Current RMA Instruments
| Reasonable Hypothesis SOP | 52 of 2020 |
| Balance of Probabilities SOP | 53 of 2020 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Code: 440.0
- ICD-10-AM Code: I70.0
Brief description
This SOP covers clinically significant atherosclerotic disease of the aorta, but not aneurysm formation, which is covered by a separate SOP. The common form is narrowing of the abdominal aorta but thoracic disease may also occur.
Confirming the diagnosis
Diagnosis for artherosclerotic narrowing of the abdominal aorta requires demonstration of the artherosclerosis (by imaging) plus clinical manifestations in the form of symptoms or signs of decreased blood supply distal to the narrowing or an identified need for treatment for the atherosclerosis. The condition needs to be distinguished from atherosclerotic disease in more distal arteries (iliacs etc), which is covered by a separate SOP.
The relevant medical specialist is a vascular surgeon.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Aortic aneurysm*
- Aortic dissection* - aortic aneurysm and aortic wall disorders SOP^
- Asymptomatic atherosclerosis of the aorta, not requiring treatment - not a disease
- Atherosclerosis in Iliac arteries* - peripheral artery disease SOP^
- Atherosclerotic peripheral vascular disease*
- False aneurysm of aorta* - aortic aneurysm and aortic wall disorders SOP^
- Intramural haematoma of aorta* - aortic aneurysm and aortic wall disorders SOP^
- Penetrating ulcer of the aorta* - aortic aneurysm and aortic wall disorders SOP
- Peripheral artery disease*^
- Rupture of aorta* - aortic aneurysm and aortic wall disorders SOP
* another SOP applies
^ At the time of publication of this page new SOPs for aortic aneurysm and for atherosclerotic peripheral vascular disease, with new names (aortic aneurysm and aortic wall disorders, and peripheral artery disease, respectively) are pending.
Clinical onset
The onset may be based on time of first symptoms, but the condition may also be first be found following clinical examination or imaging studies. Clinical manifestions are most commonly claudication pain in the lower limbs and reduced femoral artery pulses.
Clinical worsening
The normal course of abdominal atherosclerotic narrowing is gradual progression and worsening of symptoms over a course of years. Progress can be slowed by managing risk factors (stopping smoking, losing weight, lowering blood pressure etc).