Varicose vein treatment

Applies to:

All plans

Priority Health Medicare plans coverage is determined by the Centers for Medicare and Medicaid Services (CMS); if a coverage determination has not been adopted by CMS, our medical policy applies

Definition

First-line treatment of varicose veins includes conservative methods such as exercise, weight reduction, elevation of the legs, avoidance of prolonged immobility, or compression therapy. When these measures fail, medium to large incompetent veins may be treated with surgical stripping, ligation, sclerotherapy, endovenous laser therapy (EVLT), or endoluminal radiofrequency ablation (ERFA). 

Medical policy

Varicose vein treatment coverage

Certain treatments are covered only when necessary due to functional impairment. See the criteria in the medical policy.

When surgical treatments are covered, some members will have non-standard cost-sharing for those services.

Non-standard cost-sharing

If/when commercial employer group and MyPriority® individual plans cover certain surgeries, these surgeries are covered at a different cost-sharing level than our standard benefit coverage levels.

To verify member cost sharing, use the Member Inquiry tool and look in the Additional benefits drop-down menu for Certain surgeries benefit information.

Varicose vein treatment authorizations

Not required.

Varicose vein treatment billing

See the medical policy for codes that may apply and codes not covered.