FIRST COAST SERVICE OPTIONS
LOCAL COVERAGE DETERMINATION
CODING GUIDELINES
Contractor’s
Determination Number
A36470
Contractor Name
First Coast Service
Options, Inc.
Contractor
Number
09101 –
09201 – Puerto Rico/Virgin
LCD Title
Treatment of
varicose veins of the lower extremities
Coding
Guidelines
Procedure
code 76942 represents a service that is not covered by Medicare for the
purposes of this LCD.
Procedure codes
36475, 36476, 36478 and 36479 are inclusive of image guidance required
for the procedure. Therefore 93965, 93970 and 93971 will not be separately
reimbursed when billed in conjunction with 36475, 36476, 36478 and 36479. One
pre-operative imaging study (93965, 93970, 93971) is allowed as described under
the indications and limitation section of the LCD.
CPT code 37761 is
inclusive of the ultrasound guidance needed to perform the procedure described
by CPT code 37761. Therefore, CPT codes
76937, 76942, 76998 and 93971 will not be separately reimbursable when billed in
conjunction with CPT code 37761.
Sclerotherapy
Report 36470 for injection of one vein.
Report 36471 for injection of multiple veins on the same leg.
If both legs are injected report as follows:
One vein on the left, two on the right: 36470
LT and 36471 RT. Injections for each leg should be reported on separate lines.
One vein on each leg: Report 36470 LT and
36470 RT, each on a separate line of the claim.
Multiple veins on each leg: Report 36471 LT
and 36471RT, each on a separate line of the claim.
In all the above cases, bill one unit per
code
Ligation
Report the appropriate ligation code (37700,
37718, 37722, 37735, 37760, 37761,
37780, 37785) when performed bilaterally with modifier 50.
Do not report 37718 with 37735, 37780.
Do not report 37722 with 37700, 37735.
Do not report 37735 with 37700, 37718, 37722,
37780.
Other Comments
N/A
Revision History
Date |
Revision |
01/01/2010 |
1 – Annual 2010
HCPCS Update. Added CPT code
37761. The effective date of this
revision is based on date of service. |
02/16/2009 – |
Original |
Document formatted: 12/07/2009
(SS/st)