These codes are to be used for easy reference; however, the ICD-9-CM code book is the ... If you have questions or wish
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SEPTEMBER is National Vascular Disease Month 2012
Informative and educational coding information for providers
FOCUS ON: Peripheral Arterial Disease (PAD) The term peripheral artery disease (PAD) broadly encompasses the vascular diseases caused by atherosclerosis and thromboembolic pathophysiologic processes that alter the normal structure and function of the aorta, renal and mesenteric arteries, and the lower extremity arteries. Individuals with asymptomatic lower extremity PAD should be identified by examination and/or measurement of the ankle-brachial index (ABI) in order to offer therapeutic interventions known to decrease their risk of MI, stroke, amputation and death. Who should be tested for PAD?1 • Those age less than 50 years, with diabetes and one other atherosclerosis risk factor (Smoking, dyslipidemia, hypertension, or hyperhomocysteinemia) • Those age 50 to 64 and a history of smoking and diabetes • Those age 65 or older • Those with leg symptoms with exertion (suggestive of claudication) or ischemic rest pain • Those with abnormal lower extremity pulse examination • Those with known atherosclerotic coronary, carotid, or renal artery disease How is PAD diagnosed? • A simple, noninvasive test for symptomatic and asymptomatic lower extremity PAD is the ABI • Physical exam findings suggestive of severe PAD include distal hair loss, trophic skin changes, hypertrophic nails, decreased or absent lower extremity pulses, and femoral bruits • Men 60 years of age and over who are either the siblings or offspring of someone with an abdominal aortic aneurysm (AAA), and men age 65 to 75 who have ever smoked should undergo a physical examination and one time ultrasound screening for detection of AAA Treatment after PAD Diagnosis includes risk factor normalization;1 • Immediate smoking cessation • Treat hypertension: JNC-7 guidelines • Treat lipids: NCEP ATP-III guidelines • Treat diabetes mellitus: HbA1c
