Practical Tips for Accurate Blood Pressure Readings, Optimizing A1c, and Managing Statin Use in Patients With Diabetes
Posted by PHN Communications | Nov 11, 2026 | Star Central
Rechecks for Better Blood Pressure Control
Consider rechecking a patient’s blood pressure if the first reading is greater than or equal to 140/90 mmHg. Following this best practice can help facilitate assessment and appropriate administration of medication, improve member outcomes and treatment plans, and improve your practice’s blood pressure control rates and documentation practices, among other benefits.
- Empty bladder first. A full bladder adds 10 mmHg.
- Support back and feet. Unsupported, these add 6 mmHg.
- Keep legs uncrossed. Crossed legs add 2-8 mmHg.
- Use proper cuff size. One too small adds 2-10 mmHg.
- Cuff goes on bare arm. Over clothing adds 5-50 mmHg.
- Support arm at heart level. An unsupported arm adds 10 mmHg.
- Don’t have a conversation. Talking or active listening adds 10 mmHg.
Conduct rechecks at the end of a patient visit to rule out false elevations related to appointment anxiety. And document all blood pressure readings in the medical record. For quality measurement purposes, the reading closest to Dec. 31 is used.
For patients with high readings, consider reviewing the current medication regimen, discussing diet and exercise, and recommending blood pressure checks at home with a digital monitor.
*From the American Medical Association
Take Action Now for Year-End A1c Tests
The fourth quarter of the year is a critical time to identify, reach out to and retest patients with an open care gap for a glycemic assessment or an elevated glycemic result.
- Review patient lists for missing, outdated or elevated A1c results.
- Schedule testing early enough to allow time for treatment and appropriate reassessment.
- Always document the date of service, result and test together.
- Consider point-of-care A1c testing in the office setting, when applicable.
- Review medication adherence, access and side effects.
Patient-reported glucose management indicator results calculated from a continuous glucose monitor can be documented in the member’s medical record and do not need to be collected by a PCP or specialist.
For quality measurement purposes, the A1c result closest to Dec. 31 is used. Clinical decisions and repeat-testing intervals should always reflect the patient’s condition, treatment plan and applicable professional guidance.
Document Statin Therapy Exclusions Annually
The CMS Statin Use in Persons With Diabetes measure to manage cardiovascular risk includes exclusions for patients who cannot take statins, and prior intolerance or exclusion criteria must be documented each year to count for measure reporting.
Common exclusions include (anytime in the measurement year):
- In hospice or using hospice services
- End-stage renal disease
- Polycystic ovary syndrome
- Rhabdomyolysis or myopathy
- Dialysis
- Cirrhosis
- Prediabetes
- Review statin eligibility annually for patients ages 40 to 75 with diabetes.
- Document the specific reason a statin is contraindicated or not tolerated.
- If intolerant or experiencing side effects, such as myalgias, consider, if clinically appropriate:
- A different hydrophilic statin (e.g., rosuvastatin or pravastatin)
- A lower-dose statin
- Reducing frequency
- If intolerant or experiencing side effects, such as myalgias, consider, if clinically appropriate:
- Ensure the medical record supports the exclusion with clear clinical documentation.
- A claim using the appropriate ICD-10 code must be submitted annually, as applicable.
- Reassess periodically, as some patients may become candidates for therapy over time.
For patients tolerating a statin:
- Prescription must be filled through Part D insurance card to close the care opportunity; those filled through cash claims, discount programs (such as GoodRx) or medication samples will not close the measure.
- Only statin medications will close the care opportunity; other cholesterol medications such as ezetimibe or fenofibrate do not close the care gap.
- Consider extended-day fills (e.g., 90- or 100-day supply) or send to home delivery.
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