I78.8 — Other diseases of capillaries
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- Claims submitted without a valid ICD-10-CM diagnosis code will be returned as incomplete; the diagnosis code must best describe the patient's condition for the service performed.
- The patient's medical record must contain documentation fully supporting medical necessity including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
- Medical record must document history and physical findings supporting a diagnosis of symptomatic varicose veins.
- Medical record must document failure of an adequate trial of conservative treatment as described in the LCD.
Key Coverage Criteria
- Interventional treatments are covered for symptomatic varicose veins of the lower extremity when the medical record documents history and physical findings supporting the diagnosis.
- Coverage requires failure of an adequate trial of conservative treatment prior to interventional therapy as described in the LCD.
- Coverage requires exclusion of other causes of limb edema, ulceration, and pain prior to treatment of varicose veins.
- Coverage requires performance of appropriate diagnostic testing (e.g., duplex ultrasound) to confirm the presence and location of incompetent perforating veins when indicated.
- Billing and coding guidance in this article applies when immune globulin use meets the reasonable and necessary coverage criteria established in LCD L35093.
- Treatment (sclerotherapy, surgical ligation/stripping, ablation) of varicose veins of the lower extremities is appropriate when conservative measures (exercise, leg elevation, weight loss, graduated compression, avoidance of prolonged immobility) have been unsuccessful and symptoms persist.
20 Active Policies
A57554 — Billing and Coding: Immune Globulins
J05
L34536 — Treatment of Varicose Veins of the Lower Extremities
J05
L34771 — Immune Globulins
J05
A56914 — Billing and Coding: Treatment of Varicose Veins of the Lower Extremities
J05
A59105 — Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
Related Codes
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