Payment policy for radiofrequency and laser treatment of varicose veins aligns with medical policy

In support of correct coding and payment accuracy, Blue Cross Blue Shield of Michigan’s payment policy for radiofrequency and laser treatment of varicose veins aligns with our medical policy. 

Our medical policy allows a lifetime limit of two per left leg and two per right leg for radiofrequency or laser treatment of varicose veins. In addition, the appropriate modifier must be appended to the procedure code billed to indicate which side of the body the service was performed on (e.g., LT, RT, 50).

Claims submitted with CPT codes *36475 and *36478 will be evaluated to ensure that they don’t exceed the established limit and that they include the appropriate modifier. Claims that don’t meet the criteria may receive a denial.

Also, keep in mind that if the related add-on codes are submitted without the required base codes, they’ll receive a denial.  

Following are the code descriptions and other information that coincide with the treatment and modifiers referenced in the policy: 

*36475 – Endovenous radiofrequency, first vein
*36476 – Endovenous radiofrequency, add-on code

*36478 – Endovenous laser, first vein
*36479 – Endovenous laser, add-on code

LT – left side
RT – right side
50 – bilateral