CPT® Code 0337T

Deleted

Endothelial function assessment, using peripheral vascular response to reactive hyperemia, non-invasive (eg, brachial artery ultrasound, peripheral artery tonometry), unilateral or bilateral

The endothelial function assessment is a diagnostic procedure that evaluates the performance of the endothelial membrane, which is a thin layer of cells lining the interior of blood vessels and the heart. This membrane plays a crucial role in regulating vascular relaxation and contraction, as well as in the management of blood clotting, immune responses, and platelet adhesion. Dysfunction of the endothelium can be indicative of cardiovascular risk factors and is often associated with conditions such as coronary artery disease. The assessment is conducted using non-invasive techniques that measure the peripheral vascular response to reactive hyperemia, which refers to the temporary increase in blood flow to an organ following a brief period of reduced blood supply (ischemia). There are two primary methods employed for this assessment: high-resolution ultrasound of the brachial artery and peripheral artery tonometry. The brachial artery ultrasound technique involves capturing longitudinal images of the artery to establish a baseline measurement. A blood pressure cuff is then inflated to a level above systolic pressure for a duration of five minutes to induce ischemia, after which the flow-mediated dilation of the artery is measured. In contrast, peripheral artery tonometry utilizes pneumatic probes placed on the index fingers to establish a baseline pulse wave amplitude. Following the application of a blood pressure cuff to one arm, the pulse wave amplitude is measured and compared between the hyperemic finger and the contralateral, non-ischemic finger. This assessment can be performed unilaterally or bilaterally, providing valuable insights into endothelial function and cardiovascular health.