ClariVein CPT Codes It may help to have them see how Medicare values (pays) for these embolization codes: Per CMS 2012b MPFS: RVUs 18.11 for CPT 37204 EmbolizationRVUs 1.31 CPT 75894 Embolization S & ITotal:  19.42 RVUs RVUs 1.10 for CPT 36470 SclerotherapyRVUs 6.72 for CPT 36478 EVLA CPT 37204 and 75894 were not designed for Clarivein.  Typically,  I see these codes reported for selective and subselective transcatheter occlusions of vessel(s) supplying an abnormality.  Considering Clarivein is probably even less invasive than EVLA it does not make sense to assign 37204 that has been valued at least double a sclerotherapy. 

 things wont be perfect till they obtain a dedicated cpt code, which will only happen after randomized trials... 

 CPT Codes applicable to Clarivein Closure: CPT 37204

Transcatheter Occlusion or Embolization, Percutaneous, Any Method, Non-Central Nervous System, Non-Head or Neck

CPT 36011 

Selective Catheter Placement, Venous System; 1st Order Branch

CPT 75894 

Transcatheter Therapy, Embolization, any Method, Radiological Supervision & Interpretation

CPT 93799 Unlisted Cardiovascular Service or Procedure

 Consent Form

PATIENT CONSENT FORM – RFC or CLARIVEIN

I hereby authorize Dr. Susan Fox, D.O., RPVI to close my saphenous or _____________________ vein(s) using an endovenous radiofrequency obliteration technique, also known as the VNUS Closure procedure. Alternatively, Clarivein, or a combination of chemical and mechanical disruption may be used. He has explained that the device used to perform this procedure is known as the VNUS Closure System/Clarivein device; it is a commercially available product being used today specifically for this purpose. I understand that alternative treatments for obliterating the function of the saphenous vein include ligation (cutting or tying the vein in the groin or behind the knee), stripping the vein (pulling a long segment out), or compression sclerotherapy (injecting a chemical to occlude the vein).

Dr. Susan Fox, D.O. has explained that common symptoms of varicose veins, such as heaviness and pain after standing for a long time, arise from malfunctioning valves in the saphenous vein (the main external vein in the thigh and calf). The resulting increased pressure in the saphenous vein is transmitted to my varicose veins. Satisfactory treatment of varicose vein symptoms is usually achieved by obliterating the saphenous vein. Although closure of the saphenous vein using the VNUS Closure System/Clarivein Device should reduce the pressure in my varicose veins and thus relieve many of my symptoms, I understand this consent for the VNUS Closure or Clarivein procedure for treatment of my saphenous vein does not include actual removal of the varicose veins, which may still be visible.

The general nature of the procedure for treatment of the saphenous vein has been explained to me. I understand that among the known risks of this procedure are failure to close the saphenous vein, leg swelling, bruising, mild phlebitis (pain, tenderness, redness) over the treated vein, numbness and tingling in the treated area, and skin burns that may need to be treated with additional surgery. I am aware that in addition to the risks specifically described above, there are other risks that may accompany any surgical procedure, such as intra- and post-operative blood loss, infection, and clot formation in the venous system.

Dr. Fox has not guaranteed either the results of surgery or freedom from potential complications. I have had sufficient opportunity to discuss my condition and proposed treatment with Dr. Fox and all my questions have been answered to my satisfaction. I believe that I have adequate knowledge on which to base an informed consent for treatment.

Print Patient Name Patient Signature Date

Print Witness Name Witness Signature Date

I have informed the patient of the available alternatives to the VNUS Closure procedure for treatment of the saphenous vein, and of the potential surgical risks, complications and results that may occur as a result of it.

R. Anthony Carabasi, M.D. Date

PATIENT CONSENT FORM – RFC or CLARIVEIN

I verify that I have received post-operative instructions both verbally and in written form. I hereby state that all of my questions have been answered to my satisfaction.

Print Patient Name Patient Signature Date

Print Witness Name Witness Signature Date

Operative Notes - Samples