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Procedure Reimbursement

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Reimbursement

Most carriers provide coverage for the VenaCure EVLT® procedure (see list) when medically necessary, using the following codes:

Codes for VenaCure EVLT Procedure

36478: Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser, first vein treated.

36479: Second and subsequent veins treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure).

Of the numerous health insurance plans in the Unites States, many follow Medicare policy, however private payer requirements may vary. The unadjusted national average Medicare reimbursement for an in-office procedure, established by the Center for Medicare and Medicaid Services (CMS) for 2011 is:

36478: $1,447 for office-based procedures and a professional payment of $368 when services are provided at a facility.

36479: $412 for office based procedures and a professional payment of $180 when services are provided at a facility.

Hospital outpatient departments (HOPD) are compensated based on the applicable ambulatory payment classification (APC) – 0092. Payments at Ambulatory Surgical Centers (ASC) are compensated at $1117.

AngioDynamics® is committed to providing its customers with reimbursement support materials for use in conjunction with the VenaCure EVLT system. We provide a guide designed for those people responsible for payer relations, coverage and/or pre-certification and the billing and reporting of services provided to the patient. In the event that your local carrier has not provided a written coverage policy for the VenaCure EVLT procedure, you may find it helpful to contact your Provider Relations.

This information is provided by AngioDynamics as a guide for coding procedures and services involving the VenaCure EVLT procedure. It is not intended to increase or maximize reimbursement by any payer. This information is intended to assist providers in accurately obtaining coverage and reimbursement for their health care services. Providers assume full responsibility for all reimbursement decisions or actions. We strongly suggest you consult your payer organizations with regard to local coverage, bundling and reimbursement policies.