Date Printed: May 21, 2018: 08:27 PM

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Subject: Treatments for Varicose Veins/Venous Insufficiency

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This medical coverage guideline is not an authorization, certification, explanation of benefits, or a guarantee of payment, nor does it substitute for or constitute medical advice. All medical decisions are solely the responsibility of the patient and physician. Benefits are determined by the group contract, member benefit booklet, and/or individual subscriber certificate in effect at the time services were rendered. This medical coverage guideline applies to all lines of business unless otherwise noted in the program exceptions section.



Varicose veins form in your legs when special valves within the veins weaken. This may prevent blood from flowing out of your legs properly and cause pressure in the veins to increase. Your veins may become swollen and appear blue and twisted beneath your skin.

Your doctor will first determine the severity of your symptoms. At first, your doctor may recommend conservative treatments. This may include elevating your legs, wearing compression stockings, and proper wound care, when required. These treatments may help improve your symptoms.

If these fail to provide relief, your doctor may suggest other options. There are several treatments that may help reduce vein pressure and improve your symptoms. These include surgical approaches and sclerotherapy. Varicose vein surgery removes the affected veins from your legs. The vein is tied off, cut, and then stripped from the leg. This redirects the flow of blood to remaining healthy veins. Sclerotherapy is another method of treating varicose veins. In this technique, your doctor will inject medicine into the vein to shrink it.

Since 1999, the U.S. Food and Drug Administration (FDA) has approved several devices for treating varicose veins. One treatment option called endovenous radiofrequency ablation (ERFA) uses a catheter inserted into the leg. The end of the catheter emits radio waves to shrink the vein. A similar treatment called endovenous laser ablation (EVLT) uses a catheter with a high-powered laser to shrink the vein.

Visit the Clinical View of this guideline for more information.

Visit WebMD for more information on treatments for varicose veins and venous insufficiency.



Note: For all medical decisions about this service, Florida Blue uses the Position Statement in the Clinical View of this medical coverage guideline. To make the best decision for your health needs, talk to your doctor. The services covered vary from health plan to health plan. Refer to your health plan contract for complete information about your coverage.


Several treatments may be available that meet the definition of medical necessity. These may include surgery (ligation and stripping), stab avulsion, phlebectomy, or sclerotherapy.

Telangiectasia is small dilated veins in the skin. Spider veins are a common form of this condition. Treatment is considered cosmetic and does not meet the definition of medical necessity.

Visit the Clinical View of this guideline for specific coverage information.


• Federal Employee Program (FEP): Certain exceptions apply.

• State Account Organization (SAO): Certain exceptions apply.

• Medicare Advantage products: Certain exceptions apply.

Visit the Clinical View of this guideline for more coverage information.

Refer to your health plan contract for complete information about your coverage.

Date Printed: May 21, 2018: 08:27 PM