Why should I get this assessment?

Our Health Risk Assessment offers your doctor a fast and non-invasive way to effectively measure the state of your health in these and many other areas:

• Diabetes
• Obesity
• Peripheral, Circulatory, and Diabetic Neuropathies
• Pain Management,
• Heart disease, Hypotension, and Tachycardia



With this vital information immediately in hand, your doctor can quickly formulate a treatment plan.

Normal Results

A normal resting ABI is 1.0 to 1.4. This means that your BP at your ankle is the same or greater than the pressure at your arm, and suggests that you do not have significant narrowing or blockage of blood flow.

Abnormal Results

Abnormal values for the resting ABI are 0.9 or lower and 1.40 or higher. If the ABI is 0.91 to 1.00, it is considered borderline abnormal. Abnormal values might mean you have a higher chance of having narrowed arteries in other parts of your body. This can increase your risk of a heart attack or stroke.

TOP 8 Risk Factors

1. AUTONOMIC NERVOUS SYSTEM DYSFUNCTION RISK – ANSD

Problems with the ANS can range from mild to life-threatening. Sometimes only one part of the nervous system is affected. In other cases, the entire ANS is affected. Some conditions are temporary and can be reversed, while others are chronic and will continue to worsen over time. Diseases such as Diabetes or Parkinson’s disease can cause irregularities with the ANS. Problems with ANS regulation often involve organ failure, or the failure of the nerves to transmit a necessary signal.

2. SUDOMOTOR DYSFUNCTION RISK – SudoD

Sudomotor dysfunction testing may indicate to physicians a patient’s peripheral nerve and cardiac sympathetic dysfunction. Neuropathy is a common complication in diabetes mellitus (DM), with 60%-70% of patients affected over their lifetime. Symptoms of neuropathy are very common, and sub-clinical neuropathy is more common than clinical neuropathy. Neuropathy may remain undetected, and progress over time leading to serious complications. The most common associated clinical condition is peripheral neuropathy, affecting the feet. Autonomic nerve involvement is common but probably the most undiagnosed. Low scores in the sudomotor may lead a medical provider to look at clinical
neuropathy.

3. ENDOTHELIAL DYSFUNCTION RISK – EndoD

Current evidence suggests that endothelial function is an integrative marker of the net effects of damage from traditional and emerging risk factors on the arterial wall and its intrinsic capacity for repair. Endothelial dysfunction, detected as the presence of reduced vasodilation response to endothelial stimuli, has been observed to be associated with major cardiovascular risks factors, such as aging, hyperhomocysteinemia, post-menopause state, smoking, diabetes, hypercholesterolemia, and hypertension.

4. INSULIN RESISTANCE RISK – IR

Insulin resistance is defined clinically as the inability of a known quantity of exogenous or endogenous insulin to increase glucose uptake and utilization in an individual as much as it does in a normal population. Insulin resistance occurs as part of a cluster of cardiovascular metabolic abnormalities commonly referred to as “The Insulin Resistance Syndrome” or “The Metabolic Syndrome”. This cluster of abnormalities may lead to the development of type 2 diabetes, accelerated atherosclerosis, hypertension, or polycystic ovarian syndrome depending on the genetic background of the individual developing the insulin resistance.

5. CARDIOMETABOLIC RISK – CMR

The specific factors that can cause this increased risk include obesity (particularly central), hyperglycemia, hypertension, insulin resistance, and dyslipoproteinemia. When patients have one or more risk factors and are physically inactive or smoke, the cardiometabolic risk is increased even more. Medical conditions that often share the above characteristics, such as type 2 diabetes, can also increase cardiometabolic risk. The primary focus of cardiometabolic risk treatment is the management of each high-risk factor, including dyslipoproteinemia, hypertension, and diabetes. The management of these subjects is based principally on lifestyle measures, but various antihypertensive, lipid-lowering, insulin-sensitizing, anti-obesity and antiplatelet drugs could be helpful in reducing cardiometabolic risk.

6. SMALL FIBER NEUROPATHY RISK – SFN

Small fiber neuropathy occurs when damage to the peripheral nerves predominantly or entirely affects the small myelinated fibers or unmyelinated C fibers. The specific fiber types involved in this process include both small somatic and autonomic fibers. The sensory functions of these fibers include thermal perception and nociception. These fibers are involved in many autonomic and enteric functions.

7. CARDIAC AUTONOMIC NEUROPATHY RISK – CAN

High blood glucose levels over a period of years may cause a condition called autonomic neuropathy. This is damage to the nerves that control the regulation of involuntary function. When nerve damage affects the heart, it is called cardiac autonomic neuropathy (CAN). CAN encompasses damage to the autonomic nerve fibers that innervate the heart and blood vessels, resulting in abnormalities in heart rate control, vascular dynamics, and the body’s ability to adjust blood pressure. CAN is a significant cause of morbidity and mortality associated with a high risk of cardiac arrhythmias and sudden death.

8. PLETHYSMOGRAPHY CARDIOVASCULAR DISEASE RISK – PTG CVD

The PTG CVD risk factor is the combined total of the other seven risk factors assessments. It takes into consideration the cardiovascular as well as the autonomic nervous system (ANS) measurements.

A NOTE FOR Providers

All “indications” must be clearly documented in the patient’s medical record and made available to Medicare upon request. This documentation is critical and will reduce the risk of Recovery Audit Contractor (RAC) audits and recovery. Documentation must support Centers for Medicare and Medicaid Services (CMS) “signature requirements”. Physicians can bill an Evaluation and Management (E/M) code (office visit) along with these services. Also, physicians can bill one test more than once if they can document the need (i.e. borderline findings or inconsistency in critical values).