Reimbursement


CPT Codes 36465 & 36466 are here

 

CPT Codes Explained

36465 - Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein).

36466 - Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg.



How do these CPT codes affect you? Reach out to your rep for policy primers

 

2019 Medicare National Rates

As of January 1st, 2019, Varithena® may be billed with one of the following CPT codes listed below, for the physician office setting.
Per CPT instructions, the code selected should accurately describe the service performed.

 
CPT Code Description Total RVUs Payment
36465 Injection non-compounded foam sclerosant, single vein 43.64 $1,572.75
36466 Injection non-compounded foam sclerosant, multiple veins 45.87 $1,653.11
36470* Injection sclerosing solution, single vein 3.02 $108.84
36471* Injection sclerosing solution, multiple veins, same leg 5.47 $197.13


*If the targeted vein is an extremity truncal vein and injection of non-compounded foam sclerosant with ultrasound guided compression maneuvers to guide dispersion of the injectate is performed, see 36465,36466. Reference: Current Procedural Terminology (CPT®) Professional Edition 2019. CPT Copyright 2018 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.

Disclaimer

The following publicly available information is presented for illustrative purposes only and is not intended to provide coding, reimbursement, treatment, or legal advice. It is not intended to guarantee, increase or maximize reimbursement by any payer.

Laws, regulations and policies concerning reimbursement are complex and are updated frequently. Individual coding decisions should be based upon diagnosis and treatment of individual patients. BTG does not warrant, promise, guarantee, or make any statement that the codes supplied in this guide are appropriate or that the use of this information will result in coverage or payment for treatment using [insert BTG product name] or that any payment received will cover providers’ costs. BTG is not responsible for any action providers take in billing for, or, appealing [insert BTG product name] claims. Hospitals and physicians are responsible for compliance with Medicare and other payer rules and requirements and for the information submitted with all claims and appeals. Before any claims or appeals are submitted, hospitals and physicians should review official payer instructions and requirements, should confirm the accuracy of their coding or billing practices with these payers, and should use independent judgment when selecting codes that most appropriately describe the services or supplies furnished to a patient. It is the provider’s responsibility to determine and document that the services provided are medically necessary and that the site of service is appropriate.

While we have made an effort to be current as of the issue date of this document, the information may not be current when you view it. Providers are encouraged to contact third-party payers for specific information on their coverage, coding and payment policies. Please consult with your legal counsel or reimbursement specialists for any reimbursement or billing questions.

 
1.png

Ordering Varithena®

Varithena® can be ordered through BTG International or another approved specialty distributor. See the list and contact information below.
 

Reminder: Do you have the supplies you need?


A new Varithena® administration pack is needed for each patient. It is recommended that you have an additional Varithena® bi-canister and administration packs on hand at all times.
 

If you wish to return product that you have received, please review the  Returned Goods Policy.

 

Learn more about the efficacy and safety of Varithena® in our clinical data


Specialty Distributor Contact Information
(alphabetical order)

BTG Direct Physician Offices, Hospitals 855-971-8346 (VEIN) 877-626-9910 Please email: Varithena.CustomerCare@btgplc.com
Specialty Distributor Customer Telephone Fax Web Orders
ASD Healthcare Hospitals 800-746-6273 800-547-9413 asdhealthcare.com
Cardinal Health Specialty Distribution Physician Offices, Hospitals 866-677-4844 888-345-4916 specialtyonline.cardinalhealth.com
McKesson Plasma and Biologics Hospitals 877-625-2566 888-752-7626 Please Call for Ordering
McKesson Specialty Health Physician Offices 855-477-9800 800-289-2985 mscs.mckesson.com

 

If you would like materials to help tell your patients about Varithena® including patient brochures, posters, press release templates and web announcements, please Contact Us or discuss with your Varithena® Sales representative.

Questions?

Contact your
Territory Sales Manager

Contact Customer Service at

1-855-971-VEIN (8346)

Monday through Friday,
8 am to 5 pm ET

Contact Us

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

INDICATIONS

Varithena®  (polidocanol injectable foam) is indicated for the treatment of incompetent great saphenous veins, accessory saphenous veins and visible varicosities of the great saphenous vein (GSV) system above and below the knee. Varithena®  improves the symptoms of superficial venous incompetence and the appearance of visible varicosities.

IMPORTANT SAFETY INFORMATION

The use of Varithena®  is contraindicated in patients with known allergy to polidocanol and those with acute thromboembolic disease.

Severe allergic reactions have been reported following administration of liquid polidocanol, including anaphylactic reactions, some of them fatal. Observe patients for at least 10 minutes following injection and be prepared to treat anaphylaxis appropriately. Intra-arterial injection or extravasation of polidocanol can cause severe necrosis, ischemia or gangrene. Patients with underlying arterial disease may be at increased risk for tissue ischemia. If intra-arterial injection of polidocanol occurs, consult a vascular surgeon immediately.

Varithena®  can cause venous thrombosis. Follow administration instructions closely and monitor for signs of venous thrombosis after treatment. Patients with reduced mobility, history of deep vein thrombosis or pulmonary embolism, or recent (within 3 months) major surgery, prolonged hospitalization, or pregnancy are at increased risk for developing thrombosis. The most common adverse events observed were pain/discomfort in extremity, retained coagulum, injection site hematoma or pain, common femoral vein thrombus extension, superficial thrombophlebitis, and deep vein thrombosis.

Physicians administering Varithena®  must be experienced with venous procedures, possess a detailed working knowledge of the use of the duplex ultrasound in venous disease and be trained in the administration of Varithena® .

See Full Prescribing Information for Varithena®.

Follow Us