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Hypertension Rating (California)

PostPosted: Tue Jan 15, 2019 1:01 pm
by kandslaw
PQME in September 2017 used Table 4-1 and based on BP readings said Applicant did not have hypertension. In October 2018, another doctor diagnosed labile hypertension. He used on 2017 guidelines from American College of Cardiologists which lowered BP ranges for normal to >120/>80. PQME did not address this. Should PQME reassess based on change in BP guidelines? Is there provision in AMA Guides that addresses this situation?

Re: Hypertension Rating (California)

PostPosted: Tue Jan 15, 2019 1:38 pm
by denyse
I don't think there is any provision in the Guides to use other guidelines. I suppose an Almaraz argument could percolate, but the new source is outside the 4 corners. BTW, who says that is the standard. One group. The Guides rely on the JNC-6. My humble opinion. Get it rated by a pro that can attack the opinion, document your file, establish your PDA threshold and floor in negotiations. Maybe ask for a reasonable demand (assuming litigated). If not litigated, you may need a deposition. All depends on the monetary dispute. Where do you spend you money. Case Management 101.

FYI. the 6th Edition, which we don't use has the same Stage 1 and 2 numbers at the 5th, and uses JNC-7.

Re: Hypertension Rating (California)

PostPosted: Thu Jan 17, 2019 10:03 am
by vampireinthenight
Yes, I think I agree. Does not sound like a change in guidelines, just a different guideline.

Re: Hypertension Rating (California)

PostPosted: Fri Jan 18, 2019 11:22 am
by denyse
Page 5 of the Guides discusses that the ratings (5th Edition) are currently accepted and should not be changed arbitrarily.