Medical Affairs Policy
|
|
- Anabel Andrews
- 7 years ago
- Views:
Transcription
1 Service: Varicose Vein Treatments PUM Medical Affairs Policy Implemented 04/04/14, 04/01/15, 4/1/16 Reviewed 12/12/14 Revised 12/12/14, 12/11/15 Developed Arise/WPS Policy 12/12/14, 12/11/15 Committee Approval Note: For review/revision history prior to 2014 see previous Medical Policy or Coverage Policy Bulletin Disclaimer: This policy is for informational purposes only and does not constitute medical advice, plan authorization, an explanation of benefits, or a guarantee of payment. Benefit plans vary in coverage and some plans may not provide coverage for all services listed in this policy. Coverage decisions are subject to all terms and conditions of the applicable benefit plan, including specific exclusions and limitations, and to applicable state and federal law. Some benefit plans administered by Wisconsin Physicians Service and Arise Health Plan (WPS/AHP) may not utilize WPS/AHP medical policy in all their coverage determinations. Contact customer services as listed on the member card for specific plan, benefit, and network status information. Medical policies are based on constantly changing medical science and are reviewed annually and subject to change. WPS/AHP uses tools developed by third parties, such as the evidence-based clinical guidelines developed by MCG Health to assist in administering health benefits. This medical policy and MCG Health guidelines are intended to be used in conjunction with the independent professional medical judgment of a qualified health care provider. To obtain additional information about MCG to medical.policies@wpsic.com. Description: Varicose veins are abnormally enlarged tortuous and dilated veins that are usually the result of weakening of the walls of the veins or incompetent valves in the veins that allow backward flow of the blood in the vein. Although varicose veins are not uncommon, they do not usually require medical treatment until they become symptomatic. Various forms of varicose vein treatments are available including: vein ligation (stripping, division, or excision, or stab phlebectomy), endovenous radiofrequency occlusion (VNUS, ablation), laser ablation (ELAS), subfascial endoscopic perforator surgery (SEPS), transilluminated Page 1 of 8
2 phlebectomy (TriVex), sclerotherapy, mechanochemical ablation (ClariVein), and photothermal sclerosis. Indications of Coverage: I. Varicose vein treatments are considered medically necessary when ALL of the following criteria are met: A. An ultrasound evaluation of the affected extremity documents vein size and reflux as specified below: 1. Vein Size. If the treatment involves: a. The great (large) saphenous vein (GSV) or the sapheno-femoral junction (SFJ), the vein must be 5 mm or greater in diameter, as measured by duplex ultrasonography. b. The small (lesser) saphenous vein (SSV), the vein must measure 4 mm or greater just below the saphenopopliteal junction. c. The named principle branches including (posterior accessory vein, anterior accessory vein and the cephalad extension of the small saphenous vein [vein of Giacomini]), the vein must measure 5 mm or greater. d. Perforator/tributary veins, the veins must measure 3.5mm or greater. Perforator veins connect the superficial veins to the deep veins. Perforator veins which may be pertinent to varicose vein treatments include those in the thigh (Hunter s veins), knee (Boyd s veins), and calf (Cockett s veins). 2. Reflux measured when the patient is standing or in reverse Trendelenburg position. Reflux has been defined as retrograde or reversed flow equal to or greater than: a. 500 ms (0.5 seconds) duration in the superficial (GSV, SSV, SFJ) and deep calf veins. b. 350 ms of outward flow in the perforating/tributary veins. B. There is documentation of severe and persistent pain, aching, or cramping to such a degree that it inhibits or interferes with mobility and activities of daily living (ADLs) or occupation. The limiting effect of the pain on the activity or occupation must be described in terms of frequency, intensity, reduced or discontinued activity. Page 2 of 8
3 C. Within the past six months, a three-month trial of analgesic medications and fitted compression stockings (greater than 20 mmhg compression), and weight loss where indicated) has been documented as ineffective. A trial of conservative therapy may be waived if one of the following is documented: 1. Recurrent episodes of superficial phlebitis. 2. Non-healing skin ulceration that is a direct result of the varicose vein (CEAP Class 6). 3. Bleeding (internal or external) from a varicosity. If the criteria above are met, one Treatment Day of Service for each leg is approved. A Treatment Day of Service can consist of treatment (e.g. ablations, stab phlebectomies) of as many veins as have been approved, done during that one date of service. II. Sclerotherapy of varicose veins (especially perforators/tributaries) is considered medically necessary for either of these circumstances: A. After treatment of larger deep veins (of the saphenofemoral junction, saphenopopliteal junction, great saphenous vein, or lesser saphenous vein) that meet criteria have been treated, because many symptomatic varicosities of perforator and tributary veins will improve with resolution of reflux in the larger veins. Sclerotherapy of vessels is considered medically necessary after prior surgery/treatment when all of the following are met: 1. A minimum of one month has elapsed since the previous treatment, and 2. There is documentation that the individual is symptomatic and 3. Post-operative ultrasound measurements for size and reflux meet criteria above. B. When larger veins do not meet size or reflux measurement criteria above, but there is documentation of bleeding or ruptured varicose veins necessitating emergent treatment or there is skin ulceration present with large surrounding superficial varices requiring treatment, sclerotherapy of vessels/veins without prior surgery/treatment of larger veins is considered medically necessary. If the sclerotherapy criteria above are met, one Treatment Day of Service for each leg is approved. A Treatment Day of Service can consist of sclerotherapy treatments of as many veins as have been approved, done during that one date of service. Page 3 of 8
4 CEAP CLINICAL CLASSIFICATION descriptions: The CEAP classification is a method commonly used to document the severity of chronic venous disease and is based on clinical presentation (C), etiology (E), anatomy (A), and pathophysiology (P) Class C - Clinical Classification, supplemented by A for asymptomatic and S for symptomatic presentation E - Etiology A - Anatomy P - Pathophysiology Definition Class 0: No visible or palpable signs of venous disease Class 1: Telangiectasia, reticular veins, malleolar flare Class 2: Varicose veins Class 3: Edema without skin changes Class 4: Skin changes ascribed to venous disease (e.g., pigmentation, venous eczema, lipodermatosclerosis) Class 5: Skin changes as defined above with healed ulceration Class 6: Skin changes as defined above with active ulceration Congenital, Primary, Secondary, No venous disease Superficial, Perforator, Deep, No venous location Reflux or obstruction (alone or combined); Basic or Advanced Additional treatments may be approved if criteria for the initial approval have been met, a minimum of one month has elapsed since the previous treatment, there is documentation that the individual is symptomatic, and post-operative ultra-sound measurements meet criteria. Another trial of conservative therapy is not required. Limitations of Coverage: A. Review contract and endorsements for exclusions and prior authorization or benefit requirements. B. If used for a condition/diagnosis other than is listed in the Indications of Coverage, deny as experimental or investigative. C. If used for a condition/diagnosis that is listed in the Indications of Coverage, but the criteria are not met, deny as not medically necessary. D. The use of ultrasound guidance during a treatment is an integral component of the procedure, and is not reimbursed separately. E. Treatment of any vein less than 3.5 millimeters in size (e.g. telangiectasias, spider veins, reticular veins) with any method, is considered cosmetic and not medically necessary. Page 4 of 8
5 F. Treatment with Varithena (polidocanol injectable foam 1%) for treatment of varicose veins is considered experimental, investigational, unproven G. Treatment of varicose veins is considered not medically necessary in any of the following situations: 1. Without documentation of failed conservative therapy. 2. For the treatment of asymptomatic tributary veins, also known as high veins or supramelic veins. H. Sclerotherapy of varicose veins (especially perforators) is considered not medically necessary when the ultrasound evaluation of the affected extremity documents reflux of the saphenofemoral junction, saphenopopliteal junction, great saphenous vein, or lesser saphenous vein and these veins were not treated. If the criteria above are met, one date of service for each leg may be approved I. The following treatments are considered experimental or investigative as there is insufficient peer-reviewed literature documenting the effectiveness of these treatments, comparing methodologies and long term outcomes: 1. Photothermal sclerosis. 2. Transilluminated phlebectomy (TriVex). 3. Transdermal laser therapy. 4. ClariVein Occlusion Catheter(Endovenous Mechanochemical Ablation [MOCA}), Nonthermal Vein Ablation System Documentation Required: Office notes Ultrasound report Rationale: Varicose veins of the lower extremities are a common condition that affect up to 25 percent of women and 15 percent of men in the Unites States. Although varicose veins do not cause symptoms for most individuals, it is one of the most commonly performed cosmetic procedures in the United States. While common, there is no current consensus regarding the best approach for treatment, although ligation and stripping remains the Page 5 of 8
6 standard. Recent studies have shown a high recurrence rate for varicose veins treated with sclerotherapy alone as high as 50 percent at ten years. Conservative therapy for varicose veins typically consists of leg elevation, oral medications for symptom relief, avoidance of prolonged periods of immobility, and compression therapy. When conservative therapy fails, treatment may include a variety of percutaneous closure procedures, sclerotherapy, laser or radiofrequency ablation, and surgical stripping or ligation depending upon the severity of the condition. The goal of treatment is to eliminate the sources of reflux and redirect blood flow through competent veins. Many of the percutaneous procedures have not been adequately evaluated or compared against the standard surgical procedure and studies typically lack adequate long-term follow up. For example, the COMPASS sclerotherapy technique completed only a three year follow up, which is not comparable to the twenty year follow up reported following surgical intervention. Long term data on efficacy and recurrence for varicose veins treated with sclerotherapy is lacking. References: 1. Belcaro G, Cesarone MR, Di Renzo A, Brandolini R, Coen L, Acerbi G, et al. Foamsclerotherapy, surgery, sclerotherapy, and combined treatment for varicose veins: a 10-year, prospective, randomized, controlled trial (VEDICO trial). Angiology May 1; 54(3): Darwood RJ, Gough MJ. Endovenous laser treatment for uncomplicated varicose veins. Phlebology. 2009; 24 Suppl 1: Eklof B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, Meissner MH, Moneta GL, Myers K, Padberg FT, Perrin M, Ruckley CV, Smith PC, Wakefield TW; American Venous Forum International Ad Hoc Committee for Revision of the CEAP Classification. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg Dec; 40(6): Labropoulos N, Definition of venous reflux in lower-extremity veins. Journal of Vascular Surgery Oct (4): accessed 12/9/2011, 11/4/ Min RJ, Khilnani N, Zimmet SE. Endovenous laser treatment of saphenous vein reflux: long-term results. J Vasc Interv Radiol Aug; 14(8): Rigby KA, Palfreyman SJ, Beverley C, Michaels JA. Surgery versus sclerotherapy for the treatment of varicose veins. The Cochrane Database of Systematic Reviews Issue 3. Page 6 of 8
7 7. Shamiyeh A, Schrenk P, Huber E, Danis J, Wayand WU. Transilluminated powered phlebectomy: advantages and disadvantages of a new technique. Dermatol Surg Jun; 29(6): Society for Interventional Radiology. Position statement. Endovenous ablation Dec. Available at: Accessed: 10 Apr Tisi PV, Beverley CA. Injection sclerotherapy for varicose veins. The Cochrane Database of Systematic Reviews Issue Oxford Health Plans > Medical and Administrative Policies > Procedures for Ablation of Varicose Veins ACCESED 12/9/2011 at Hayes Medical Technology Directory. Endovenous Laser Therapy for Varicose Veins due to Great Saphenous Vein Reflux. Publication Date: February 6, Annual Review February 21, Report archived Mar 01, Hayes Medical Technology Directory. Endovenous Laser Therapy for Varicose Veins due to Small Saphenous Vein Reflux. Publication Date: February 6, Annual Review February 21, Hayes Search and Summary. ClariVein Occlusion Catheter, Nonthermal Vein Ablation System. November 7, Health Technology Brief. Ultrasound-Guided Foam Sclerotherapy (UGFS) for Varicose Veins. Publication Date: November 4, Annual Review: December 9, UpToDate Overview and management of lower extremity chronic venous disease. Literature review current through Aug This topic last updated: Mar 19, UpToDate Medical management of lower extremity chronic venous disease. Literature review current through Sep This topic last updated: Aug 18, MCG Ambulatory Care 19 th Edition. ACG-A-0174 (AC). Saphenous Vein Ablation, Radiofrequency 18. MCG Ambulatory Care 19 th Edition. ACG-A-0425 (AC). Saphenous Vein Ablation, Laser Page 7 of 8
8 19. MCG Ambulatory Care 19 th Edition. ACG-A-0171 (AC). Sclerotherapy Plus Ligation, Saphenofemoral Junction 20. MCG Ambulatory Care 19 th Edition. ACG-A-0172 (AC). Saphenous Vein Stripping 21. MCG Ambulatory Care 19 th Edition. ACG-A-0170(AC).Sclerotherapy, Leg Veins 22. Hayes Technology Brief Endovenous Mechanochemical Ablation (MOCA) (ClariVein Occlusion Catheter) for Treatment of Varicose Veins Pub Date March 15, 2015 Hayes D2 23. UpTo Date Endovenous Laser Ablation for the Treatment of Lower Extremity Chronic Venous Disease. Lit review current through Aug Topic last updated March 20, UpToDate Radiofrequency Ablation for the Treatment of Lower Extremity Chronic Venous Disease. Lit review current through Aug Topic last updated Aug 2, Hayes HTB Varithena (Polidocanol Injectable Foam) 1% (Provensis Ltd.) Pub date March 31, Hayes D2. Approved by Medical Director Page 8 of 8
Effective Date: March 2, 2016
Medical Review Criteria Varicose Vein Procedures Effective Date: March 2, 2016 Treatmetn Subject: Varicose Vein Procedures VeinTreatment of Varicose Policy: Veins HPHC covers specific non-experimental
More informationClinical Medical Policy Varicose Vein Treatment
Benefit Coverage Covered Benefit for lines of business including: Health Benefits Exchange (HBE), Rite Care (MED), Children with Special Needs (CSN), Substitute Care (SUB), Rhody Health Partners (RHP),
More informationMEDICAL COVERAGE POLICY. SERVICE: Varicose Veins of the Lower Extremities. PRIOR AUTHORIZATION: Required.
Page 1 of 5 MEDICAL COVERAGE POLICY Important note Even though this policy may indicate that a particular service or supply may be considered covered, this conclusion is not based upon the terms of your
More informationYes when meets criteria below
Vein Disease Treatment MP9241 Covered Service: Prior Authorization Required: Additional Information: Medicare Policy: BadgerCare Plus Policy: Yes when meets criteria below Yes None Dean Health Plan covers
More informationMedicare C/D Medical Coverage Policy
Varicose Vein Treatment Medicare C/D Medical Coverage Policy Origination Date: June 1, 1993 Review Date: September 16, 2015 Next Review: September, 2017 DESCRIPTION OF PROCEDURE OR SERVICE Varicose veins
More informationMedicare C/D Medical Coverage Policy
Varicose Vein Treatment Origination Date: June 1, 1993 Review Date: July 20, 2016 Next Review: July, 2018 Medicare C/D Medical Coverage Policy DESCRIPTION OF PROCEDURE OR SERVICE Varicose veins of the
More informationPROVIDER POLICIES & PROCEDURES
PROVIDER POLICIES & PROCEDURES SCLEROTHERAPY TREATMENT OF SUPERFICIAL VARICOSE VEINS OF THE LEGS The purpose of this document is to provide guidance to providers enrolled in the Connecticut Medical Assistance
More informationSurgical Options for Venous Disease. Sandra C Carr MD Vascular Surgery Meriter Wisconsin Heart
Surgical Options for Venous Disease Sandra C Carr MD Vascular Surgery Meriter Wisconsin Heart Chronic Venous Disease Approximately 23% of adults in the US have varicose veins Estimated 22 million women
More informationMedical Coverage Policy Treatment for Varicose Veins-PREAUTH
Medical Coverage Policy Treatment for Varicose Veins-PREAUTH Device/Equipment Drug Medical Surgery Test Other Effective Date: 9/1/2001 Policy Last Updated: 12/20/2011 Prospective review is recommended/required.
More informationMEDICAL COVERAGE POLICY SERVICE: Varicose Veins of the Lower Extremities. SERVICE: Treatment of Varicose Veins of the Lower Extremities
Important note Even though this policy may indicate that a particular service or supply may be considered covered, this conclusion is not based upon the terms of your particular benefit plan. Each benefit
More informationLOWER EXTREMITY VENOUS DUPLEX ULTRASOUND:
LOWER EXTREMITY VENOUS DUPLEX ULTRASOUND: Chronic Venous Insufficiency Phillip J Bendick, PhD William Beaumont Hospital Royal Oak, Michigan Prevalence: Carotid ASO ~ 3M Peripheral Arterial Dz ~ 5M + CAD
More informationNon-surgical treatment of severe varicose veins
Non-surgical treatment of severe varicose veins Yasu Harasaki UCHSC Department of Surgery General Surgery Grand Rounds March 19, 2007 Definition Dilated, palpable, subcutaneous veins generally >3mm in
More informationSpotlight Series: Interventional Radiology. Varicose Veins and Venous Insufficiency
Spotlight Series: Interventional Radiology Varicose Veins and Venous Insufficiency What is venous insufficiency? Spectrum of Disease Spider veins and telangiectasias Small reddish and purple veins near
More informationClinical Review Criteria
Clinical Review Criteria Treatment of Varicose Veins Radiofrequency Catheter Closure Sclerotherapy Surgical Stripping Trivex System for Outpatient Varicose Vein Surgery VenaSeal Closure System VNUS Closure
More informationLocal Coverage Determination (LCD): Varicose Veins of the Lower Extremities (L31796)
Local Coverage Determination (LCD): Varicose Veins of the Lower Extremities (L31796) Contractor Information Contractor Name Palmetto GBA LCD Information Document Information LCD ID L31796 LCD Title Varicose
More informationPeninsula Commissioning Priorities Group. Commissioning Policy Varicose Vein Referral
NHS Devon NHS Plymouth Torbay Care Trust Peninsula Commissioning Priorities Group Commissioning Policy Varicose Vein Referral Varicose Vein Referral Guidelines 1. Description of service/treatment Most
More informationMedical Coverage Policy Varicose Vein Treatment sad
Medical Coverage Policy Varicose Vein Treatment sad EFFECTIVE DATE: 10 28 2001 POLICY LAST UPDATED: 05 07 2013 OVERVIEW Varicose veins are large superficial veins that have become swollen. These veins
More informationX-Plain Varicose Veins Reference Summary
X-Plain Varicose Veins Reference Summary Introduction Varicose veins are very common, in both women and men. Varicose veins can be painful and unattractive. Vein doctors use non-invasive ultrasound imaging
More informationModern Management of Varicose Veins
Modern Management of Varicose Veins GPCME 2008 David Ferrar Vascular and Endovascular Surgeon Vascular Ultrasound Specialist Multimodality treatment Compression stockings Sclerotherapy Ultrasound guided
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: varicose_veins_treatment_for 12/2000 11/2014 11/2015 11/2014 Description of Procedure or Service A variety
More informationRANDOMIZED CONTROL TRIALS (RCT s) on VARICOSE VEIN ENDOVENOUS TREATMENT
RANDOMIZED CONTROL TRIALS (RCT s) on VARICOSE VEIN ENDOVENOUS TREATMENT M. PERRIN Lyon - France CONTROVERSIES AND UPDATES IN VASCULAR SURGERY JANUARY 19-21, 2012 Paris B. Eklof Helsingborg, Sweden Thirty
More informationDEBATE ON Management of primary Varicose Veins SURGERY. Adel Husseiny, Kamhawy Vascular Surgery Unit Tanta University
DEBATE ON Management of primary Varicose Veins SURGERY Adel Husseiny, Kamhawy Vascular Surgery Unit Tanta University Efficacy of treatment alternatives Durability of results Cosmetically acceptable results
More informationVenous Reflux Disease and Current Treatments VN20-87-A 01/06
Venous Reflux Disease and Current Treatments Leg Vein Anatomy Your legs are made up of a network of veins and vessels that carry blood back to the heart The venous system is comprised of: Deep veins Veins
More informationMEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION
MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT PAGE: 1 OF: 10 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including
More informationRecurrent Varicose Veins. Vineet Mishra, MD Director of Mohs Surgery and Procedural Dermatology University of Texas Health Science Center San Antonio
Recurrent Varicose Veins Vineet Mishra, MD Director of Mohs Surgery and Procedural Dermatology University of Texas Health Science Center San Antonio Disclosures None Possible Causes of Recurrence DNA:
More informationtreatment of varicose and spider veins patient information SAMPLE a publication by advancing vein care
treatment of varicose and spider veins patient information a publication by advancing vein care Since most veins lie deep to the skin s surface, vein disorders are not always visible to the naked eye.
More informationPatient Information Understanding Varicose Veins
Patient Information Understanding Varicose Veins The Circulatory System Arteries carry oxygenated blood to your legs and the veins carry de-oxygenated blood away from your legs. The blood returns to the
More informationVaricose Veins: Causes, Symptoms and Management. Andrew C. Stanley MD Section of Vascular Surgery
Varicose Veins: Causes, Symptoms and Management Andrew C. Stanley MD Section of Vascular Surgery Circulation Heart (Pump)-MI, Sudden Death Arteries (Stroke, Aneurysms, Walking dysfunction, Limb loss) Veins
More informationVaricose Vein Therapy: An Introduction to Surgical and Endovascular Treatment
Varicose Vein Therapy: An Introduction to Surgical and Endovascular Treatment Lower Extremity Venous Anatomy Deep, Superficial, Perforating, Reticular veins Located in two separate compartments (deep and
More informationMicrofoam Ultrasound-Guided Sclerotherapy of Varicose Veins in 100 Legs
Microfoam Ultrasound-Guided Sclerotherapy of Varicose Veins in 1 Legs JOHN M. BARRETT, FRNZCGP, n BRUCE ALLEN, FRACR, n ANNE OCKELFORD, FRNZCGP, n AND MITCHEL P. GOLDMAN, MD w n Palm Clinic, Auckland,
More informationTREATMENT OF VARICOSE VEINS: CAN IT BE IMPROVED BY MECHANOCHEMICAL ABLATION USING THE CLARIVEIN DEVICE?
TREATMENT OF VARICOSE VEINS: CAN IT BE IMPROVED BY MECHANOCHEMICAL ABLATION USING THE CLARIVEIN DEVICE? Michel MJP Reijnen Rijnstate Hospital, Arnhem The Netherlands mmpj.reijnen@gmail.com Disclosures
More informationVenous leg ulcers. Venous Ulcers. Treat the source, not just the symptom
Venous leg ulcers Venous Ulcers Treat the source, not just the symptom Topics What causes venous ulcers (VU) Treating the source, not just the symptom Diagnosis with venous duplex ultrasound scan Treatment
More informationTHE VEIN CENTER. State-of-the-Art Treatment for Varicose Veins and Spider Veins
THE VEIN CENTER State-of-the-Art Treatment for Varicose Veins and Spider Veins Vein Disorders Nearly 50 percent of the adult population suffers from undesirable, sometimes painful vein disease. The most
More informationSURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS
SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Protocol: SUR037 Effective Date: 5/1/2015 Table of Contents COMMERCIAL INDICATIONS FOR COVERAGE DEFINITIONS MEDICARE AND MEDICAID
More informationModern Varicose Vein Treatments: What Every Patient Should Know
The Skin and Vein Center Oneonta Laser Derm & Day Spa Natural Good Looks and Leg Veins Our Specialty Dr Eric Dohner, MD 41-45 Dietz St Oneonta, NY 13820 607/431-2525 www.oneontalaserderm.com Modern Varicose
More informationTREATMENT OF VARICOSE AND SPIDER VEINS Patient Info
TREATMENT OF VARICOSE AND SPIDER VEINS Patient Info www.heartofthevillages.com TIRED & ACHING LEGS? If you suffer from varicose and spider veins, you are not alone. It is estimated that there are more
More informationMedical Policy Manual. Date of Origin: October 11, 1999. Topic: Varicose Vein Treatment. Last Reviewed Date: May 2015.
Medical Policy Manual Topic: Varicose Vein Treatment Section: Surgery Policy No: 104 Date of Origin: October 11, 1999 Last Reviewed Date: May 2015 Effective Date: September 1, 2015 IMPORTANT REMINDER Medical
More informationTreatment of Varicose Veins/Venous Insufficiency
MEDICAL POLICY POLICY RELATED POLICIES POLICY GUIDELINES DESCRIPTION SCOPE BENEFIT APPLICATION RATIONALE REFERENCES CODING APPENDIX HISTORY Treatment of Varicose Veins/Venous Insufficiency Number 7.01.519
More informationSURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS
COVERAGE POLICY SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: 237.E Effective Date: March 1, 2015 Table of Contents BENEFIT CONSIDERATIONS. COVERAGE RATIONALE...
More informationVARICOSE VEINS. Information Leaflet. Your Health. Our Priority. VTE Ambulatory Clinic Stepping Hill Hospital
VARICOSE VEINS Information Leaflet Your Health. Our Priority. Page 2 of 7 Varicose Veins There are no accurate figures for the number of people with varicose veins. Some studies suggest that 3 in 100 people
More informationCorporate Medical Policy Treatment of Varicose Veins/Venous Insufficiency. Medical Policy
Corporate Medical Policy Treatment of Varicose Veins/Venous Insufficiency File name: Treatment of Varicose Veins/ Venous Insufficiency File code: UM.SURG.03 Origination: 9/01/2010 Last Review: 07/15/2010,
More informationSURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS
CLINICAL POLICY SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: OUTPATIENT 013.24 T2 Effective Date: July 1, 2014 Table of Contents CONDITIONS OF COVERAGE...
More informationSURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS
MEDICAL POLICY SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: 2015T0447O Effective Date: March 1, 2015 Table of Contents BENEFIT CONSIDERATIONS COVERAGE RATIONALE
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of endovenous mechanochemical ablation for varicose veins Treating varicose veins
More informationVeins. Zapping Varicose. Venous diseases affect many people and represent a major cost to the health-care system.
Zapping Varicose Veins Improving the Quality of Life for Sufferers By Jeannette Soriano, MD Venous diseases affect many people and represent a major cost to the health-care system. Hippocrates used compression
More informationCHAPTER 15 SCLEROTHERAPY FOR VENOUS DISEASE
Introduction CHAPTER 15 SCLEROTHERAPY FOR VENOUS DISEASE Original authors: Niren Angle, John J. Bergan, Joshua I. Greenberg, and J. Leonel Villavicencio Abstracted by Teresa L. Carman New technology has
More informationVaricose veins: Surgery can still be considered as an option in the treatment
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 13, Issue 12 Ver. I (Dec. 2014), PP 72-77 Varicose veins: Surgery can still be considered as an option
More informationSEDICO Newsletter Issue 8. Varicose veins
SEDICO Newsletter Issue 8 Definition: Varicose veins Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins occur elsewhere.
More informationProvided by the American Venous Forum: veinforum.org
CHAPTER 17 SURGICAL THERAPY FOR DEEP VALVE INCOMPETENCE Original author: Seshadri Raju Abstracted by Gary W. Lemmon Introduction Deep vein valvular incompetence happens when the valves in the veins (tubes
More informationPrevalence and surgical outcomes of varicose veins at Regional Institute of Medical Sciences, Imphal
ORIGINAL ARTICLE JIACM 2013; 14(3-4): 209-13 Prevalence and surgical outcomes of varicose veins at Regional Institute of Medical Sciences, Imphal Ksh Kala Singh*, A Surjyalal Sharma**, L Sunil Singh***,
More informationDiagnosis and Treatment of Venous Insufficiency and Varicose Veins
Diagnosis and Treatment of Venous Insufficiency and Varicose Veins Joseph Conley, MD Scott and White Memorial Hospital Temple, TX September 22, 2012 Objectives Anatomy and Pathophysiology of venous insufficiency
More informationHealth Technology Assessment of Scheduled Surgical Procedures
HTA of Scheduled Surgical Procedures April 2013 Health Technology Assessment of Scheduled Surgical Procedures Varicose Vein Surgery April 2013 Safer Better Care About the The (HIQA) is the independent
More informationPRIMARY VARICOSE VEIN management has undergone a
Treatment of Primary Varicose Veins Has Changed with the Introduction of New Techniques Eric Mowatt-Larssen* and Cynthia K. Shortell* New technologies have produced a revolution in primary varicose vein
More informationVaricose Vein Treatment (Endovenous Ablation of Varicose Veins)
Scan for mobile link. Varicose Vein Treatment (Endovenous Ablation of Varicose Veins) Varicose vein treatment, also known as endovenous ablation, uses radiofrequency or laser energy to cauterize and close
More informationThe Treatment of Varicose Veins and Spider Veins
The Treatment of Varicose Veins and Spider Veins St. Joseph Vein Center Surgical Specialists of St. Joseph, P.C. Glen H. Hastings, M.D., F.A.C.S. 820 Lester Ave., Suite 105 St. Joseph, MI 49085 (269) 983-3368
More informationVaricose veins - 1 -
Varicose veins - 1 - Varicose Veins About 3 in 10 adults develop varicose veins at some time in their life. Most people with varicose veins do not have an underlying disease and they usually occur for
More informationGreater Manchester EUR Policy Statement. Title/Topic: Varicose Veins Reference: GM003 Date: January 2015
Greater Manchester EUR Policy Statement Title/Topic: Varicose Veins Reference: GM003 Date: January 2015 VERSION CONTROL Version Date Details Page number 0.1 23/10/2013 Initial Draft for consideration by
More informationAMERICAN VENOUS FORUM
Revised Venous Clinical Severity Score AMERICAN VENOUS FORUM Pain : 0 Mild: 1 or other discomfort (ie, aching, heaviness, fatigue, soreness, burning) origin Occasional pain or other discomfort (ie, not
More informationVARICOSE VEINS AND VENOUS INSUFFICIENCY
VARICOSE VEINS AND VENOUS INSUFFICIENCY SURGICAL AND ABLATION TREATMENTS Policy Number: 2014M0064A Effective Date: September 1, 2014 Table of Contents: Page: Cross Reference Policy: POLICY DESCRIPTION
More informationPOLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY
Original Issue Date (Created): 7/12/2003 Most Recent Review Date (Revised): 3/29/2016 Effective Date: 8/1/2016 I. POLICY Great or Small Saphenous Veins Treatment of the greater small saphenous veins by
More informationVaricose veins are generally identified
Management of Varicose Veins Richard H. Jones, MD, MSPH, Naval Health Clinic, Quantico, Virginia Peter J. Carek, MD, MS, Medical University of South Carolina, Charleston, South Carolina Varicose veins
More informationLONG TERM FOLLOW-UP AFTER ENDOVENOUS LASER ABLATION
LONG TERM FOLLOW-UP AFTER ENDOVENOUS LASER ABLATION Giorgio Spreafico Centro Multidisciplinare Day Surgery Azienda Ospedaliera Università Padova - Italy Faculty Disclosure I have no financial relationships
More informationInstitute of Health Economics ENDOVENOUS ABLATION INTERVENTIONS FOR SYMPTOMATIC VARICOSE VEINS OF THE LEGS
Institute of Health Economics ENDOVENOUS ABLATION INTERVENTIONS FOR SYMPTOMATIC VARICOSE VEINS OF THE LEGS September 2014 INSTITUTE OF HEALTH ECONOMICS The Institute of Health Economics (IHE) is an independent,
More informationEndovenous Treatment of Varicose Veins
Supplement to Produced under an unrestricted educational grant from Diomed, Inc. November/December 2004 Endovenous A comprehensive guide to the techniques and technology necessary to establish and maintain
More informationAustralian Safety and Efficacy Register of New Interventional Procedures Surgical. Rapid review ASERNIP-S REPORT NO. 66
ASERNIP S Australian Safety and Efficacy Register of New Interventional Procedures Surgical Rapid review Treatments for varicose veins ASERNIP-S REPORT NO. 66 Australian Safety & Efficacy Register of New
More informationAustralian Safety and Efficacy Register of New Interventional Procedures Surgical. Systematic review ASERNIP-S REPORT NO. 69
ASERNIP S Australian Safety and Efficacy Register of New Interventional Procedures Surgical Systematic review Treatments for varicose veins ASERNIP-S REPORT NO. 69 Australian Safety & Efficacy Register
More informationTreatment of Varicose Veins
Varicose Vein Treatment of Varicose Veins JMAJ 47(3): 146 151, 2004 Osamu SATO Associate Professor, Department of Surgery, Saitama Medical Center Abstract: Varicose vein is a condition that was first described
More informationVenous and Lymphatic Disorders
Venous and Lymphatic Disorders. ก. Venous and Lymphatic Disorders Varicose Veins Deep Vein Thrombosis (DVT) Lymphedema What Is Varicose Veins? Latin: Varicose = Varix = twisted Abnormal venous dilatation
More informationSUMMARY OF GUIDELINES FOR MANAGEMENT OF PATIENTS WITH VARICOSE VEINS AND ASSOCIATED CHRONIC VENOUS DISEASES
The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum Peter Gloviczki, MD, a Anthony
More informationTreatment by LASER. Understanding Varicose veins and. Dr. Rajesh Mundhada (MD. DNB) Dr. Atul Rewatkar (MD)
Understanding Varicose veins and Treatment by LASER Dr. Rajesh Mundhada (MD. DNB) Dr. Atul Rewatkar (MD) Orange city Hospital & Research Institute 19, Pandey Lay out, Veer Sawarkar Square, Nagpur 440015
More informationUnderstanding Varicose Veins
Understanding Varicose Veins Professor Bruce Campbell Published by Family Doctor Publications Limited in association with the British Medical Association IMPORTANT NOTICE This book is intended not as a
More informationV03 Varicose Veins Surgery
V03 Varicose Veins Surgery What are varicose veins? Varicose veins are enlarged and twisted veins in the leg. They are common and affect up to 3 in 10 people. More women than men ask for treatment, with
More informationCHINOOK VASCULAR - ENDOVENOUS LASER ABLATION PROCEDURE
CHINOOK VASCULAR - ENDOVENOUS LASER ABLATION PROCEDURE Endovenous Laser Ablation is a minimally invasive option for treating great saphenous vein incompetence (leaky valves). The first stage of your surgery
More informationEndoVenous Laser Therapy (EVLT) Information Booklet. Dr. Dueck. Varicose Veins
EndoVenous Laser Therapy (EVLT) Information Booklet Dr. Dueck Varicose Veins Varicose veins are abnormally large veins that protrude from under the skin in the legs. They can be associated with a brown
More informationDr Marc Vuylsteke Sint-Andriesziekenhuis Tielt Belgium
Endovenous Laser Treatment of non-gsv truncs Dr Marc Vuylsteke Sint-Andriesziekenhuis Tielt Belgium Superficial venous insufficiency Very common Evolution to chronic venous insufficiency Varicose Disease
More informationNational Medical Policy
National Medical Policy Subject: Policy Number: Varicose Veins Surgical Interventions NMP148 Effective Date*: September 2003 Updated: July 2016 Please contact the Medical Policy Department for an archive
More informationEffectiveness of foam sclerotherapy for the treatment of varicose veins
Effectiveness of foam sclerotherapy for the treatment of varicose veins Vascular Medicine 15(1) 27 32 The Author(s) 2009 Reprints and permission: http://www. sagepub.co.uk/journalspermission.nav DOI: 10.1177/1358863X09106325
More informationRecurrent Varicose Veins
Information for patients Recurrent Varicose Veins Sheffield Vascular Institute Northern General Hospital You have been diagnosed as having Varicose Veins that have recurred (come back). This leaflet explains
More informationSuffering from varicose veins? Patient Information. ELVeS Radial Minimally invasive laser therapy of venous insufficiency
Suffering from varicose veins? Patient Information ELVeS Radial Minimally invasive laser therapy of venous insufficiency Do you suffer from heavy legs or visible veins? This makes diseases of the veins
More informationDr. Linde is an international beauty expert and an acclaimed keynote speaker at conferences all over the world. He is specialized in the treatment of
VEINS Dr. Linde is an international beauty expert and an acclaimed keynote speaker at conferences all over the world. He is specialized in the treatment of fat pads, wrinkles and transformations of the
More informationL. H. Rasmussen, M. Lawaetz, L. Bjoern, B. Vennits, A. Blemings and B. Eklof
Randomized clinical trial Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins L. H. Rasmussen,
More informationBeaumont Hospital. Varicose Veins. and their TREATMENT. Professor Austin Leahy, MCh, FRCS, FRCSI WWW.VEINCLINICSOFIRELAND.COM
Beaumont Hospital Varicose Veins and their TREATMENT Professor Austin Leahy, MCh, FRCS, FRCSI WWW.VEINCLINICSOFIRELAND.COM Department of Surgery Beaumont Hospital and Royal College of Surgeons in Ireland
More informationClassical Varicose Vein Surgery in a Diverse Ethnic Community
ORIGINAL ARTICLE Classical Varicose Vein Surgery in a Diverse Ethnic Community N L Murli, FRCS*, I D Navin, BSc** *Consultant Vascular Surgeon, Penang Adventist Hospital, 10350 Penang, Malaysia, *School
More informationVARICOSE VEINS; OUTCOME OF SURGICAL MANAGEMENT AND RECURRENCES
The Professional Medical Journal www.theprofesional.com ORIGINAL PROF-2328 VARICOSE VEINS; OUTCOME OF SURGICAL MANAGEMENT AND RECURRENCES 1. FCPS Consultant surgeon Department of general surgery Liaquat
More informationDo you have any of these varicose vein symptoms?
Do you have any of these varicose vein symptoms? Heaviness Achiness Swelling Throbbing Itching HASTI Symptoms Ask your doctor if Varithena is right for you Varithena (polidocanol injectable foam) is a
More informationReflux patterns and risk factors of primary varicose veins clinical severity
Published online on 16 February 2012 Phlebology, doi: 10.1258/phleb.2011.011114 Reflux patterns and risk factors of primary varicose veins clinical severity M García-Gimeno*, S Rodríguez-Camarero, S Tagarro-Villalba*,
More informationRandomized clinical trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years
Randomized clinical trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years Lars Rasmussen, MD, Martin Lawaetz, MB, Lars Bjoern,
More informationVaricose veins and spider veins
Varicose veins and spider veins Summary Varicose veins are knobbly, twisted and darkish-blue in appearance, and are most commonly found on people s legs. Varicose veins are caused by faulty valves within
More informationDevelopments in Endovascular and Endoscopic Surgery
Developments in Endovascular and Endoscopic Surgery Radiofrequency Ablation and Laser Ablation in the Treatment of Varicose Veins Jose I. Almeida, MD, FACS, RVT, 1,2 and Jeffrey K. Raines, PhD, RVT, 1,2
More informationEndovenous Laser: A New Minimally Invasive Method of Treatment for Varicose Veins - Preliminary Observations Using an 810 nm Diode Laser
Endovenous Laser: A New Minimally Invasive Method of Treatment for Varicose Veins - Preliminary Observations Using an 810 nm Diode Laser Luis NAVARRO, MD,* ROBERT J. MIN, MD, AND CARLOS BONE, MD *Vein
More informationARTICLE IN PRESS. D.G. Bountouroglou, M. Azzam, S.K. Kakkos, M. Pathmarajah, P. Young and G. Geroulakos*
Eur J Vasc Endovasc Surg xx, 1 8 (xxxx) doi:10.1016/j.ejvs.2005.08.024, available online at http://www.sciencedirect.com on Ultrasound-guided Foam Sclerotherapy Combined with Sapheno-femoral Ligation Compared
More informationVaricose Veins and Spider Veins
page 1 Varicose Veins and Spider Veins Q: What are varicose veins and spider A: Varicose (VAR-i-kos) veins are enlarged veins that can be blue, red, or fleshcolored. They often look like cords and appear
More informationTired, Aching Legs? Swollen Ankles? Varicose Veins? An informative guide for patients
Tired, Aching Legs? Swollen Ankles? Varicose Veins? An informative guide for patients Are You at Risk? Leg problems are widespread throughout the world, but what most people don t know is that approximately
More informationPart Two: Against the Motion. Venous Perforator Surgery is Unproven and Does not Reduce Recurrences
242 Trans-Atlantic Debate 17 Kianifard B, Browning L, Holdstock JM, Whiteley MS. Surgical technique and preliminary results of perforator vein closure e TRLOPS (Transluminal Occlusion of Perforators).
More informationNew approaches for the treatment of varicose veins
Surg Clin N Am 84 (2004) 1397 1417 New approaches for the treatment of varicose veins Theodore H. Teruya, MD, FACS a, Jeffrey L. Ballard, MD, FACS b,c, * a Division of Vascular Surgery, Loma Linda University,
More informationChronic Venous Disease
Varicose Veins Steven M. Dean, DO, FACP, RPVI Associate Professor of Internal Medicine Department of Internal Medicine Division of Cardiovascular Medicine The Ohio State University Wexner Medical Center
More informationEmory Healthcare s model for a PA based vein clinic
Emory Healthcare s model for a PA based vein clinic Stephen Konigsberg PA-C No relationships to disclose Society for Vascular Surgery 2011 Vascular Annual Meeting Chicago, IL June 17, 2011 Division of
More informationwomen and 15% of men (1). Great saphenous vein (GSV) reflux is the most common underlying cause of symptomatic
Standards of Practice Recommended Reporting Standards for Endovenous Ablation for the Treatment of Venous Insufficiency: Joint Statement of the American Venous Forum and the Society of Interventional Radiology
More informationTHE RELATIONSHIP BETWEEN PATIENT STATUS AND RECURRENCY RATE FOLLOWING LASER SURGERY OF VARICOSE VEINS
THE RELATIONSHIP BETWEEN PATIENT STATUS AND RECURRENCY RATE FOLLOWING LASER SURGERY OF VARICOSE VEINS Dr Imre Bihari PhD Budapest, Hungary What can influence laser surgery results? Instrument and method
More information11 Varicose Veins and Venous Ulcers*
11 Varicose Veins and Venous Ulcers* Sue Simpson and Paul Roderick 1 Summary Introduction/statement of the problem Chronic venous disease is the most common vascular condition to affect the lower limb.
More information