Varicose Veins of the Lower Extremity, Treatment of

Medically necessary interventional treatment (sclerotherapy, ligation/stripping, endovenous radiofrequency or laser ablation) of lower-extremity varicose veins is covered only after a documented six-week failed trial of conservative therapy and when the patient has specified symptomatic findings (e.g., stasis ulcer, significant pain/edema, recurrent phlebitis). Specific modality limits include sclerotherapy only for vessels ≤4 mm (and not for saphenous-junction veins or noncompressive techniques), laser ablation limited to veins ≤20 mm, and endovenous ablation requires absence of thrombosis/venous tortuosity and significant peripheral arterial disease and use of FDA-approved devices; cosmetic or otherwise non–medically necessary treatments are excluded.

"Interventional treatment (sclerotherapy, ligation ± stripping, endovenous radiofrequency or laser ablation) is covered if the patient remains symptomatic after a documented six-week trial of conser..."