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G73.. Other peripheral vascular disease
G73y. Other specified peripheral vascular disease (v26)
G73z. Peripheral vascular disease NOS
G73z0 Intermittent claudication
G73zz Peripheral vascular disease NOS
Gyu74 [X]Other specified peripheral vascular diseases
G734. Peripheral arterial disease
This exception is only applicable for the first ‘ever’ diagnosis of PAD for the patient. For a subsequent diagnosis, this exception rule is not considered.
Patients with PAD may have symptoms, but can also be asymptomatic.
About 20 per cent of patients older than 60 have PAD, although only a quarter
of these have symptoms. Symptoms become severe and progressive in approximately
20 per cent of patients with symptomatic PAD.
Reduced Ankle Brachial Pressure Index (ABPI) is an independent predictor of
cardiac and cerebrovascular morbidity and mortality and may help to identify
patients who would benefit from secondary prevention.
Scottish Intercollegiate Guidelines Network (2006) Diagnosis and management of peripheral arterial disease: A national clinical guideline (89). Available from www.sign.ac.uk/pdf/sign89.pdf
The SIGN guideline states that a resting ABPI of 0.9 or under has been shown in several clinical studies to be up to 95 per cent sensitive in detecting angiogram positive disease and around 99 per cent specific in identifying supposedly healthy subjects174. The SIGN guideline also states that there is no strict definition of what constitutes a normal ABPI. In practice, an ABPI of below 0.9 is considered to be abnormal174. The ABPI of patients with intermittent claudication typically lies between 0.5 and 0.9. Imaging may be appropriate to exclude PAD when there is a discrepancy between clinical presentation and ABPI.
NICE clinical guideline CG147. Lower limb PAD. 2012.
SIGN clinical guideline 89. Diagnosis and management of PAD. 2006.
See indicator wording for requirement criteria.
Prepared By Jean Keenan