Effective February 15, 2010, Blue Cross and Blue Shield of Florida will no longer pay for ultrasound guidance when performed with sclerotherapy. Their medical director seems to believe that there is no clinical reason for using ultrasound guidance. They appear to be confused between being able to treat visual veins and those deeper system perforators, anterior accessories, and the like.
While many of you are not in Florida we thought you should be aware. We are advocating for the ACP to become involved in this issue. Once one Blues program gets an idea in their head, it sometimes migrates to other Blues in the same region.
Some smaller plans have gone down this road already. We have had some success in working with the nurse case manager on these claims. When we ask them if they personally would really want a physician injecting a sclerosing solution into their leg without ultrasound guidance… we receive some assistance and then payment.
No comments yet.