Amputation of a Limb and Lower Extremity Peripheral Arterial Disease Diagnosis and Documentation

Activity description

During the first part of this activity, we will discuss limb amputations. Approximately 75% of amputations in older adults are related to vascular disease. Some best practices for amputation documentation include four key steps: specify location, document complications, document causal conditions and document use of a prosthetic device. Limb amputations should be documented and coded at least annually to depict the individual's health status and care needs accurately.

During the second part of this activity, we will discuss PVD/PAD in the lower extremities along with proper documentation and coding. Peripheral vascular disease (PVD) is a blood circulation disorder that causes blood vessels outside the heart and brain to narrow, block or spasm. PVD can be caused by arteriosclerosis or blood vessel spasms. In arteriosclerosis, plaque builds up in a vessel and limits the flow of blood and oxygen to the organs and limbs.

Peripheral arterial disease (PAD) is a disorder of the large- and medium-sized peripheral arteries, not including the coronary or carotid arteries. It is a progressive disease that causes partial or complete obstruction of one or more peripheral arteries, usually in the lower extremities. The most common cause of PAD is atherosclerosis. PAD is the most common form of PVD.

PAD affects approximately 6.5 million individuals aged 40 or older. More than 20% of the elderly aged 80 or older have PAD, and Blacks are affected almost twice as often as non-Hispanic Whites at any given age.

Provided by
This activity is provided by Optum Health Education and Optum.

Commercial support
No commercial support was received for this activity.

Hardware/Software Requirements
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Target Audience

This activity is designed to meet the educational needs of nurses, physicians and other health care professionals interested in the care of individuals with limb amputations or with PVD and/or PAD.

Learning Objectives

At the end of this educational activity, participants should be able to:

  • Define and identify types of limb amputations.
  • Identify the etiologies and predictors for adverse outcomes and complications associated with limb amputation.
  • Recognize how to document limb amputations to the highest level of specificity.
  • Define PVD and PAD and distinguish the differences between coding and clinical definitions of each.
  • Describe current screening tools and diagnostic standards for PVD, PAD and atherosclerosis.
  • Recognize the clinical implications of ischemic pain at rest, which may be a sign of critical limb ischemia.
  • Provide proper documentation to support coding for PAD vs other venous diseases such as PVD and atherosclerosis.
Activity summary
Available credit: 
  • 1.00 AMA - Physicians
  • 1.00 ANCC - Nurses
  • 1.00 Attendance - General Attendance
Activity opens: 
Activity expires: 

Rebecca Gleason, RN, CCM
Clinical Planner 
Optum Health Education

Chanda Mayo-Ford, MD
Regional Medical Director
Optum Services

Kelli Graziano, MD
Medical Director
Optum Care

Disclosures of relevant financial relationships
In accordance with the Accreditation Council for Continuing Medical Education's (ACCME) Standards for Integrity and Independence in Accredited Continuing Education, OptumHealth Education (OHE) requires all those in control of educational content to disclose their financial relationships with ineligible companies within the prior 24 months. Ineligible companies are defined by the ACCME as companies whose primary business is producing, marketing, selling, re-selling, or distributing health care products used by or on patients. Individuals must disclose all financial relationships, regardless of the amount, with ineligible companies and regardless of their view of the relevance of the relationship to the education. OHE ensures that the content is independent of commercial bias.

The activity faculty or planners have no financial relationships to disclose.

Method for calculating CE credit
CE credit was calculated by the complexity of content.

Accreditation Statement
Joint Accreditation LogoIn support of improving patient care, this activity has been planned and implemented by Optum Health Education and Optum. Optum Health Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.

Credit Designation Statements
The participant will be awarded up to 1.00 contact hour(s) of credit for attendance and completion of supplemental materials.

Nurse Practitioners
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Optum Health Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization with which they wish to obtain credit.

Available Credit

  • 1.00 AMA - Physicians
  • 1.00 ANCC - Nurses
  • 1.00 Attendance - General Attendance
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