Upper & Lower Extremity Arteries

Diagnostics

Upper / Lower Extremity Arterial

Diagnosing

The arteries of the upper and lower extremities function to transport oxygenated blood from the left side of the heart to the capillaries within the peripheral tissues. The arterial systems are designed to transport large volumes of blood at relatively high pressures (systolic pressures of 120mmHg). The named arteries systematically branch into smaller and smaller arteries until they reach the arterioles, where the pressure drops just before the blood enters the capillaries. Capilllaries connect the arterioles on one end and the venules on the other. As the blood traverses the capillaries, it delivers oxygen and nutrients and picks up carbon dioxide and toxic metabolic wastes that are returned to the right side of the heart via the venous system.

Arterial Disease

Peripheral arterial disease (PAD) is quite common, impacting approximately 10 million Americans. PAD is caused by atherosclerosis, or the gradual accumulation of calcified plaque in the arterial walls. Plaque can eventually restrict or completely block the flow of blood through the arteries. When the blockage or stenosis is tight enough, it can block blood flow to downstream organs such as the heart, brain, and extremities.

The biggest risk factors for developing atherosclerosis include elevated cholesterol and triglycerides, high blood pressure, smoking, chronic inflammation, and family history.

Arterial Ultrasound Examination

Duplex ultrasound examination of the arteries of the upper or lower extremities is performed to evaluate for arterial stenoses and blockages. Arterial duplex ultrasound uses real-time imaging and color Doppler to evaluate the structure and function of the named arteries in about 30 minutes. Because duplex technology allows evaluation of the blood flow as well as the arterial structure, it is considered the gold standard in evaluating the arterial system of the extremities. Because it does not use ionizing radiation, duplex ultrasonography is considered harmless and can be safely used with pregnant patients and patients of any age.There is no required prep and NPO is not necessary.

Diagnosis

Indications

Pain with ambulation (claudication)
Rest pain
Abdominal aortic aneurysm or stenosis
Cold foot or leg
Swelling
Lower extremity cellulitis
Brawny edema
Non-healing foot ulcer

Common Findings

Peripheral arterial disease (PAD)
Arterial stenosis
Arterial blockage
Arterial aneurysm
Baker’s cyst

CPT Codes

93925 – Duplex scan of lower extremity arteries, complete bilateral study
93926 – Duplex scan of lower extremity arteries, unilateral or limited study
93978 – Duplex scan of aorta, IVC, iliac vasculature, or bypass grafts, complete study
93979 – Duplex scan of aorta, IVC, iliac vasculature, or bypass grafts; unilateral or limited study

Common ICD-10 Codes

93925 – LOWER EXTREMITY ARTERIAL
M79.604 – Pain in right leg
M79.605 – Pain in left leg
I73.9 – Peripheral vascular disease, unspecified
I71.4 – Abdominal aortic aneurysm, without rupture
E11.59 – Type 2 diabetes mellitus with other circulatory complications
I70.211 – Atherosclerosis of native arteries of extremities with intermittent claudication, (R) leg
I70.212 – Atherosclerosis of native arteries of extremities with intermittent claudication, (L) leg
I70.213 – Atherosclerosis of native arteries of extremities with intermittent claudication, (B) legs
I73.00 – Raynaud’s syndrome without gangrene
I170.229 – Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
I70.25 – Atherosclerosis of native arteries of other extremities with ulceration
I70.90 – Unspecified atherosclerosis
I72.4 – Aneurysm of artery of lower extremity
I73.89 – Other specified peripheral vascular diseases
R94.30 – Abnormal result of cardiovascular function study, unspecified
I70.269 – Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity

1701 Highway 75 North
Suite 100
Sherman, Texas