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

Billing for treatment of lower-extremity varicose veins requires a payable diagnosis and documentation that conservative measures failed before procedural treatment; procedures for cosmetic purposes should be reported with Z41.1 and are not paid as medical treatment. Specific coding and billing rules apply: use RT/LT or 50 modifiers for opposite-leg or bilateral services, use unlisted code 37799 when fewer than 10 stab phlebectomies are done with a description in Item 19, do not bill separately for sclerosant or chemical adhesive (practice expense included), and follow CPT-specific rules for first versus subsequent veins and access-site requirements.

"Treatment (sclerotherapy, surgical ligation/stripping, ablation) of varicose veins of the lower extremities is appropriate when conservative measures (exercise, leg elevation, weight loss, graduate..."

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