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ANNIVERS
DECEMBER 2017/JANUARY 2018 Vol. 10, No. 6 VEINTHERAPYNEWS.COM
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An ACP recognized resource for news and information for and about the phlebology community
Medtronic VenaSeal gets more favorable codes
BTG gets CPT codes for Varithena
By Larry Storer The U.S. Centers for Medicare and Medicaid Services have published the final fee schedule for new Current Procedural Terminology (CPT) Category 1 codes for BTG International’s Varithena® procedures and changed CPT codes for Medtronic’s VenaSeal, effective Jan. 1, 2018. The new codes for Varithena, which close veins through the ultrasound-guided injection of non-compounded
foam scleroscant, allow for automated claims adjudication, substantially simplifying and allowing consistent and predictable reimbursement policies for physicians, Medicare and commercial payers. Also on Jan. 1, Medtronic’s VenaSeal varicose vein closure device will get new CPT codes setting higher billable rates for those procedures, which use cyanoacrylate, a proprietary adhesive, to close an incompetent vein in lower extremities in
people suffering from symptomatic venous reflux or varicose veins. Medtronic has been able to get more favorable rates for its VenaSeal Closure System under the new CPT codes 36482 and 36483 going forward in 2018.
CPT CODES
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WHAT’S UP IN 2018?
Physicians respond to concerns facing them in the new year By Larry Storer When I recently polled a dozen physician leaders by email about what issues were at the top of their list of the most critical issues facing them in 2018, concerns fell into two categories: political and medical. Then, face-to-face conversations with some of the physicians attending the 31st American College of Phlebology in Austin demonstrated how deeply these and other issues affect the way these doctors see the future of venous disorder treatment and medicine in general. Not surprisingly, those issues causing the most angst were political – things that are difficult to impossible to change. These “external” issues are the leading cause of the professional frustration of these doctors as they prepare for another year.
POLITICAL ISSUES
At the top of the list of “political” concerns is reimbursement. Easy enough to understand, right? Because money is not exchanged at the time of service, physicians are challenged because it is reimbursed by a third party, either Medicare/Medicaid or private. The problem comes when the amount reimbursed and
the time that it takes to receive that reimbursement can become a gray area that can squeeze larger practices and mercilessly shut down smaller ones.
“Basically I am feeling the squeeze as reimbursement drops and the costs go up,” said Edward Mackay, MD, RVI, RPVI, who has offices in St. Petersberg and Palm Harbor, Fla. “The margins on some of our main procedures are narrowing. The costs of employees are up, mostly because of health insurance. As this squeeze occurs, the temptation for some doctors to overprescribe procedures rises.” Laura Ellis, MD, with offices in Asheville, N.C., and Laguna Beach, Calif., is concerned about insurance. “In both my North Carolina and California practices we are mindful of various insurance company “Policy Statements” on treatment of varicose veins and venous insufficiency, and changes in these statements. “Extremely problematic right now in North Carolina is the Blue Cross Blue Shield policy change as of Jan. 1, 2017,” she said. “They now allow approval of endovenous ablation of only one vein per leg per lifetime for their policyholders. As you know, we often have to ablate two or even three veins per leg in certain patients,” Dr. Ellis said. “The expense of treating any diseased veins after the one “allowed” becomes the 2018
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AVF plans 30th Annual Meeting By Larry Storer Registration for the 30th Annual Meeting of the American Venous Forum (AVF) Feb. 20-23 in Tucson, Ariz., is underway, and final touches on the program are being made. The site of this year’s event will be the JW Marriott Tucson Starr Pass Resort & Spa in
Tucson. Detailed information and registration is available at veinforum.org AVF President Marc A. Passman, MD, said that while many of the events are traditional favorites of returning members, there will be AVF
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