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2025 CPT code 36466

Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (e.g., great saphenous vein, accessory saphenous vein), same leg.

Refer to the National Correct Coding Initiative (NCCI) and other relevant coding guidelines for proper coding and billing practices.

Modifiers such as 50 (Bilateral Procedure), 76 (Repeat Procedure by Same Physician), and others may be applicable depending on the specific circumstances of the procedure.

Medical necessity must be established for this procedure. The varicose veins must be symptomatic, causing pain, aching, swelling, or other symptoms impacting the patient's quality of life. Simply having varicose veins visible is insufficient to demonstrate medical necessity if cosmetic reasons are the main concern.

The physician is responsible for preparing the patient, using ultrasound to identify the diseased veins, inserting the needle/catheter, injecting the sclerosant, applying compression maneuvers, removing the needle, and applying pressure to stop bleeding. They repeat the procedure on multiple veins on the same leg.

IMPORTANT:(Do not report 36465, 36466 in conjunction with 29520, 29530, 29540, 29550, 29580, 29581, 29584, for the same extremity)(Do not report 36465, 36466 in conjunction with 37241 in the same surgical field)(For extremity truncal vein injection of compounded foam sclerosant(s), see 36470, 36471)(For injection of a sclerosant into an incompetent vein without compression maneuvers to guide dispersion of the injectate, see 36470, 36471)(For endovenous ablation therapy of incompetent vein(s) by transcatheter delivery of a chemical adhesive, see 36482, 36483)(For vascular embolization and occlusion procedures, see 37241, 37242, 37243, 37244)

In simple words: This procedure involves injecting a special foam solution into varicose veins in the same leg to close them. Ultrasound is used to see the veins and guide the injection.

This code describes a procedure where a physician injects a non-compounded foam sclerosant into multiple incompetent truncal veins in the same leg. Ultrasound guidance is used to monitor the dispersion of the injectate and compression maneuvers are used to guide this dispersion. This code includes all imaging guidance and monitoring.

Example 1: A patient presents with multiple varicose veins in their left leg causing pain and discomfort. The physician uses ultrasound guidance and compression maneuvers to inject a foam sclerosant into the great saphenous vein and the accessory saphenous vein in the left leg., A patient with multiple incompetent truncal veins in the right leg, including the great saphenous vein and two of its tributaries, is treated with ultrasound-guided foam sclerotherapy using compression maneuvers., A patient presents with cosmetic concerns and symptomatic varicose veins in the right leg and prefers foam sclerotherapy. The physician confirms medical necessity after duplex ultrasound demonstrates the presence of reflux in multiple truncal veins.

Documentation should include the diagnosis, the number and location of veins treated, the type of sclerosant used, the use of ultrasound guidance and compression maneuvers, any complications, and the post-procedure instructions given to the patient.

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