Billing and Coding: Treatment of Varicose Veins of the Lower Extremity

Medicare covers interventional treatment of varicose veins of the lower extremity when medical records document symptomatic disease, failure of adequate conservative therapy, exclusion of other causes, and appropriate diagnostic testing (e.g., duplex ultrasound) identifying incompetence. Cosmetic indications—treatment of asymptomatic varicosities, telangiectases (CPT 36468), and sclerotherapy performed for cosmetic purposes—are excluded; specific coding, modifier, documentation, and frequency rules (including limits on sclerotherapy sessions and per-extremity reporting of certain CPT codes) must be followed.

"Interventional treatments are covered for symptomatic varicose veins of the lower extremity when the medical record documents history and physical findings supporting the diagnosis."

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