Reimbursement
Endovenous radiofrequency ablation of the saphenous vein, also known as the VNUS Closure™ procedure, is a functional surrogate to vein stripping in appropriate patients. As an alternative to conventional surgery, positive medical insurance coverage policies have been established with Medicare as well as with national private plans including Aetna, Cigna, Coventry, Humana , Health Net and United Healthcare, and regional plans including BCBS.
As with most venous therapy procedures, medical necessity must first be established in order for reimbursement to be obtained. Within each coverage policy the payor will list the criteria that need to be satisfied in order for a service or procedure be considered medically appropriate, effective and necessary. Physicians who treat their symptomatic patients with the Closure System are advised to review the medical policies in their area to familiarize themselves with the specific criteria.
Physicians, along with billing personnel from the hospital or ambulatory surgicenter, should analyze the use of the Closure System, and review current policy guidelines to determine which codes are most appropriate for submitting claims for reimbursement.
The Reimbursement Services Department at VNUS Medical Technologies is committed to assisting physicians and facilities through the reimbursement process .The Reimbursement Services team offers on-going expert consultation for the Closure procedure pre-authorizations with payors. They are trained to respond to incoming requests for billing, medical necessity documentation and appeal assistance. In addition to being a liaison with CMS & National/ Regional payors to broaden medical coverage and to ensure Closure procedure is reimbursed appropriately.
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