Peripheral Venous Ultrasound

Peripheral venous ultrasound is covered for evaluation of suspected or confirmed deep vein thrombosis (including as source of pulmonary embolism), follow-up of DVT when clinical change would alter treatment, evaluation of postthrombotic syndrome and suspected valvular incompetence in symptomatic chronic venous insufficiency or varicose veins, post-ablation assessment, and preoperative vein mapping for bypass graft harvest. Unwarranted or routine screening (including asymptomatic varicose veins), imaging that will not change management, imaging while on adequate anticoagulation unless it will change treatment, and certain plethysmography methods are not covered; in low pretest probability outpatients (Wells <2) a positive D-dimer is required before ultrasound. Documentation must include relevant history/physical findings (including Wells score when applicable), test results (e.g., D-dimer), study outputs and interpretation, and justification that results will impact management; provider scope and supervision rules apply.