tci General Surgery Coding Alert - 2006 Issue 9

Reader Questions: Sclerotherapy Payment May Hinge on 454

Question: Does Medicare cover sclerotherapy for varicose veins with 36470 and 36471? If so, are there any specific criteria that need to be met?Florida Subscriber Answer: Medicare may cover sclerotherapy under specific circumstances. Best bet: Check your local Medicare carrier's local coverage determinations (LCD) to decide whether it covers 36470 (Injection of sclerosing solution; single vein) and 36471 (- multiple veins, same leg).  For instance, the Medicare carriers for Florida and Texas will pay for sclerotherapy when the patient has an ulcer, inflammation or other complications of the lower extremities. To indicate medical necessity for sclerotherapy...

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