Treatment of Varicose Veins of the Lower Extremities

Covered: surgical treatments (ligation, stripping, stab phlebectomy), compressive sclerotherapy for local small–medium symptomatic varices or recurrent disease, foam sclerotherapy for incompetent GSV/accessory saphenous veins, and endoluminal radiofrequency or laser ablation for symptomatic greater/lesser saphenous varicosities; excluded are treatment of spider veins or asymptomatic varicosities, non‑compressive sclerotherapy, devices not FDA‑approved, and separate billing for intraoperative ultrasound. Key requirements: documentation of symptoms and failure of ≥3 months conservative therapy, one pre‑operative duplex allowed, anatomy must be amenable (no aneurysm/thrombosis/tortuosity, diameter ≤12 mm for ERFA and ≤20 mm for laser), use FDA‑approved devices, appropriately trained providers, and complete records or services will be denied as not reasonable/necessary.

"Treatment of symptomatic varicose veins of the lower extremities caused by venous insufficiency as a result of valve reflux (dilated, tortuous, superficial vessels)."