FIRST COAST SERVICE OPTIONS
LOCAL COVERAGE DETERMINATION
CODING GUIDELINES


Contractor’s Determination Number

A36470

Contractor Name

First Coast Service Options, Inc.

Contractor Number

09101 – Florida
09201 – Puerto Rico/Virgin Islands

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 – Florida
03/02/2009 – Puerto Rico/Virgin Islands

Original

 


Document formatted: 12/07/2009 (SS/st)