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Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease diagnosis codes

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

Peripheral Arterial Disease exception reporting codes

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.

9hS.. Exception reporting: peripheral arterial disease quality indicators
9hS0. Excepted from peripheral arterial disease quality indicators: patient unsuitable
9hS1. Excepted from peripheral arterial disease quality indicators: informed dissent
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Peripheral Arterial Disease 001.1 Rationale

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.
http://guidance.nice.org.uk/CG147/Guidance

SIGN clinical guideline 89. Diagnosis and management of PAD. 2006.
http://www.sign.ac.uk/guidelines/fulltext/89/index.html

Peripheral Arterial Disease 001.2 Reporting and verification

See indicator wording for requirement criteria.

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Prepared By Jean Keenan