LCD Reference Article Response To Comments Article

Response to Comments: Treatment of Varicose Veins of Lower Extremities

A54715

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Document Note

The correct response to Comment 4 should be: Since the service you describe has an unspecified code, and was not priced by the RUC, it is contractor priced. Noridian has a price after studying the procedure.

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General Information

Source Article ID
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Article ID
A54715
Original ICD-9 Article ID
Not Applicable
Article Title
Response to Comments: Treatment of Varicose Veins of Lower Extremities
Article Type
Response to Comments
Original Effective Date
03/12/2016
Revision Effective Date
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Revision Ending Date
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Article Text
Noridian’s Response to Provider Recommendations (for comment period ending 04/10/2015):

Response To Comments

Number Comment Response
1 Three commenters, commented on the use of foam sclerotherapy, particularly the compound polidocanol, for larger varicosities. Foam sclerotherapy can be used for larger and smaller veins as suggested in the policy.
2 Noridian received a position paper from an officer of the American College of Phlebology with several suggestions and supporting data. Many of the suggestions are in the coverage policy. Endothermal and radiofrequency ablation are covered as is foam sclerotherapy, compression therapy and surgical treatment. ICD-9 coding suggestions are appreciated but we must now use ICD-10-CM and will try to include similar codes to the suggested ICD-9-CM codes.
3 One commenter felt that ultrasound helped locate subcutaneous and deeper veins and that use of ultrasound to identify needle placement was helpful. . Noridian does allow ultrasound to map varicosities. In several of the procedures ultrasound is considered part of the procedure code.
4 Another physician was concerned that the nonspecific code for the mechano-chemical ablation (Clarivein device) and treatment did not have a specific reimbursement included. We will find an appropriate contractor rate reimbursement as AMA RUC has not yet completed an evaluation on all costs of this device Noridian has a temporary contractor rate for this service until the AMA RUC completes its evaluation of costs and publishes a definite number of units for a final rate.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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Updated On Effective Dates Status
01/15/2016 03/12/2016 - N/A Currently in Effect You are here

Keywords

  • Varicose Vein, sclerotherapy, varicosities, lower extremity, treatment