Billing and Coding: Treatment of Chronic Venous Insufficiency of the Lower Extremities

This billing and coding guidance specifies appropriate CPT reporting for sclerotherapy and ablation treatments of chronic venous insufficiency in the lower extremities (e.g., CPT 36465–36471, 36473–36483) and clarifies that sclerosants, supplies, and compression dressings are included in procedure codes and not separately billable. Documentation must support medical necessity within a 90-day plan of care including history, physical, CEAP, VCSS, and venous duplex scan (for CEAP C2–C3, reflux ≥500 ms and no deep venous obstruction); certain codes (e.g., CPT 37241, CPT 29581) are not appropriate for these services.

"Injection sclerotherapy (CPT 36468) is appropriate for treatment of symptomatic spider veins / telangiectasia of the lower extremities."

Sign up to see full coverage criteria, indications, and limitations.