Blue Cross Blue Shield of Mississippi
site map

About Us   Careers    Site Map

  • Be Healthy
  • I'm a Member
  • I'm a Provider
  • I'm an Employer
  • Find Coverage

I'm a member

You will be redirected to myBlue. Would you like to continue?

please waitPlease wait while you are redirected.

myBlue member login

 Username:
 Password:
  • Forgot Username »
  • Forgot Password »
  • Learn more about myBlue »

Find a Network Provider

be RxSmart

Community PLUS Pharmacy
     Search

State & School Health Plan

Federal Employee Program

Member Links

Healthy You! Wellness Benefit »

Pay by Bank Draft »

View Our Medical Policy »

Military Benefit Information »

Register for myBlue »

Fight Fraud »


Contact Us
Customer Service Team
601-664-4590 or 1-800-942-0278

General Information
601-932-3704

Medical Policy Search



Printer Friendly Version Echosclerotherapy

Echosclerotherapy

 

DESCRIPTION

Sclerotherapy is a treatment for varicose veins. Long-term recurrence rates are higher after sclerotherapy than after surgery for the treatment of varicose veins. In Echosclerotherapy, the use of duplex ultrasound is being utilized during sclerotherapy (echosclerotherapy) to guide injections.

Ambulatory patients with varicose veins as a result of greater saphenous veins reflux are treated by duplex ultrasound-guided compression. The duplex ultrasound is proposed to enhance the precision of saphenous vein sclerotherapy when performed by experienced practitioners.

See separate policy Endoluminal Radiofrequency Ablation for Varicose Veins and Sclerotherapy.

 

POLICY

The use of duplex ultrasound during sclerotherapy, (echosclerotherapy), is considered investigational in the treatment of varicose veins.

The use of duplex ultrasound alone to diagnose varicosities of the extremities is considered medically necessary and is a covered service. See Ultrasound policy

 

POLICY EXCEPTIONS

None

 

POLICY GUIDELINES

Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.

The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.

 

POLICY HISTORY

6/1997: Approved by Medical Policy Advisory Committee (MPAC)

2/14/2002: Investigational definition added

3/5/2002: Prior authorization deleted, hyperlinks added

4/26/2002: Type of Service and Place of Service deleted

6/13/2002: Code Reference section completed, hyperlink added

12/16/2002: CPT codes 93970 and 93971 added

8/5/2005: Code Reference section reviewed, no changes

 

SOURCE(S)

A search of literature was completed through the MEDLINE database for the period of January 1990 through December 1996. The search strategy focused on references containing the following Medical Subject Headings:

  • Echosclerotherapy
  • Ultrasound

 

CODE REFERENCE

All codes are non covered for the use of duplex ultrasound during sclerotherapy (echosclerotherapy).

Non-Covered Codes

Code Number

Description

CPT-4

36468

Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk

36469

Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); face

36470

Injection of sclerosing solution; single vein

36471

Injection of sclerosing solution; multiple veins, same leg

93970Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study (added 12-16-2002)
93971
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study (added 12-16-2002)

ICD-9 Procedure

39.92

Injection of sclerosing agent into vein

ICD-9 Diagnosis

 

 

HCPCS

S2202

Echosclerotherapy

 

Top




Copyright © 2007-2013, Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Company. All Rights Reserved.
An independent licensee of the Blue Cross and Blue Shield Association.

About Us  ·   Careers   ·   Terms of Use  ·   Privacy Practices  ·   Accreditation  ·   Site Map