In simple words: This code describes a procedure to treat varicose veins.After the first varicose vein in a leg is treated (using a different code), this code is used for each additional varicose vein treated in that same leg, using a special tool that combines mechanical and chemical methods to close the vein. Each additional vein treated needs its own small skin opening.

This CPT code, 36474, reports endovenous ablation therapy of incompetent veins in the same extremity following the initial vein treatment (coded as 36473).The procedure involves percutaneous access, mechanochemical ablation (using a device that combines mechanical disruption and chemical sclerosis), and includes all imaging guidance and monitoring. Each subsequent vein treated requires a separate access site and is reported with 36474.This code should only be used in conjunction with 36473 for the first vein treated and is not to be reported more than once per extremity.

Example 1: A patient presents with multiple varicose veins in their left leg.The physician performs endovenous mechanochemical ablation on the largest vein (36473).Two additional varicose veins in the same leg are then treated using the same technique, each requiring a separate access site, coded with 36474., A patient with varicose veins in their right leg undergoes endovenous mechanochemical ablation of the primary vein (36473).Two smaller, secondary varicose veins in the same leg require ablation using separate access points, each coded as 36474., A patient presents with extensive varicose veins in their left leg. The physician performs mechanochemical ablation on the most significant vein (36473). Three additional varicose veins are treated with mechanochemical ablation, each through a separate access site (36474 x 3).

Detailed patient history and physical examination noting the presence of varicose veins. Pre-procedure imaging (e.g., ultrasound) to identify the location and extent of varicose veins.Intra-operative imaging documentation of catheter placement, device deployment, and confirmation of vein occlusion. Post-procedure imaging documentation to confirm successful ablation.Operative report detailing the technique used, the number of veins treated, and the access site(s) used. Any complications encountered should also be documented.

** The mechanochemical ablation technique combines mechanical disruption and chemical sclerosis.Always refer to the most up-to-date CPT manual and payer guidelines for the most accurate coding and reimbursement information.