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tci General Surgery Coding Alert - 2002 Issue 8

Preauthorization Bolsters Payment Odds for Vein Ligation

Although payers often classify vein ligation (e.g., 37720, 37730 and 37785) as cosmetic, many will reimburse for these surgeries if their individual reporting and documentation guidelines are observed. Generally, the payer will prescribe a specific course of treatment that must have been followed prior to surgery, as well as the need for preauthorization, before they will reimburse for the procedures. For example, Regence Blue Cross/Blue Shield of Oregon guidelines specify that "Cosmetic or potentially cosmetic procedures (e.g., breast surgery, rhinoplasty, septorhinoplasty, varicose vein surgery/sclerotherapy, male gynecomastia surgery)" require preauthorization. The policy notes that varicose veins, for instance...

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