2025 CPT code 36466
Effective Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Feed
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.
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.
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.
- Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
- Specialties:Vascular surgery, Interventional radiology, Phlebology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center