Peripheral arterial disease (PAD) affects over 8.5 million Americans, yet up to 75% of cases go undiagnosed in primary care settings. For independent practices, this diagnostic gap represents both a clinical opportunity and a patient safety concern. PAD screening with the CMAT Advantage system takes just 7-10 minutes per patient, is billable under established CPT codes when medically necessary, and provides objective data to support evaluation of vascular disease before it progresses to critical limb ischemia or contributes to cardiovascular events.
Why Is PAD Screening Critical for Independent Practices?
PAD prevalence ranges from 3-4% in the general population over age 45 to more than 20% in patients over 70. In high-risk populations — patients with diabetes, hypertension, smoking history, or known cardiovascular disease — prevalence reaches 27.8% according to published screening studies. Despite these numbers, a primary care screening study found that the number needed to screen is just 31 patients to identify one new PAD case, making it one of the most efficient screening protocols available.
The consequences of missed PAD diagnosis are severe: patients with undiagnosed PAD face a 5-year mortality rate of 30%, primarily from heart attack and stroke. Early detection through ankle-brachial index (ABI) testing allows for timely intervention, risk factor management, and referral when appropriate.
What Does the CMAT Advantage PAD Screening Process Look Like?
The CMAT Advantage system streamlines PAD detection into a non-invasive, 7-10 minute protocol that fits seamlessly into existing clinical workflows. The system measures:
- Ankle-Brachial Index (ABI): Compares blood pressure in the ankle to the arm. Normal range is 1.0-1.3. Values below 0.9 indicate PAD, while values above 1.3 suggest arterial calcification common in diabetic patients.
- Toe-Brachial Index (TBI): Particularly important for diabetic patients where calcified arteries can produce falsely elevated ABI readings. TBI provides accurate assessment even in calcified vessels.
- Segmental Blood Pressure (SBP) and Volume Plethysmography: Identifies the specific location and severity of arterial obstruction, enabling targeted treatment planning.
- Autonomic Nervous System Testing: Heart rate variability (HRV), Ewing tests, and sudomotor function assessment help evaluate autonomic neuropathy often associated with vascular disease.
Unlike handheld Doppler-only screening, the CMAT Advantage provides a comprehensive vascular and autonomic profile in a single patient visit, documented with FDA-cleared clinical reports suitable for payer documentation and referral coordination.
How Does PAD Testing Generate Revenue for Independent Practices?
PAD screening with the CMAT Advantage system adds an objective, documented diagnostic service for independent practices. The primary billing codes include:
- CPT 93923: Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries — billable when medically necessary; coverage varies by payer
- CPT 93923: Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, including 3+ levels — billable when medically necessary; coverage varies by payer
- Combined testing: When ABI is performed alongside autonomic function testing, the components are separately billable when each is medically necessary; coverage varies by payer
For a practice screening 3-5 patients per day, the test requires minimal staff time and no physician presence during the automated data collection phase.
Which Patients Should Be Screened for PAD?
Current clinical guidelines recommend ABI screening for the following patient populations:
- All patients age 65 and older
- Patients age 50-64 with diabetes or smoking history
- Patients with known atherosclerotic disease in other vascular beds
- Patients with symptoms suggestive of PAD (claudication, non-healing wounds, leg pain at rest)
- Patients with multiple cardiovascular risk factors (hypertension, hyperlipidemia, obesity)
In a typical independent primary care practice, 15-25% of the patient panel may qualify for PAD screening under these criteria, representing a significant clinical and revenue opportunity.
How Do Independent Practices Implement PAD Testing?
HealthWright Technologies provides a turnkey implementation program through the CMAT Advantage partnership. The process typically takes 2-4 weeks from commitment to first patient scan:
- Equipment installation and calibration — CMAT Advantage system setup with technical support
- Clinical staff training — Medical assistants learn to operate the system in 1-2 training sessions
- Billing and coding setup — Credentialing support and payer documentation templates for CPT 93923
- Patient identification workflow — EHR-integrated screening criteria to flag eligible patients during scheduling
- Cloud reporting via CMAT Cloud — Automated report generation for clinical documentation and referral coordination
The system is designed for independent practices that may not have a dedicated vascular lab — it brings diagnostic capability that previously required referral to a hospital or specialty center directly into the primary care setting.
How Does CMAT Advantage PAD Testing Compare to Other Screening Options?
Independent practices generally have three options for PAD testing: handheld Doppler ABI, referral to a hospital vascular lab, or in-office screening with the CMAT Advantage system. The table below compares how each approach fits a primary care workflow so you can decide which best supports early vascular disease detection in your patient panel.
| Factor | Handheld Doppler ABI | Hospital Vascular Lab Referral | CMAT Advantage (In-Office) |
|---|---|---|---|
| Where it happens | In your practice | Requires outbound referral | In your practice |
| Parameters measured | ABI ratio only | Comprehensive vascular studies | ABI, TBI, segmental pressures, plethysmography, HRV, and autonomic function |
| Time per patient | Operator-dependent | Separate appointment plus patient travel | 7-10 minutes, automated data collection |
| Reproducibility | Operator-dependent | High | Automated and reproducible |
| Documentation | Manual notes | Returned by the lab | FDA-cleared CMAT Cloud reports |
| Diabetic patients with calcified vessels | ABI may read falsely elevated | TBI available | TBI included to assess calcified vessels |
Frequently Asked Questions About PAD Testing in Independent Practices
How long does a CMAT Advantage PAD screening take?
A complete CMAT Advantage screening takes 7-10 minutes of patient contact time. The automated system collects data while the patient is seated comfortably, requiring minimal staff involvement after initial setup. Results are available immediately through the CMAT Cloud platform.
Is PAD screening covered by Medicare?
Yes. ABI testing (CPT 93923) is covered by Medicare and most commercial insurance plans when performed on patients meeting clinical screening criteria. Combined with autonomic function testing, the components are separately billable when each is medically necessary; coverage varies by payer.
Can medical assistants perform the PAD screening test?
Yes. The CMAT Advantage system is designed for medical assistant operation under physician supervision. Staff training typically takes 1-2 sessions, and the automated data collection process requires no specialized vascular training.
What is the difference between ABI-only screening and full CMAT Advantage testing?
ABI-only screening measures blood pressure ratios in the extremities. The CMAT Advantage system adds toe-brachial index (critical for diabetic patients), segmental blood pressure mapping, volume plethysmography, heart rate variability, and autonomic function assessment — providing a comprehensive vascular and neurological profile in a single visit.
How does CMAT Advantage compare to handheld Doppler screening?
Handheld Doppler provides a single data point (ABI ratio) with operator-dependent accuracy. CMAT Advantage delivers automated, reproducible multi-parameter assessment including ABI, TBI, SBP, plethysmography, and autonomic testing — with FDA-cleared clinical reports that support both billing documentation and specialist referral coordination.
Ready to add PAD screening to your practice? Contact HealthWright Technologies to learn more about the CMAT Advantage system or request a free demo.
HealthWright Technologies
60 Bear Creek Marina Road, Mansfield, GA 30055
Phone: (678) 322-7146
Email: contact@healthwrighttechnologies.com
Medical Disclaimer: This article is for informational purposes only and does not constitute medical or billing advice. CPT codes are provided for reference only and do not guarantee reimbursement. Verify code applicability and coverage with the relevant payer and your billing department before submitting claims. CPT is a registered trademark of the American Medical Association. Individual practice results may vary.
Related Articles
- PAD screening with the CMAT Advantage system
- What is an ABI test?
- Introduction to the TM-Flow System
- How three diagnostic CPT codes stack from one CMAT visit
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