY 02/19/09 PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including
More informationORIGINAL ARTICLE AMBULATORY BLOOD PRESSURE IN OBESITY. Introduction. Patients and Methods
Vol. 2, Issue 1, pages 31-36 ORIGINAL ARTICLE AMBULATORY BLOOD PRESSURE IN OBESITY By Alejandro de la Sierra, MD Luis M. Ruilope, MD Hypertension Units, Hospital Clinico, Barcelona & Hospital 12 de Octubre,
More informationAmbulo Ambulatory Blood Pressure Monitoring Systems. Innovative Diagnostics Better Care
Ambulo 2400 Ambulatory Blood Pressure Monitoring Systems Innovative Diagnostics Better Care About Tiba Medical Private medical device company founded in 2003 and based in Portland, Oregon, USA Focused
More informationIs Traditional Clinic Blood Pressure Dead?
Royal College of Physicans May 16 th 2017 Is Traditional Clinic Blood Pressure Dead? Professor Bryan Williams MD FRCP FAHA FESC Chair of Medicine UCL Director National Institute for Health Research Biomedical
More informationAssessing Blood Pressure for Clinical Research: Pearls & Pitfalls
Assessing Blood Pressure for Clinical Research: Pearls & Pitfalls Anthony J. Viera, MD, MPH, FAHA Department of Family Medicine Hypertension Research Program UNC School of Medicine Objectives Review limitations
More informationImportance of Ambulatory Blood Pressure Monitoring in Adolescents
Importance of Ambulatory Blood Pressure Monitoring in Adolescents Josep Redon, MD, PhD, FAHA Internal Medicine Hospital Clinico Universitario de Valencia University of Valencia CIBERObn Instituto de Salud
More information4/4/17 HYPERTENSION TARGETS: WHAT DO WE DO NOW? SET THE STAGE BP IN CLINICAL TRIALS?
HYPERTENSION TARGETS: WHAT DO WE DO NOW? MICHAEL LEFEVRE, MD, MSPH PROFESSOR AND VICE CHAIR DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE UNIVERSITY OF MISSOURI 4/4/17 DISCLOSURE: MEMBER OF THE JNC 8 PANEL
More informationMEDICAL POLICY No R4 NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL TESTING
NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL TESTING Effective Date: October 1, 2015 Review Dates: 7/07, 6/08, 6/09, 8/09, 8/10, 8/11, 8/12, 8/13, 8/14, 8/15, 8/16, 8/17 Date Of Origin: July 2007 Status: Current
More informationGETTING THE NUMBERS RIGHT: ACCURATE MEASUREMENT OF BLOOD PRESSURE
GETTING THE NUMBERS RIGHT: ACCURATE MEASUREMENT OF BLOOD PRESSURE Pamela B. Morris, MD, FACC, FAHA, FASPC, FNLA Professor Medicine and Cardiovascular Diseases Director, Seinsheimer Cardiovascular Health
More informationSTATE OF THE ART BP ASSESSMENT
STATE OF THE ART BP ASSESSMENT PROFESSOR MOLECULAR PHARMACOLOGY CONWAY INSTITUE UNIVERSITY COLLEGE DUBLIN CO-CHAIRMAN BLOOD PRESCSURE MANAGEMENT IN LOW RESOURCE SETTINGS CENTRE FOR INTERNATIONAL HUMANITARIAN
More informationMEDICAL POLICY No R9 DETOXIFICATION I. POLICY/CRITERIA
DETOXIFICATION MEDICAL POLICY Effective Date: January 1, 2018 Review Dates: 1/93, 2/97, 4/99, 2/01, 12/01, 2/02, 2/03, 1/04, 1/05, 12/05, 12/06, 12/07, 12/08, 12/09, 12/10, 12/11, 12/12, 12/13, 11/14,
More informationAMBULATORY BLOOD PRESSURE REPORT. Patient Name: Sample 2 - Systolic Hypertension Patient ID: Test Date: 15-Sep-2005
Interpretive Summary Based upon JNC 7 and AHA recommendations, the ABPM data suggests 24 hour SYS hypertension (136 mmhg) with normal 24 hour DIA pressure (73 mmhg) Awake SYS hypertension (138 mmhg) with
More informationAmbulatory Blood Pressure Monitoring Clinical Practice Recommendations
Acta Medica Marisiensis 2016;62(3):350-355 DOI: 10.1515/amma-2016-0038 UPDATE Ambulatory Blood Pressure Monitoring Clinical Practice Recommendations Mako Katalin *, Ureche Corina, Jeremias Zsuzsanna University
More informationQuality ID #122: Adult Kidney Disease: Blood Pressure Management National Quality Strategy Domain: Effective Clinical Care
Quality ID #122: Adult Kidney Disease: Blood Pressure Management National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Intermediate
More informationBLOOD PRESSURE MEASUREMENT HOME BASED OR OFFICE BP MONITORING WHICH, HOW AND WHEN?
BLOOD PRESSURE MEASUREMENT HOME BASED OR OFFICE BP MONITORING WHICH, HOW AND WHEN? DECLARATION OF INTEREST Medical Director and Chairman, Advisory Board dabl Ltd., Dublin, Ireland. BLOOD PRESSURE MEASUREMENT
More informationMEDICAL POLICY No R8 EATING DISORDERS POLICY/CRITERIA
EATING DISORDERS MEDICAL POLICY Effective Date: June 27, 2016 Review Dates: 1/93, 8/96, 4/99, 12/01, 12/02, 11/03, 11/04, 10/05, 10/06, 10/07, 8/08, 8/09, 8/10, 8/11, 8/12, 8/13, 5/14, 5/15, 5/16 Date
More informationKDIGO Controversies Conference on Blood Pressure in CKD
KDIGO Controversies Conference on Blood Pressure in CKD September 7-10, 2017 Edinburgh, Scotland Kidney Disease: Improving Global Outcomes (KDIGO) is an international organization whose mission is to improve
More informationK/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease
K/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease GUIDELINE 1: GOALS OF ANTIHYPERTENSIVE THERAPY IN CKD Hypertension is common in CKD, and is a risk
More informationTodd S. Perlstein, MD FIFTH ANNUAL SYMPOSIUM
Todd S. Perlstein, MD FIFTH ANNUAL SYMPOSIUM Faculty Disclosure I have no financial interest to disclose No off-label use of medications will be discussed FIFTH ANNUAL SYMPOSIUM Recognize changes between
More informationHipertensión enmascarada. Alejandro de la Sierra Hospital Mútua Terrassa Universitat de Barcelona
Hipertensión enmascarada Alejandro de la Sierra Hospital Mútua Terrassa Universitat de Barcelona HTA enmascarada Definición Prevalencia Características clínicas Riesgo derivado Asociación con LOD Progresión
More informationBOTOX Injection (Onabotulinumtoxin A) for Chronic Migraine Headaches
BOTOX Injection (Onabotulinumtoxin A) for Chronic Migraine Headaches [For the list of services and procedures that need preauthorization, please refer to www.mcs.com.pr go to Comunicados a Proveedores,
More informationEgyptian Hypertension Guidelines
Egyptian Hypertension Guidelines 2014 Egyptian Hypertension Guidelines Dalia R. ElRemissy, MD Lecturer of Cardiovascular Medicine Cairo University Why Egyptian Guidelines? Guidelines developed for rich
More informationChapter 4 Section Combined Heart-Kidney Transplantation (CHKT)
Surgery Chapter 4 Section 24.3 Issue Date: May 7, 1999 Authority: 32 CFR 199.4(e)(5) 1.0 POLICY 1.1 is a TRICARE benefit that requires preauthorization. 1.1.1 A TRICARE Prime enrollee must have a referral
More informationANTIHYPERTENSIVE DRUG THERAPY IN CONSIDERATION OF CIRCADIAN BLOOD PRESSURE VARIATION*
Progress in Clinical Medicine 1 ANTIHYPERTENSIVE DRUG THERAPY IN CONSIDERATION OF CIRCADIAN BLOOD PRESSURE VARIATION* Keishi ABE** Asian Med. J. 44(2): 83 90, 2001 Abstract: J-MUBA was a large-scale clinical
More informationInterested parties (organisations or individuals) that commented on the draft document as released for consultation.
23 June 2016 EMA/CHMP/345847/2015 Committee for Medicinal products for Human Use Overview of comments received on ''Guideline on clinical investigation of medicinal products in the treatment of hypertension'
More informationClinical Policy: Ambulatory Electroencephalography Reference Number: CP.MP.96
Clinical Policy: Ambulatory Electroencephalography Reference Number: CP.MP.96 Effective Date: 09/15 Last Review Date: 09/17 See Important Reminder at the end of this policy for important regulatory and
More informationDr Doris M. W Kinuthia
Dr Doris M. W Kinuthia Objectives Normal blood pressures in children Measurement of blood pressure in children Aetiology of Hypertension in children Evaluation of children with hypertension Treatment of
More informationAFFORDABLE TECHNOLOGY
World Health Organization AFFORDABLE TECHNOLOGY BLOOD PRESSURE MEASURING DEVICES FOR LOW RESOURCE SETTINGS CARDIOVASCULAR DISEASES Blood Pressure Measurement in Low Resource Settings Annex 1: Blood Pressure
More information가정혈압의활용 CARDIOVASCULAR CENTER. Wook Bum Pyun M.D., Ph.D. HOME BLOOD PRESSURE MONITORING. Ewha Womans University, school of Medicine
가정혈압의활용 HOME BLOOD PRESSURE MONITORING CARDIOVASCULAR CENTER Wook Bum Pyun M.D., Ph.D. pwb423@ewha.ac.kr Ewha Womans University, school of Medicine Non-Invasive Blood Pressure Measurement 5-20% Resistant
More informationProtocol. Automated Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure
Automated Ambulatory Blood Monitoring for the Diagnosis of Hypertension in Patients with Elevated Office Blood (10102) Medical Benefit Effective Date: 07/01/14 Next Review Date: 03/15 Preauthorization
More informationLumify. Lumify reimbursement guide {D DOCX / 1
Lumify Lumify reimbursement guide {D0672917.DOCX / 1 {D0672917.DOCX / 1 } Contents Overview 4 How claims are paid 4 Documentation requirements 5 Billing codes for ultrasound: Non-hospital setting 6 Billing
More informationClinical Policy: Digital EEG Spike Analysis
Clinical Policy: Reference Number: CP.MP.105 Last Review Date: 01/18 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationClinical Policy: Cochlear Implant Replacements Reference Number: CP.MP.14
Clinical Policy: Reference Number: CP.MP.14 Effective Date: 02/09 Last Review Date: 09/17 Revision Log Coding Implications See Important Reminder at the end of this policy for important regulatory and
More informationTaking and recording blood pressure and pulse. City Gate Training Centre all rights reserved
Taking and recording blood pressure and pulse City Gate Training Centre all rights reserved Course Content: Definition of Blood Pressure Normal Blood Pressure Readings Systolic and Diastolic Blood Pressure
More information5.2 Key priorities for implementation
5.2 Key priorities for implementation From the full set of recommendations, the GDG selected ten key priorities for implementation. The criteria used for selecting these recommendations are listed in detail
More informationUltrasound Reimbursement Guide 2015: BioJet Fusion
Ultrasound Reimbursement Guide 2015: BioJet Fusion Diagnosis codes explain the rationale for a given service and are a key factor in a payer s evaluation of medical necessity and coverage determination
More informationTIP. Documentation and coding guide. Disease definitions* Prevalence and statistics associated with HTN**
Documentation and coding guide Disease definitions* HTN is diagnosed when the average of two or more (systolic of diastolic) blood pressure readings are found to be elevated on two or more office visits
More informationAmbulatory Blood Pressure Monitoring
Ambulatory Blood Pressure Monitoring and Devices Chapter.1 Enrollment..................................................................... -2.2 Benefits, Limitations, and Authorization Requirements...........................
More informationDr Diana R Holdright. MD, FRCP, FESC, FACC, MBBS, DA, BSc. Consultant Cardiologist HYPERTENSION.
Dr Diana R Holdright MD, FRCP, FESC, FACC, MBBS, DA, BSc. Consultant Cardiologist HYPERTENSION www.drholdright.co.uk Blood pressure is the pressure exerted on the walls of the arteries when the heart pumps;
More informationClinical Policy: Cochlear Implant Replacements
Clinical Policy: Reference Number: CP.MP.14 Last Review Date: 07/18 Revision Log Coding Implications See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationPrimary hypertension in adults
Primary hypertension in adults NICE provided the content for this booklet which is independent of any company or product advertised Hypertension Welcome NICE published an updated guideline on the diagnosis
More informationCorporate Medical Policy
Corporate Medical Policy Continuous Monitoring of Glucose in the Interstitial Fluid File Name: Origination: Last CAP Review: Next CAP Review: Last Review: continuous_monitoring_of_glucose_in_the_interstitial_fluid
More informationHIGH BLOOD PRESSURE. What is malignant or accelerated hypertension?
HIGH BLOOD PRESSURE Is high blood pressure important? What is blood pressure? What is high blood pressure? What are the causes of high blood pressure? What are the symptoms of high blood pressure? What
More informationCHAPTER 4 SECTION 24.2 HEART TRANSPLANTATION TRICARE POLICY MANUAL M, AUGUST 1, 2002 SURGERY. ISSUE DATE: December 11, 1986 AUTHORITY:
SURGERY CHAPTER 4 SECTION 24.2 ISSUE DATE: December 11, 1986 AUTHORITY: 32 CFR 199.4(e)(5) I. CPT 1 PROCEDURE CODES 33940-33945, 33975-33980 II. POLICY A. Benefits are allowed for heart transplantation.
More information2/27/2017. Point of Care Testing- current and future opportunities for pharmacists in Virginia. Financial Disclosures. Pre-Assessment.
Point of Care Testing- current and future opportunities for pharmacists in Virginia Objectives Define the Pharmacy Practice Act in Virginia M AR G AR E T L AN D I S, P H AR M. D. K R O G E R P H AR M AC
More informationStudy of Ambulatory Blood Pressures in Hypertensive medical personnel controlled on Drugs: A cross sectional observational Study
International Journal of Scientific and Research Publicatio, Volume 6, Issue 2, February 2016 128 Study of Ambulatory Blood Pressures in Hyperteive medical personnel controlled on Drugs: A cross sectional
More informationChapter 4 Section 24.2
Surgery Chapter 4 Section 24.2 Issue Date: December 11, 1986 Authority: 32 CFR 199.4(e)(5) 1.0 CPT 1 PROCEDURE CODES 33940-33945, 33975-33980 2.0 POLICY 2.1 Benefits are allowed for heart transplantation.
More informationGenetic factors. A number of genetic factors or interactions between genes play a major role in essential hypertension.
Hypertension Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Hypertension is another term used to describe high blood pressure.
More information2017 AAP Guidelines for Childhood Hypertension
2017 AAP Guidelines for Childhood Hypertension Joseph T. Flynn, MD, MS, FAAP Professor of Pediatrics, University of Washington Chief, Division of Nephrology, Seattle Children s Hospital Disclaimer In the
More informationTitle: Automatic External Defibrillators Division: Medical Management Department: Utilization Management
Retired Date: Page 1 of 7 1. POLICY DESCRIPTION: Automatic External Defibrillators 2. RESPONSIBLE PARTIES: Medical Management Administration, Utilization Management, Integrated Care Management, Pharmacy,
More informationEvaluation and Management of Hypertension in Women. Vesna D. Garovic, M.D. Moscow, Russia, December 2016
Evaluation and Management of Hypertension in Women Vesna D. Garovic, M.D. Moscow, Russia, December 2016 2016 MFMER 3508058-1 Women are not small men There is nothing as powerful as an idea whose time has
More informationMedical Policy An Independent Licensee of the Blue Cross and Blue Shield Association
Ambulatory Blood Pressure Monitoring Page 1 of 14 Medical Policy An Independent Licensee of the Blue Cross and Blue Shield Association Title: Ambulatory Blood Pressure Monitoring Professional Institutional
More informationChanges to Texas Medicaid Hearing Services Benefits to Accompany PACT Transition
Changes to Texas Medicaid Hearing Services Benefits to Accompany PACT Transition Information posted July 31, 2009 Effective for dates of service on or after September 1, 2009, Texas Medicaid clients who
More informationPATIENT INFORMATION. Medicine To Treat: H ypertension. Patient Awareness and Self-Care
PATIENT INFORMATION Medicine To Treat: H ypertension Patient Awareness and Self-Care WHAT IS BLOOD PRESSURE AND HIGH BLOOD PRESSURE? Blood pressure is the force generated as your heart pumps blood and
More informationNew Hypertension Guideline Recommendations for Adults July 7, :45-9:30am
Advances in Cardiovascular Disease 30 th Annual Convention and Reunion UERM-CMAA, Inc. Annual Convention and Scientific Meeting July 5-8, 2018 New Hypertension Guideline Recommendations for Adults July
More informationAutomatic External Defibrillators
Last Review Date: April 21, 2017 Number: MG.MM.DM.10dC3v4 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
More informationAutomated Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure
Automated Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure Policy Number: 1.01.02 Last Review: 9/2014 Origination: 1/1989 Next Review:
More informationMedStar Health considers External Counterpulsation Therapy (ECP) medically necessary for the following indications:
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.107.MH External Counterpulsation Therapy This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar
More informationCLINICAL MEDICAL POLICY
Policy Name: Policy Number: Responsible Department(s): CLINICAL MEDICAL POLICY Single-use Ambulatory Electrocardiographic Monitors (e.g., Zio Patch) MP-076-MD-DE Medical Management Provider Notice Date:
More informationClinical Policy: Multiple Sleep Latency Testing
Clinical Policy: Reference Number: CP.MP.24 Last Review Date: 04/18 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: esophageal_ph_monitoring 4/2011 5/2017 5/2018 5/2017 Description of Procedure or Service Acid reflux is the
More informationOHTAC Recommendation: Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension. Ontario Health Technology Advisory Committee
OHTAC Recommendation: Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension Ontario Health Technology Advisory Committee May 2012 Background Hypertension in Canada Hypertension occurs when
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented National Quality Strategy Domain: Community / Population Health 2018 OPTIONS F INDIVIDUAL MEASURES:
More informationAMBULATORY BLOOD PRESSURE MONITORING AND DEVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL
AMBULATORY BLOOD PRESSURE MONITORING AND DEVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL FEBRUARY 2018 CSHCN PROVIDER PROCEDURES MANUAL FEBRUARY 2018 AMBULATORY B LOOD PRESSURE MONITORING AND DEVICES Table
More informationCPAP. The CPAP will be covered
CPAP CPAP Did your patient have a face to face visit with the physician prior to having a sleep study that documented (1) Sleep History and symptoms and/or (2) Epworth Scale and/or (3) Physical Examination?
More informationComparison of arbitrary definitions of circadian time periods with those determined by wrist actigraphy in analysis of ABPM data
Journal of Human Hypertension (1999) 13, 449 453 1999 Stockton Press. All rights reserved 0950-9240/99 $12.00 http://www.stockton-press.co.uk/jhh ORIGINAL ARTICLE Comparison of arbitrary definitions of
More information24-Hour Ambulatory Blood Pressure Monitoring
No. 15 Jan 2003 Before CCO decides to undertake a health technology assessment, a pre-assessment of the literature is performed. Pre-assessments are based on a limited literature search; they are not extensive,
More informationOxygen and Oxygen Equipment
Oxygen and Oxygen Equipment Policy Number: Original Effective Date: MM.01.008 12/01/2010 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 08/25/2017 Section: DME Place(s) of Service:
More informationQuality ID #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care
Quality ID #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS F INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Intermediate Outcome
More informationMEDICAL POLICY Cardiac Event Monitors/ Cardiac Event Detection
POLICY: PG0039 ORIGINAL EFFECTIVE: 10/01/11 LAST REVIEW: 12/12/17 MEDICAL POLICY Cardiac Event Monitors/ Cardiac Event Detection GUIDELINES This policy does not certify benefits or authorization of benefits,
More informationBlood Pressure Competency Training
Blood Pressure Competency Training WORKBOOK Table of Contents 3..... Introduction 4..... Background 6..... Equipment Accurate blood pressure What impacts a patient s blood pressure Strategies for proper
More informationStaff-Assisted Home Hemodialysis
Medical Coverage Policy Staff-Assisted Home Hemodialysis Table of Contents Coverage Policy... 1 Overview... 1 General Background... 2 Coding/Billing Information... 4 References... 4 Effective Date...11/15/2017
More informationName of Policy: Computerized Pulse Waveform Analysis
Name of Policy: Computerized Pulse Waveform Analysis Policy #: 020 Latest Review Date: September 2012 Category: Medical Policy Grade: Active Policy but no longer scheduled for regular literature reviews
More informationMeasuring Hypertension Control. Reporting Methods for Measure Up/Pressure Down
Measuring Hypertension Control and Reporting Methods for Measure Up/Pressure Down November 2013 Agenda Recent guideline activity regarding cardiovascular disease Current measurement approach for Measure
More informationNIA Magellan 1 and Blue Cross and Blue Shield of Nebraska (BCBSNE) Spine Surgery Program Frequently Asked Questions
NIA Magellan 1 and Blue Cross and Blue Shield of Nebraska (BCBSNE) Spine Surgery Program Frequently Asked Questions Question GENERAL Why is BCBSNE implementing a pain management program focused on spine
More informationHypertension and the SPRINT Trial: Is Lower Better
Hypertension and the SPRINT Trial: Is Lower Better 8th Annual Orange County Symposium on Cardiovascular Disease Prevention Saturday, October 8, 2016 Keith C. Norris, MD, PhD, FASN Professor of Medicine,
More informationBlueCHiP for Medicare Not applicable
Medical Coverage Policy Hearing Aid Mandate EFFECTIVE DATE: 01 14 2014 POLICY LAST UPDATED: 09 04 2018 OVERVIEW As defined by the Mandate, "hearing aid is any nonexperimental, wearable instrument or device
More informationMedicare Shared Savings Program Accountable Care Organization (ACO) Measures Deep Dive Series
Medicare Shared Savings Program Accountable Care Organization (ACO) Measures Deep Dive Series At-Risk Population (HTN-2): Measure 28 Hypertension (HTN): Controlling High Blood Pressure ACO_QRM28PPTv9_0518_IA
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS ONLY. MEASURE TYPE: Process
Quality ID #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented National Quality Strategy Domain: Community / Population Health 2018 OPTIONS F INDIVIDUAL MEASURES:
More informationSAMPLE. Behavioral Health Services
Coding and Payment Guide www.optumcoding.com Behavioral Health Services An essential coding, billing, and reimbursement resource for psychiatrists, psychologists, and clinical social workers 2017 a ICD-10
More informationThe accurate measurement of blood pressure
Position Paper ASH Position Paper: Home and Ambulatory Blood Pressure Monitoring When and How to Use Self (Home) and Ambulatory Blood Pressure Monitoring Thomas G. Pickering, MD, D Phil; 1 William B. White,
More informationHome Blood Pressure Log
Home Blood Pressure Log 2 You or your health care professional may want to monitor your blood pressure at home twice a day for a week or more before appointments to accurately confirm your average blood
More informationRecent Advances in Ambulatory Blood Pressure
C H A P T E R 150 Recent Advances in Ambulatory Blood Pressure Ashok L Kirpalani, Dilip A Kirpalani The understanding of Hypertension has evolved over the last century. A single mercury manometer reading
More informationObjectives. Describe results and implications of recent landmark hypertension trials
Hypertension Update Daniel Schwartz, MD Assistant Professor of Medicine Associate Medical Director of Heart Transplantation Temple University School of Medicine Disclosures I currently have no relationships
More informationNIH Public Access Author Manuscript JAMA Intern Med. Author manuscript; available in PMC 2015 August 01.
NIH Public Access Author Manuscript Published in final edited form as: JAMA Intern Med. 2014 August ; 174(8): 1397 1400. doi:10.1001/jamainternmed.2014.2492. Prevalence and Characteristics of Systolic
More informationWebinar Logistics. Now What Do I Need To Do? Blood Pressure in Kids January NC Department of Health and Human Services Division of Public Health
NC Department of Health and Human Services Division of Public Health Now What Do I Need To Do? Blood Pressure in Kids January 2018 Gerri Mattson, MD, MSPH, FAAP Pediatric Medical Consultant Children and
More informationData Collection Worksheet
Data Collection Worksheet 1. Has a doctor or nurse ever said that you have: High blood pressure or hypertension? [ ] No [ ] Yes [ ] Not Sure 1.a. If Yes, then at what age were you first told this? Age
More informationDEPARTMENT OF GENERAL MEDICINE WELCOMES
DEPARTMENT OF GENERAL MEDICINE WELCOMES 1 Dr.Mohamed Omar Shariff, 2 nd Year Post Graduate, Department of General Medicine. DR.B.R.Ambedkar Medical College & Hospital. 2 INTRODUCTION Leading cause of global
More informationCorporate Medical Policy Investigational (Experimental) Services
Corporate Medical Policy Investigational (Experimental) Services File Name: Origination: investigational_(experimental)_services 1/1996 Description of Procedure or Service BCBSNC defines the terms "investigational"
More informationPremier Health Plan considers Oral Appliances for Obstructive Sleep Apnea (OSA) medically necessary for the following indications:
Premier Health Plan POLICY AND PROCEDURE MANUAL MP.063.PH - al Appliances for Obstructive Sleep Apnea This policy applies to the following lines of business: Premier Commercial Premier Employee Premier
More information& Wilkins. a Division of Cardiology, Schulich Heart Centre, b Institute for Clinical and
Original article 333 Optimum frequency of office blood pressure measurement using an automated sphygmomanometer Martin G. Myers a, Miguel Valdivieso a and Alexander Kiss b,c Objective To determine the
More informationCHAPTER 3 SECTION 1.6E COMBINED LIVER-KIDNEY TRANSPLANTATION. TRICARE/CHAMPUS POLICY MANUAL M DEC 1998 Surgery And Related Services
TRICARE/CHAMPUS POLICY MANUAL 6010.47-M DEC 1998 Surgery And Related Services CHAPTER 3 SECTION 1.6E Issue Date: October 26, 1994 Authority: 32 CFR 199.4(e)(5) I. PROCEDURE CODE RANGE 47150 II. POLICY
More information