Highmark Medical Policy Bulletin |
Section: | Surgery |
Number: | S-55 |
Topic: | Injection of Sclerosing Solution into Varicose Veins and Telangiectasis |
Effective Date: | August 28, 2000 |
Issued Date: | August 28, 2000 |
Date Last Reviewed: |
Varicose Veins The injection of sclerosing solution into varicose leg veins for specific medical indications is eligible for payment for those patients who meet all of the following criteria:
This procedure should be reported under codes 36470 and 36471, as appropriate. Sclerotherapy treatment for reasons other than those listed above remains a cosmetic procedure, and therefore, is a noncovered service. Multiple injections should be processed in accordance with the multiple surgery guidelines on Medical Policy Bulletin S-100, regardless of the number of injections given. Ligation and stripping procedures (e.g., 37720, 37730) are also beneficial in the treatment of symptomatic varicose veins and, as such, are covered surgical services. However, in some cases, limited sclerotherapy may be necessary during the routine surgical postoperative period to achieve a better and more complete surgical result. As such, sclerotherapy performed by the surgeon, his associate or, the assistant surgeon during the postoperative period following vein ligation and stripping procedures is part of the global surgical allowance. Echosclerotherapy Sclerotherapy is a treatment for varicose veins. In echosclerotherapy (S2202), duplex ultrasound is being utilized during sclerotherapy to guide the injections and enhance the precision of saphenous vein sclerotherapy. However, there are no proven indications that echosclerotherapy provides any advantage over and above conventional methods of treatment such as sclerotherapy or ligation and stripping. Echosclerotherapy is considered investigational and, therefore, is a noncovered service. Any method of treatment for superficial telangiectases, including laser, is a noncovered service. |
36468 | 36469 | 36470 | 36471 | S2202 |
Traditional (UCR/Fee Schedule) Guidelines
|
Comprehensive/Wraparound/PPO Guidelines
Managed Care (HMO/POS) Guidelines
PRN References |
Term | Description |
---|---|