This article written by Bandina Harris marks it clear that even the famous also have the same issues we all have. They have varicose vein issue. They have spider vein issues. And they have to think about varicose vein treatments, laser treatments, Vnus procedures, all the minimally invasive vein treatment procedures available, spider vein removal, etc.
Here’s the Spider Vein Article board certified doctors, learn more
“Yes, Some Celebrities Probably Have Spider Veins”
Celebrities are supposed to look perfect, but there are definitely some who have problems like spider veins. Of course, trash magazines tend to focus more on the cellulite issue, but, whatever. First of all, just look at those ridiculous heels that celebrities (sometimes both male and females) wear on the red carpet. Those are more than enough to create spider veins, since they are caused by pressure placed on the legs.
Oh, and another thing that causes spider veins? Too much running! There are tons of paparazzi photos of celebrities jogging around. Well, they had better have the right shoes, because that pounding on the ground not only leads to shin splints, it also results in spider veins! Oh yes, celebrities are not immune to the everyday woes of regular people. The difference, however, is that they have the money to cover up problems quickly. In this case, they can have laser treatments to zap away those little annoying veins. In the interim, they can wear pants or flowing skirts, and no one would ever know the difference!
Article Source: http://EzineArticles.com/?expert=Bandina_Harris

Tags: Uncategorized by platinum
No Comments »

Medically, when we think of spider veins we think of laser treatment almost immediately. Here is an article from ABOUT.COM which discusses other alternatives, specifically, comedic concealers.

Unsightly veins on the legs (known as “spider veins”) can be camouflaged with long-lasting body makeup specially formulated to cover tattoos, spider veins, scars, stretch marks and bruises.

You’ll want to choose a concealer that matches the color of the skin on your legs (this will likely be different from your face). Once applied, body makeup should be set with a powder so it won’t come off on your clothes.

The best body makeup on the market today is Dermablend Leg and Body Cover and Cover FX. Another good body makeup product is Cover FX. Don’t want to buy online? Check out Dermablend’s store locator. To remove scars, spider veins permanently, see a doctor about fractional lasers, such as Fraxel. These can be pricey, but in just a few sessions your scars and veins will disappear.
By Julyne Derrick, About.com
http://beauty.about.com/od/beautybyageteensto50/qt/coverveins.htm

Tags: Home Remedies, Uncategorized by platinum
No Comments »

Isn’t it a little comforting to know that ordinary people and luminaries often suffer from the same ailments as you and I? Here are some articles that make it clear varicose veins, spider veins, vein issues, and the need for vein treatment is something that affects all of us.

Hollywood is the place of dreams for many people. Every year, thousands of people from around the world get it in their heads that they want to become an actor or an actress, and flock to the epicenter of moviemaking. Some of these people end up living in their cars for a while, but they keep trying. Others happen to know someone in the industry, have a great publicity agent, and become (gasp!) celebrities.
Celebrities are supposed to look perfect, but there are definitely some who have problems like spider veins. Of course, trash magazines tend to focus more on the cellulite issue, but, whatever. First of all, just look at those ridiculous heels that celebrities (sometimes both male and females) wear on the red carpet. Those are more than enough to create spider veins, since they are caused by pressure placed on the legs.
Oh, and another thing that causes spider veins? Too much running! There are tons of paparazzi photos of celebrities jogging around. Well, they had better have the right shoes, because that pounding on the ground not only leads to shin splints, it also results in spider veins! Oh yes, celebrities are not immune to the everyday woes of regular people. The difference, however, is that they have the money to cover up problems quickly. In this case, they can have laser treatments to zap away those little annoying veins. In the interim, they can wear pants or flowing skirts, and no one would ever know the difference!
From:Ezinearticles.com
Link: http://ezinearticles.com/?Yes,-Some-Celebrities-Probably-Have-Spider-Veins&id=1466149

Here is an article from an Eastern European Point of view:
“Too much fitness makes Hollywood celebrities look ugly”
To look beautiful and fabulous is a professional duty for every star. Sometimes celebrities may go too far in their attempts to remain eternally young.
Too much fitness makes Hollywood celebrities look ugly

Many of Hollywood celebrities are addicted to physical exercises, diets and plastic surgery. Fitness has always seemed to be least harmful among these manias. However, if sport does not damage people’s health as starvation and operations do, it may distort their looks. See more below about Varicose and Spider Veins
Another “well-shaped” American is a 42-year-old star of Sex and the City, Sarah Jessica Parker. Five years ago the actress astonished the public when she got back into shape only a month after child-bearing. Not everyone admires her looks now. Every-day jogging and pilates led to thinness and aging. Due to the low level of subcutis, Parker’s veins and muscles are distinctly seen on her arms, whereas weight-lighting made her breast muscles look masculine.
Contagious sport-addiction reached other countries as well. British actress Tara Palmer Tompkinson, the beloved of Robbie Williams, claims that she is ashamed of her great biceps she has acquired while working as a model. Still every time she goes out, she shows them by wearing low-cut dresses. She complained to The Daily Mail reporters that it was all because of peculiarities of her body. She cann’t put on weight in spite of unsparing workouts, no matter how hard she tries. Besides, constant exercises for arm muscles resulted in varicose veins that cannot be covered by subcutaneous fat.
Translated by Julia Bulygina Pravda.ru
Link: http://english.pravda.ru/society/showbiz/12-03-2008/104466-hollywood_celebrities-0

Tags: Uncategorized by platinum
No Comments »

How likely is it that someone, on average will suffer from venous issues such as spider veins and varicose veins? That question comes up frequently. Here is some information which will give you a rough idea of what your probability is, other factors, not considered. Obviously you will want to research more as to types of treatment for spider and varicose vein issues – surgerical, non-surgerical treatments, laser treatments, VNUS procedure, compression stocking, etc. But that is getting a bit ahead of ourselves. Here is some raw probability data:

First, understand that varicose veins are enlarged veins which are flesh-colored, darkish purple, even blue. They will appear primarily in your legs as cords, twisted and bulging. They are above the skin and appear to be swollen. Most commonly you will find varicose veins on the backs of your calves or on the inside of your legs.

About 50% to 59% percent of women and 38% to 48% percent of men (in the US) incur or suffer from some degree of this vein ailment. From an age point of view varicose veins appear in 50% of people that are over 50 years old.

Tags: Uncategorized by platinum
No Comments »

We have often been asked to discuss the relationship between varicose veins, spider veins other venous issues and fitness activities. This copyrighted information from RUNNING AND FITNESS NEWS is very interesting reading on the subject.

I am 73 years old and weigh 155 lbs at 5′ 10″. I’ve been running five miles a day since I was 39. Recently I cut it back to four miles (11:00/mile) every other day, working out on Nautilus machines on off-days.

I have had varicose veins since I was 25 and now both legs have bulging veins. I have been told that running won’t make them worse, but in the last few weeks I’ve noticed several new veins emerging in the inner-thigh area. They sting slightly as I near the end of my runs. Would support hose help keep them from getting any worse? Should I continue to run?

Dale Smutz, Danville, IL

Varicose (dilated) veins are common and usually become symptomatic between age 20 and 40.The function of normally operating leg veins is to send blood upward to the heart. These veins have valves that prevent the downward flow of blood. When the valves malfunction and blood flows away from the heart, the veins become dilated. This is usually a slow chronic process, and running is not a problem.

In your case, however, the bulging of the veins in the inner-thigh occurred in a few weeks time and was accompanied by stinging. This is more of an acute process, and potential causes include thrombophlebitis and trauma. It is best to cease running and visit a vascular surgeon for tests. Once an acute problem is ruled out, you may then resume running with an appropriate support hose.

David D. Picascia, M.D., Holmdel, NJ

The veins may seem more prominent during or after running because blood vessels become dilated. In addition to surgical stripping, discuss sclerotherapy with your vascular surgeon. This process consists of injecting the veins with a medication that shrinks them down in size. Aside from support hose there are custom-fitted stockings available which are more expensive and sometimes uncomfortably tight, but work better.

Todd Miller, M.D.I Rob McBane, M.D., Rochester, MN

COPYRIGHT 2003 American Running & Fitness Association
COPYRIGHT 2008 Gale, Cengage Learning

http://findarticles.com/p/articles/mi_m0NHF/is_1_21/ai_98594715/

Tags: Questions and Answers by platinum
No Comments »

This is varicose vein information with treatment information you have seen many times. What new is the use of the English language written by Scots.

VARICOSE VEINS MEDICAL APPENDIX
DEFINITION
1. Varicose veins are veins affected by saccular dilatation. The dilatation is permanent and tends to be accompanied by lengthening and tortuosity.
2. While varicose veins may occur in other parts of the body, the most common site is in the lower limbs. This Appendix concerns only varicose veins in the lower limbs, whether primary or of secondary causation.

CLINICAL MANIFESTATIONS
3. The milder degrees of varicose veins may be symptomless and they are often only brought to notice because of the cosmetic effect of the enlarged veins. Their extent, prominence and tortuosity vary; they may be widespread in both legs or they may be confined to a single varix in one or other leg.
4. The commonest symptom is a tired and aching sensation felt in the whole of the
lower leg, especially in the calf, towards the end of the day. Sharp pains, when
present, are localised to the site of the varices and are especially noticeable in
dilated thigh veins. The ankles may swell towards evening and the skin of the leg
may itch. Cramps in the calf of the leg may occur shortly after retiring to bed.
5. The relationship between pain and the visible degree of dilatation and tortuosity is extremely variable from patient to patient. Women tend to suffer more pain than do me with varicosities of similar severity, but the reason for this is obscure.
6. Secondary effects may occur, including:
6.1. Ankle oedema, which is usually mild and noticeable only towards the end of
the day. More severe oedema is likely to have another cause.
6.2. Skin pigmentation, which occurs in long-standing cases due to gradual
extravasation and the deposition of blood pigment. In some cases this
progresses to include induration and inflammation, a combination called
lipodermatosclerosis.
6.3. Varicose eczema, which may follow minor trauma, chronic irritation due to
scratching or deposition of blood pigment and the use of ointments or strapping.
6.4. Varicose ulceration, which invariably occurs in the lower half of the leg above
the ankle and which is more common in long-standing cases. This is a painful
and sometimes intractable condition.
6.5. Thrombophlebitis (clotting of the blood with inflammatory changes in the walls
of the veins) of superficial veins, often precipitated by minor trauma or a period
of bed rest, but in many cases with no predisposing cause.
6.6. Haemorrhage, often profuse, which may follow spontaneous rupture of a
diseased vein, ulceration or trauma. Subcutaneous haemorrhage from varicose
veins causing bruising is a common, alarming but not dangerous, occurrence in
the elderly.
7. Varicose veins have a propensity to recur after treatment, more so when this has involved sclerosing injections rather than radical surgery. The wearing of elastic stockings, especially those giving graduated compression, may be helpful in relieving discomfort but has no curative value.
AETIOLOGY
8. To appreciate how varicose veins arise, reference must be made to certain features of the venous circulation of the lower limbs. Venous blood is returned to the heart by virtue of the negative pressure in the thorax and the vis-a-tergo (pushing force) of the circulation, as veins have only slight intrinsic pulsatile contractility. In the lower limbs, where gravity hampers the venous return, the veins have valves which allow flow only towards the heart. The superficial veins lie supported in the loose tissues underneath the skin and empty into the deep veins through a series of communicating veins which perforate the deep fascia. The deep veins form large channels in the powerful muscles of the calf and thigh which, in turn, are surrounded by dense, unyielding fascia. These deep veins are compressed by every muscular action of the lower limbs, pumping blood towards the heart. When the limbs are in action, the pressure in the deep veins is high and fluctuant whilst that in the superficial veins is low as they empty into the “venous pump”. Any failure of the valve system results in reflux, raising the pressure in the ill-supported superficial veins and varicose veins may result.
9. Primary varicose veins.
9.1. Primary varicose veins are widespread, affecting 10-20% of people in Western
countries. In Eastern countries, the prevalence is lower. In India and Africa
particularly in those countries where the way of life is more traditional, it is very
much lower. The reasons for these wide differences are unclear, but diet is
thought to be one factor and physical stature another. A comparative study
showed that German soldiers were six times more likely to have varicose veins
than their Japanese counterparts. On the other hand, there is a very low
incidence in Zulus who are a very tall race.
9.2. Primary varicose veins may occur at any age from adolescence onwards.
Sophisticated studies (e.g. by duplex scanning) have detected symptomless
venous reflux in cohorts of children as young as 10-12 years of age. 8% of
these children had obvious varicosities by the age of 20. The prevalence of
varicose veins rises to about 50% in the over-50’s, although many cases are
mild and need no treatment. Incidence peaks between the ages of 50 and 60
years, falling in old age.
9.3. There is a definite hereditary factor. Different surveys have elicited a parental
or family incidence of varicose veins in proportions of the cases surveyed
varying from 43% to almost 90%. 80% of patients seeking treatment for
varicose veins report a family history. Several members of a family in
successive generations may not only suffer from varicosity but not infrequently
the same portion of the same vein is found to be involved. The pattern of
heredity is believed to be polygenic rather than one of simple dominance.
Unfortunately, no twin study is available.
9.4. The hereditary weakness causing varicosities was originally believed to be
confined to the valves themselves, and indeed the valves may be irregularly
arranged, deformed, fewer than normal in number, or otherwise deficient.
Evidence to the contrary came from studies which showed that that dilatation
often begins proximal (referring to direction of flow) to valves. It known that
dilatation is eccentric, while valves are concentric. It is now generally accepted
that the abnormality is a more generalised weakness of the walls of the veins.
Varicose veins contain relatively more muscle and elastin, but less collagen
than normal veins. Further support for this view is in the behaviour of vein
grafts and patches in arteries. Sections of normal saphenous vein withstand
arterial pressure, whereas sections of varicose vein dilate or develop
aneurysms.
9.5. Gender is a significant factor. Men are affected less frequently than women
and this difference is independent of the increased incidence associated with
parity. Women with neither parent having varicose veins have a 10% risk of
developing varices, but 80% when both parents are affected.
9.6. Parity increases the risk of developing varicose veins. In a study of over 400
women with varices, 13% were primiparous, 30% secundiparous and 57%
multiparous. It is believed that hormonal changes, particularly increased
oestrogen, is the responsible factor. Uterine pressure on the iliac veins in
advanced pregnancy may contribute. However, although the left common iliac
vein is more vulnerable to compression, varicosities are not more likely to
appear in the left leg than in the right.
9.7. Many observers believe that an important factor in the production of varicosities in those with the hereditary endowment is the increase in venous pressure which results from the human being’s erect posture. In support of this view is the fact that varicose veins are exceedingly rare in the upper limbs, commoner in taller people and not seen in quadrupeds.
9.8. Occupation Evidence on the relation between occupation – particularly the
time spend standing still, and risk of varicose veins is limited. Published studies
are old and outcome conflicting. The suggested association of standing at work
and risk of varicose veins is confined to women and in particular western
Europeans and Americans. No such increase was found in Egyptian female
cotton workers, more of whom stood at work and for longer periods than English
equivalents. It has been suggested that the different risks may relate to
attitudes to corsetry in the different communities.
9.9. The existence of a haemodynamic abnormality as a factor in the causation of
primary varicose veins has been postulated but, so far, not proven.
10. Secondary varicose veins result from damage to the valves of the veins or, less
frequently, obstruction of the venous flow. The commonest causes are:
10.1. Phlebothrombosis (deep vein thrombosis)
10.2. Thrombophlebitis
10.3. Increased intra-abdominal pressure, such as in pregnancy (but see paragraph
9.5 above), ascites, abdominal tumour or aneurysm.
10.4. Arterio-venous aneurysm.
10.5. Obesity is said to predispose to both venous thrombosis and varicose veins and it may be that increased pressure is exercised on the main intra-abdominal
veins, impeding the blood flow from the lower limbs.
11. Physical activity and strain
11.1. Activities such as walking, marching, running, jumping, climbing or physical
strain generally aid the return of the blood to the heart and therefore can never
be the cause of varicose veins. However, these factors, especially when
operating over a prolonged period may aggravate varicose veins which are
already established.
11.2. The wearing of heavy boots, anklets or gaiters does not impede the return of
venous blood to the heart and plays no part in the development or progress of
varicose veins.
11.3. Sedentary occupations carry no risk for the development or progress of
varicose veins.
CONCLUSION
12. Primary varicose veins are the most common type of varicose veins and arise
spontaneously as a result of inherited structural defects in the walls of the veins.
Predisposing factors include age, female gender, parity, and race.
13. The aetiology of secondary varicose veins is that of the underlying condition
causing the varicosities. Both types may be aggravated by certain activities.
REFERENCES
Browse N L, Burnand K G, Irvine A T and Wilson N M. Diseases of the Veins. 2nd Ed.
1999. London. Arnold. p145-169.
Lake M et a. Arteriosclerosis and varicose veins: Occupational activities and other factors.
JAMA 1943;119:696-701
Mekky S et al. Varicose veins in women cotton workers. An epidemiological study in
England and Egypt. BMJ 1969;2:591-595
Russel R C G, Williams N S and Bulstrode C J K (Eds). Bailey and Love’s Short Practice
of Surgery. 23rd Ed. 2000. London. Arnold. p237-240.
June 2002

Tags: Uncategorized by platinum
No Comments »

A friend has a torn rotator and was hoping it would heal. It wasn’t a varicose vein, it was a shoulder issue. But it raised the question of whether or not a varicose vein or spider vein issue could disappear without treatment. Here are a couple posting we found that might be of interest.
Questions: I’ve got spider veins on the inner thighs on both legs and was wondering if it can go away with regular excercise and a good diet?

Response: 1 have been dealing with spider veins and also verisose veins for many years, since I was 22 years old and now I am 44. I have had many procedures, mostly for the larger veins but as far as the spiser veins, I have had saline injections. It is not painfull, but if I can remember right medical insurance dosen’t cover this procedure. I think they consider this cosmetic. I don’t think they will go away once they show up, mine never has. Excersice, especially walking can prevent them, that is what I was told from my Dr. Good luck…

Questions: 1have a spider vein (telangiectasia, if you want to be specific) on the side of my nose. It’s pretty small and doesn’t show up much, but I would love to get rid of it for good. The little red spot that you see; that’s it. This isn’t the best picture but it should give you the idea. I have gotten it zapped (sclerotherapy) about 4 or 5 times, but each time it has returned. It has gotten slightly better and less bright than before, but I want it to REALLY go away!! I will be getting Bare Escentuals for Christmas, and I recently heard that mineral makeup (the stuff it gets in the air??) is bad for spider veins, not sure if that’s true or not? I have also been using this natural spider vein cream that my mom bought, but it doesn’t seem to be doing much. The cream is called Spider Vein Cream but Derma-E. I’m not sure if I should keep using it or not, because it’s pointless if it doesn’t help my skin. Thank you, and have a lovely day!

Best Response: Laser treatment is the only method I’ve heard of that is really effective for spider veins. However, it sometimes takes many treatments, doesn’t always work, and does not prevent new spider veins from occuring.

As for make-up to mask them, I don’t much about that. Put your search engine to work and do some research online (that’s what I would have to do to find your answer for you).

Tags: Uncategorized by platinum
No Comments »

It is unclear where the line is drawn between the need and the desire for surgery. As this article points out the debate has been going on for a long long time:

“Physicians have been debating the treatment of varicose veins for well over two thousand years – the legendary Hippocrates himself wrote about them in the fifth century BC – but today both medical necessity and health insurance are major factors in determining the course of treatment for the condition.
When varicose or spider veins are treated for the exclusive purpose of improving the patient’s appearance, it is considered cosmetic surgery and will not be covered by the patient’s health insurance or Medicare. Virtually all procedures addressing spider veins will fall into this category.
If, however, the varicose veins are causing symptoms like pain, swelling, fatigue or other symptoms that affect the patient’s ability to work or function normally, or if the underlying venous reflux disease is producing complications like skin ulcers or blood clots, a physician can determine that treatment is required to restore or preserve the patient’s health and well-being, and is therefore considered a medical necessity. Under those circumstances, most health insurance and Medicare plans will cover the procedure.

All VNUS Closure® procedures are performed as medical necessities – as diagnosed by a trained vein specialist – and are covered to the extent of the patient’s health coverage policy. The Closure procedure is not designed to address spider veins and is rarely performed for primarily cosmetic reasons. However, the successful treatment of venous reflux with the Closure procedure frequently produces significant cosmetic improvements.

http://www.vnus.com/vascular-disease/difference-between-varicose-veins-and-spider-veins.aspx

Source: The Vnus Closure Procedure

Tags: Uncategorized by platinum
No Comments »

We are all aware of the rising cost of medical insurance. In particular it is helpful to understand what aspects of vein treatments are covered. Here is a typical coverage statement which might be helpful to become familiar with when considering vein treatments, for, in this case varicose veins and sclerotheraphy. The source for this is Oxford Health Plans – NY

Sclerotherapy for Varicose Veins of the Lower Extremities for Medicare
The services described in Oxford policies are subject to the terms, conditions and limitations of the Member’s contract or certificate. Unless otherwise stated, Oxford policies do not apply to Medicare Advantage enrollees. Oxford reserves the right, in its sole discretion, to modify policies as necessary without prior written notice unless otherwise required by Oxford’s administrative procedures. The term Oxford includes Oxford Health Plans, LLC and all of its subsidiaries as appropriate for these policies as well as SecureHorizons and Evercare.

Certain policies may not be applicable to Self-Funded Members and certain insured products. Refer to the Member’s plan of benefits or Certificate of Coverage to determine whether coverage is provided or if there are any exclusions or benefit limitations applicable to any of these policies. If there is a difference between any policy and the Member’s plan of benefits or Certificate of Coverage, the plan of benefits or Certificate of Coverage will govern.
________________________________________
Policy #: OUTPATIENT 035.3 T3
Coverage Statement:
Policy is applicable to:
AARP MedicareComplete, Evercare Plan DH and SecureHorizons MedicareComplete, including Group Retiree Plans underwritten by Oxford Health Plans (NY/NJ/CT), Inc. (CMS Contract Numbers: H0752, H3107 and H3307)
Note: For Commercial Members, refer to policy: Sclerotherapy.
Conditions of Coverage
Benefit Type General benefits package
Referral Required
(Does not apply to non-gatekeeper products) No
Authorization (Precertification always required for inpatient admission) Yes1
Precertification with MD Review Yes
Site(s) of Service
(If not listed, MD Review required) Outpatient, Office
Special Considerations 1Sclerotherapy for varicose veins of the lower extremities is not covered for services rendered by podiatrists.
Description of Service/Assessment/Background Information:
The treatment of choice for moderate to large symptomatic varicose veins is ligation and stripping of the saphenous vein. This procedure has proven to usually have the lowest failure rate. Sclerotherapy is an alternative method of treating varicose veins by injecting sclerosing solutions directly into the abnormal veins. While this can sometimes offer an alternative in the case of varicose veins without significant saphenofemoral or saphenopopliteal incompetence, it is not considered to be as reliable and effective as surgical ligation and stripping.
Injection of the saphenous vein at its junction with the deep venous system has been proposed as an alternative to ligation or saphenectomy, its efficacy lacks significant scientific evidence to support its widespread use. There is currently no consensus on the place of sclerotherapy in the treatment of the long saphenous vein and incompetent perforating veins.
Sclerotherapy of the saphenous vein at its junction with the deep system is not a covered procedure.
Microsclerosis refers to injection of telangiectasiae. This procedure is considered cosmetic and is thus not a covered service.
Non-compressive Sclerotherapy involves injection of a sclerosant into a vein without the application of a compressive dressing. This method has not been shown to be effective in producing long-term obliteration of the incompetent veins.
Compressive sclerotherapy involves injection of the sclerosant into an empty vein (elevated limb) followed by application of a compressive bandage or dressing. This is the most commonly performed sclerotherapy procedure for varicose veins of the lower extremity.
High ligation and Compression sclerotherapy refers to ligation of a truncal junction (saphenofemoral or saphenopopliteal) followed by compressive sclerotherapy of one or more veins.
Duplex ultrasound is often used in conjunction with other non-invasive physiologic testing to characterize the anatomy and physiology of the varicose vein network prior to injection or surgical intervention (CPT 93965). However, duplex scanning (CPT 93970, 93971) has been utilized during the sclerotherapy procedure itself. Its usefulness, in this regard, is limited to the saphenous vein near their junction with the deep system. There is little evidence, in the form of randomized prospective clinical trials to support that ultrasound makes a significant difference in the outcome of injections of varicose veins.
Policy and Rationale:
Oxford will cover Sclerotherapy as indicated in the Treatment/Application Guidelines below.
Treatment/Application Guidelines:
Indications
Oxford will cover sclerotherapy of varicose veins according to the following guidelines:
1. Prior to sclerotherapy, and where clinically appropriate, the patient must have been offered and undergone a 3-6 month trial of medically supervised conservative medical therapy including such measures as leg elevation, compressive elastic stockings (support hose) and weight loss. This must be documented in the medical record.
2. Presuming the foregoing criteria are satisfied, sclerotherapy for varicose veins will be covered for the following clinical indications when any of the following conditions can be attributed to the varicosities:
pain in the affected extremities substantial enough to impair mobility or activities of daily living;
significant recurrent superficial phlebitis;
skin ulceration;
bleeding; or
refractory dependent edema or other complications from venous stasis such as dermatitis.
3. Sclerotherapy will also be covered if performed in conjunction with surgical ligation or stripping procedures in appropriately selected patients.
Documentation required for Precertification:
Limitations
1. The following code represents a procedure considered to be cosmetic and is therefore not covered by Medicare: 36468 Single or multiple injections of sclerosing solutions, spider veins (telangiectasiae); limb or trunk
2. Noncompressive sclerotherapy is not effective and is therefore not covered by Medicare.
3. Compressive sclerotherapy is indicated for local small to medium symptomatic varices, isolated incompetent perforators, or recurrence of symptomatic varices after adequate surgical removal of varices. It is not considered an appropriate option for large, extensive or truncal varicosities.
4. Ultrasound-monitored or duplex-guided techniques (CPT 76998) for sclerotherapy will not be covered when used in conjunction with injection sclerotherapy techniques. Pre-operative venous studies (CPT 93965, 93970, 93971) will be covered when initially performed to determine the extent of venous valvular incompetence. Additional reimbursement is not available for these or other radiologically guided or monitoring techniques when performed solely to guide the needle or introduce the sclerosant into the varicose vein.
5. Reimbursement is not available at this time for sclerosing of the saphenous vein at its junctions with the deep system.
6. Symptomatic improvement is the primary goal and indicator of a satisfactory outcome. Documentation of recanalization or failure of vein closure without recurrent signs or symptoms does not necessarily indicate a need for additional injections.
Sclerotherapy for varicose veins of the lower extremities is not covered for services rendered by podiatrists.
Documentation Requirements
1. The patient’s medical record must document the following:
a history and physical findings supporting a diagnosis of symptomatic varicose veins
failure of an adequate trial of conservative treatment as described in bullets one and three of the Indications section of this policy.
exclusion of other causes of edema, ulceration and pain in the limbs
performance of appropriate tests to confirm the presence and location of incompetent perforating veins.
location and number of varicosities, level of incompetence of the vein and the veins involved
2. The medical record must also include pre-treatment photographs of the varicose veins.

Tags: Uncategorized by platinum
No Comments »

We have mentioned the use of Ultrasound for diagnosing varicose veins. Here is an interesting article which discusses how ultrasound is used in the treatment of varicose veins (in contrast to the treatment of other vein issues such as spider veins).

In the past, people with large varicose veins had no option but to treat them with conventional plastic surgery techniques. These techniques often involved pain, bleeding and general anesthesia as the veins were stripped out of the body using surgical instruments. Smaller veins could be treated with sclerotherapy, a method of injecting a substance into veins that would cause them to shrink and disappear. Conventionally, sclerotherapy was only used on these smaller veins; that is, until the advent of new technology called ultrasound guided sclerotherapy.

Ultrasound guided sclerotherapy is a godsend for individuals who have always wanted a fast, relatively painless method for varicose vein removal. Often a single treatment with ultrasound-guided sclerotherapy will also remove a cluster of spider veins especially if they are networked with large varicose veins. This is an important point because often before having conventional sclerotherapy you may be asked by your surgeon to deal with very large varicose veins first if you suffer from both spider and varicose veins. Varicose veins are dead veins that are very painful and laser surgery on the skin surrounding them can cause all kinds of discomfort and complications. Obviously, if there is a chance that ultrasound guided sclerotherapy can remove them all then you will greatly minimize the cost of your total treatment.
Source: Plastic Surgery Advisor

http://www.plasticsurgeryadvisor.com/skin-improvement-surgery/ultrasound-guided-sclerotherapy.shtml

Tags: Sclerotherapy by platinum
No Comments »