AHA Coding Clinic® for HCPCS - 2021 Issue 2; Ask the Editor

Vein stripping with excision of cluster varicosities

A patient with left lower extremity varicose veins presented for stripping and ligation of the accessory saphenous vein in addition to excision of cluster varicosities in the lower leg. A small incision was made in the groin for dissection of the saphenofemoral junction. Tributary veins were divided and the saphenofemoral junction was ligated. A transverse incision was made at the start of the varicosities in the medial distal thigh where the saphenous vein was identified. An endoluminal vein stripper was placed inside the vein and brought up to the groin. The vein was pulled slightly beneath the skin and the groin incision was closed. A series of stab wounds were made overlying the cluster varicosities in the lower leg. The varicose veins were avulsed and removed with the tributary veins, and the wounds were closed. Placing manual pressure on the thigh, the segment of accessory saphenous vein was removed through the transverse incision with the use of the endoluminal vein stripper. Is CPT 37700 the correct code for stripping and ligation of the accessory saphenous vein as it is a tributary of the greater saphenous vein? Would the excision of the cluster varicosities be additionally reported as they were removed via a separate incision?...

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