ABI with Exercise Exam

ABI with Exercise Exam | Newman Medical

Uncovers Hidden PAD

ABI with Exercise Exam

When resting ABI looks normal but the clinical picture says otherwise, the Exercise ABI captures the pressure drop that only appears under physiologic stress — revealing PAD that a resting exam misses.

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Sample Report

When the Resting ABI Is Falsely Normal

In early or compensated PAD, collateral circulation may be sufficient to maintain near-normal resting pressures. The patient presents with classic symptoms — exertional leg pain, claudication, fatigue — but the resting ABI falls in the normal range.

Post-exercise ABI solves this. After controlled exertion, demand on the arterial system increases. A hemodynamically significant stenosis that was compensated at rest will produce a measurable pressure drop after exercise. A post-exercise ABI decrease of 15–20% or more is diagnostic for PAD.

How It Works

The exam begins with a baseline resting ABI. The patient then performs a standardized exercise protocol before serial post-exercise readings are taken.

Baseline Resting ABI

Standard resting ABI captured with all cuffs in place. This serves as the pre-exercise baseline.

Provocative Functional Maneuvers

Patient performs dorsiflexions, heel raises, or hall walking until claudication onset or a set time limit. No treadmill required.

Post-Exercise ABI Captured

Cuffs remain in place. Immediate post-exercise readings taken and tracked over recovery. Pressure drop and recovery time are documented.

When to Order This Exam

✔

Classic claudication symptoms with normal resting ABI

✔

Risk factors present but resting exam inconclusive

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Patients reporting exertional leg pain only

✔

Differentiating vascular from neurogenic claudication

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Athletes or active patients with preserved resting perfusion

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Borderline resting ABI (0.91–0.99) needing confirmation

Reimbursable CPT Code:

93923

Billed as a single-level study with provocative functional maneuvers (dorsiflexions, heel raises, hall walking, postural provocative tests). Note: CPT 93924 applies to treadmill stress protocols only — see the ABI Stress-Treadmill Exam.