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Last Modified: 6/15/2022 Location: FL, PR, USVI Business: Part A, Part B

Billing for vein ablation services? Access our LCD guidelines

Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treatment for lower extremity varicose veins. Common findings indicate that medical necessity and documentation requirements are often not supported within the medical records submitted.

Code
Description
36475
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated
36478
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated
We’d like to remind providers who bill for these services to review First Coast’s LCD L38720 Treatment of chronic venous insufficiency of the lower extremities external link which provides coverage and documentation guidance. Our LCD provides details regarding medical necessity and documentation requirements that will help you avoid unnecessary claim denials.
Within the LCD is a link to the corresponding LCA A58250 Billing and Coding: Treatment of Chronic Venous Insufficiency of the Lower Extremities external link for coding guidance and additional documentation guidelines.
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