Sclerotherapy The purpose of this policy is to provide general information applicable to the administration of health benefits that Horizon Blue Cross Blue Shield of New Jersey and Horizon Healthcare of New Jersey, Inc. (collectively "Horizon BCBSNJ") insures or administers. For medical providers, you can also complete and submit preauthorization requests . Phone. Medicare and AHCCCS will also cover treatment. MCG care guidelines - Call BCBSAZ at 1-800-446-8331. Please refer member-specific questions to the Customer Care number on the back of the member ID card. FEP 7.01.124 Treatment of Varicose Veins/Venous Insufficiency The policies contained in the FEP Medical Policy Manual are developed to assist in administering contractual benefits and do not constitute medical advice. Six . Medical policies are medical determinations about a particular technology, service or drug that, while such technology, service or drug may be medically necessary, it is excluded under the terms of a member's benefit plan. Providing current and pertinent information regarding technologies (devices, procedures for medical and behavioral health) Improving the quality . Pharmacy; Medical and Payment Policies; Preauthorization; Dental; . It's important that you know the answer not only for your health but for medical insurance coverage as well. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is not responsible for the content, advice, products or services offered therein. Includes the cost of the sclerosing agent. In Connecticut: Anthem Health Plans, Inc. On January 24, 2019, the Medical Policy and Technology Assessment Committee (MPTAC) approved the following Medical Policies applicable to Anthem Blue Cross and Blue Shield (Anthem). Our insurance concierge will contact your Blue Cross Blue Shield providers on your behalf to help maximize your coverage. Apr 16, 2020. If your Medicare coverage does allow for varicose vein treatment, your specific costs can vary based on the specific procedure and its recovery process. BlueCard (Out-of-Area) plans - Access information from other BCBS Plans through the secure provider portal at "Practice Management > Medical Policies > BlueCard (Out of-Area) Members" Federal Employee Program (FEP) plans - Go to FEPblue.org > Policies & Guidelines Surgical treatment of varicose veins on the contralateral extremity may be considered medically necessary only if that leg is also symptomatic. BCBSTX Medical Policies and BCBSTX Clinical Payment and Coding Policies Blue Cross and Blue Shield of Texas (BCBSTX) Medical Policies are based on scientific and medical research. View Provider Manual . BCBSTX Clinical Payment and Coding Policies are based on criteria developed by specialized professional societies . For example, tight stockings can correct circulation issues. Most insurance companies will pay for a clinical evaluation and venous color duplex ultrasound exam, if indicated, for pain, tenderness, swelling, abnormal skin conditions, or varicose veins. View Medical Policies. As you review medical policies, please consider the following: Medical policies are written for physicians and may be highly technical and complex. Search: Medical Policy Medicare Policy . The Blue . Varicose Vein Treatment Upload date. While medical Insurance carriers typically update medical policies annually, there are many reasons why they might review or update a policy. ALL of the general medically necessary criteria above outlining when treatment for symptomatic varicose veins is eligible for reimbursement are met. Key Points: Find the medical policy you need in the library below. InterQual criteria is used to evaluate whether a medical procedure or equipment . Insurance Information. The first step is elimination of the refluxing saphenous vein using either ligation and stripping, or endovenous radiofrequency or laser ablation. . Management of Varicose Veins ; Manipulation under Anesthesia for Treatment of Chronic Spinal or Pelvic Pain; Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders ; Measurement of Long-Chain Omega-3 Fatty Acids in Red Blood Cell Membranes as a Cardiac Risk Factor If medical policy is not located, please refer to the list of specialized services to confirm if medical necessity review is needed. Surgical treatment of varicose veins on the contralateral extremity is eligible only if that leg is also symptomatic. They are often used as guidelines for coverage determinations in health care benefit programs. In addition to the active and pending Medical Policies, BCBSIL has included policies which are under development or being revised. BlueCross adopts and disseminates specific nationally recognized clinical practice guidelines for use by our network providers. larger vein. Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississippi. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. To aid in the . Treatment of Varicose Veins/Venous Insufficiency Policy # 00034 Original Effective Date: 08/26/2002 Current Effective Date: 10/10/2022 Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc. Provider Manual. View Medical Policies Attention Blue Cross Blue Shield of NC Customers This is an important message for individuals with BlueCross BlueShield of North Carolina insurance. View Medical Policies on MedPolicy Blue Medical policy and pre-certification guidelines are specific to each member's Blue Plan. Blue Cross Blue Shield of Massachusetts' privileging requirement for our providers in Massachusetts who perform radiology procedures to treat varicose veins (such as endovenous radiofrequency ablation (RFA) and laser ablation) is designed to ensure that our members receive access to appropriate treatment from providers and facilities that meet standards of care for these procedures. You must answer each question by choosing either Yes, No or another appropriate option. Mailing Address. You can choose to view a listing of all our medical policies or search for a specific policy. Ablation, Endovenous, Varicose Vein . Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. The answer is YES, varicose vein treatment is covered by most commercial insurance carriers such as Blue Cross Blue Shield, Champus, Aetna, Cigna, Humana, Health Net, Tricare, UMR, and UnitedHealthCare to name a few. Insurance companies like Blue Cross Blue Shield will typically cover treatment if you have: Leg pain Leg swelling Leg cramping Leg heaviness Restless Leg Syndrome Skin discoloration around the ankles (venous stasis) The purpose of the Horizon Medical Policy Manual is to provide clinical policies applicable to the administration of health benefits insured or administered by Horizon Blue Cross Blue Shield of New Jersey, Horizon Healthcare of New Jersey, Inc., Horizon Insurance Company, and Healthier . Medical policies, which are based on the most current research available at the time of policy development, state whether a medical technology, procedure, drug or device is: . The memo was from Blue Cross Blue Shield of Massachusetts (BCBSMA). Some other treatment options can include surgically removing the veins, stripping the entire affected vein out of the body, closing the veins with chemicals, and laser therapy. Requests directly related to medical policy content or requests for clinical criteria may be sent to the Medical Policy Operations Specialist via email, fax, phone or mail. Many people only try home treatment for . A uniform set of medical policies, including criteria for medical necessity of certain DME/HME products, is established by the Blue Cross and Blue Shield of Nebraska Medical Policy Committee. Email. Prior authorization Our staff including Michella, Beth, or Lucy will call BCBS of Arizona and request "prior authorization" as well as obtain benefits. Your source for commonly asked questions about healthcare coverage, claims procedures, policies and more. this policy is intended to be used for some or all of the following purposes in blue cross and blue shield's administration of plans: (i) adjudication of claims (including pre-admission certification, pre-determinations and pre-procedure review), (ii) retrospective review of provider claims, (iii) provider audits, (iv) fraud and abuse 2/27/2019. They want to be confident that you do have some problems with the circulation or symptoms associated with your varicose veins. Blue Cross and Blue Shield of Texas (BCBSTX) Medical Policies are based on scientific and medical research. Author: Blue Cross/BCN Provider Communications Created . What is the CIGNA varicose vein policy? They have guidelines that are plan specific, which allow payment based on medical necessity. Negative Pressure Wound Therapy for the Treatment of Wounds - DME101.036 Orthotics - DME103.001 . Reimbursement policy documents our payment policy and correct coding for medical and surgical services and supplies. Medical policy list. (2011) assessed compression stockings as initial treatment for varicose veins in patients without venous ulceration. View the medical and drug authorization tables to determine when to request an authorization. Medical insurance won't . Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company , Capital Advantage Assurance Company and Keystone Health Plan Central. The following explain Blue Cross Blue Shield of Michigan and Blue Care Network's policies and practices: Additional Information; Blue Care Network policies and practices; Michigan HMO laws; Services That Need Preapproval; How We Choose Providers for Our PPO and EPO Networks; How We Choose Providers for Our HMO Networks View PDF. The online Medical Policy Reference Manual contains approved medical policies and operating procedures for all products offered by CareFirst. View PDF. Blue Cross Blue Shield may cover your varicose vein treatment if your situation meets their definition of "medical necessity." They provide different levels of coverage for different procedures. Are varicose veins covered by insurance? This way you know how much you will owe before any treatment is done and you can be assured the insurance has "authorized" the treatment as well. Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc. (collectively referred to as "BCBSLA") have developed these medical . Blue Shield of California Reproduction without authorization from 601 12th Street, Oakland, CA 94607 Blue Shield of California is prohibited Medical Policy An i ndependent m ember of the Blue Shield Association C. 7.01.124 Treatment of Varicose Veins/Venous Insufficiency Original Policy Date: October 11, 2000 Effective Date: July 1, 2022 Effective Date: January 1, 2014 . Title: Varicose vein tx, adults: Authorization criteria . Some patients who suffer from varicose veins and spider veins (a mild variation of varicose veins) seek treatment for cosmetic reasons. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. According to a publication about varicose vein treatments on the company's website, it appears that Blue Cross Blue Shield may cover varicose vein treatment. The number of legs with varicose veins increased to 40.7% at 5 years. For all other codes, Blue Cross & Blue Shield of Rhode Island (BCBSRI) follows the medical necessity criteria from Centers for Medicare and Medicaid Services (CMS) National and Local Coverage . . Answered by Advanced Varicose Veins Treatments of Manhattan (View Profile) Blue Cross plans do often pay for varicose vein procedures. One of the first paths of treatment for varicose veins is compression therapy. Does Medicaid cover varicose vein treatment? Our medical policies include evidence-based treatment guidelines and address common medical situations. Blue Cross Blue Shield may cover varicose vein treatment if it's deemed medically necessary, i.e., you have underlying vein disease. Since medical technology is dynamic, the Company reserves . It is also inconvenient and uncomfortable for many patients. A Cochrane review by Shingler et al. . Med Policy Blue. 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