Treatment of Varicose Veins/Venous Insufficiency

Policy Statements Greater or Lesser Saphenous Veins Treatment of the greater or lesser saphenous veins by surgery (ligation and stripping) or endovenous radiofrequency or laser ablation may be considered medically necessary for symptomatic varicose veins/venous insufficiency when the following criteria have been met:  There is demonstrated saphenous reflux; AND  There is documentation of one or more of the following indications: o Ulceration secondary to venous stasis that fails to respond to compressive therapy; OR o Recurrent superficial thrombophlebitis that fails to respond to compressive therapy; OR o Hemorrhage or recurrent bleeding episodes from a ruptured superficial varicosity; OR o Persistent pain, swelling, itching, burning, or other symptoms are associated with saphenous reflux, AND the symptoms significantly interfere with activities of daily living, AND conservative management including compression therapy for at least 3 months has not improved the symptoms*.