State of the art, patient, and compassionate care performed by highly trained Vascular Sonographers at the patient’s bedside!

What is a physiological arterial evaluation?

Ankle/Brachial Index: ABI
A blood pressure cuff is placed on the arm and the ankles bilaterally. The systolic pressures are compared to the blood pressure at your arms and ankles, with a low ABI indicating PAD.

Pulsed Volume Recording: PVR
Cuffs are placed on the arms and at 3 or 4 sections of both legs. The cuffs are inflated slightly, and the total volume change within the leg or arm is measured.

Segmental Pressures
Cuffs are placed on the arms and legs. The blood pressure is taken at each cuff and compared to the pressure in the arm. This is a useful tool in the localization of arterial disease or stenosis.

Toe/Brachial Index: TBI
A small digit cuff and PPG sensor are placed on the great toe. The pressure and waveform are compared to the brachial pressure. Pressureless than 0.65 indicates decreased flow to small vessels of the toe.

 

Common ICD-9-CM Codes for PAD

250.70-250.73 – Diabetes with peripheral circulatory disorders

440.21 – Atherosclerosis of native arteries of the extremities with intermittent claudication

440.22 – Atherosclerosis of native arteries with rest pain

440.23 – Atherosclerosis of native arteries with ulcerations

440.3-440.32 – Atherosclerosis of bypass graft of the extremities

443.0-443.1 – Raynaud’s syndrome/thromboagngitis obliteranms

443.89 – Other peripheral vascular disease

443.9 – Peripheral vascular disease unspecified

707.10 – Unspecified ulcer of lower limb

707.11 – Ulcer of the thigh

707.12 – Ulcer of the calf

707.13 – Ulcer of ankle

707.14 – Ulcer of midfoot

707.15 – Ulcer of foot

707.19 – Ulcer of lower limb

707.8 – Chronic ulcer of other specified sites

785.4 – Gangrene

ICD-9 codes are subject to verification. Please refer to the LMRP guidelines for the Medicare provider in your area. Information obtained through the US Department of Health and Human Services for Medicare and Medicaid services (http://www.cms.hhs.gov/)

Symptoms of PAD

• Pain or cramping in feet, calves or thighs after activity
• Leg numbness or weakness
• Coldness in toes or feet when compared to the other side
• Non-healing wounds of ulcers on ties, feet or calves
• Cyanosis of the toes or feet
• Hair loss on feet and legs
• Shiny of scaly appearance to the skin on feet and legs
• Slow nail growth
• Decreased or absent pulses in feet

Risk Factors for PAD

• Current or previous smoker
• Diabetes
• High blood pressure
• High cholesterol
• Obesity
• Family history of heart disease or stroke
• Patients 50 and older

How to Order a Non-Invasive Arterial Study

93922 – Unilateral or limited study use when only an ABI is needed, or the study is in any way limited

93923 – Bilateral/Complete study includes ABI, PVR, segmental pressures and bi-directional waveform analysis

TBI will be done when written on the order. There is no additional charge for TBI.