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Printed Date: 9/22/2015
Veins are the blood vessels that carry deoxygenated blood from the tissues back to the heart.
Varicose veins are enlarged, swollen and twisting veins which often appear blue or dark purple when faulty valves in the veins allow blood to flow in the wrong direction or to pool. This increases the pressure in the vein, often causing swelling, pain, itching and discoloration to the affected area. Endovenous ablation is a procedure to close off varicose veins. Endovenous means that the procedure is done inside the vein. Ablation heat is used to close off the vein.
Some patients may want varicose vein treatment for cosmetic reasons. Cosmetic surgery or expenses incurred in connection with such surgery is not covered by Medicare. Cosmetic surgery includes any surgical procedure directed at improving appearance, except when required for the prompt (i.e., as soon as medically feasible) repair of accidental injury, or for the improvement of the functioning of a malformed body member. If the patient has no symptoms, discomfort, functional impairments or activity limitations treatment may not be appropriate.
General Documentation Requirements for Vein Ablation and related services:
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Last Updated: 05/14/2020
Applies to: Prior Authorization, JJ Part A, JJ Part B, JM Part A, JM Part B
Article Topics: Appeals, Redeterminations, and PTANs