I83.899 — Varicose veins of unspecified lower extremity with other complications
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- Endoluminal radiofrequency ablationorendoluminal laser ablation:
- The following modalities are consideredmedically necessarywhen the criteria below (I, II,andIII) have been met:
- Ablative Modalities:Endoluminal radiofrequency;orEndoluminal laser;and
- Endoluminal radiofrequency;or
- Endoluminal laser;and
- The veins to be treated include one or more of the following:Anterior accessory great saphenous vein (AAGSV) also known as anterior saphenous vein (ASV);orGreat saphenous vein (GSV);orSmall saphenous veins (SSV)and
1 Active Policy
ANTHEM-CG-SURG-119 — CG-SURG-119 Treatment of Varicose Veins (Lower Extremities)
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