by AJ Riviezzo
Aetna is proposing a rather significant change to their Varicose Vein policy with an effective date of September 1 of this year. The three key changes are:
- Ultrasounds will need to be interpreted by an ‘independent’ radiologist. They do not further define what they mean by this.
- Ultrasounds, per the new policy, may only be interpreted by an RPVI or an MD/DO holding RVT credentials. There is no mention of the RPhS credentials.
- They also state “Office practices should have Intersocietal Accreditation Commission (IAC) Vein Center accreditation to be reimbursed…” Interesting that the language is should rather than must. Again, we are unsure how this will work in reality.
Other criteria listed includes:
- Relatively normal medical criteria such as venous ulcer, bleeding, superficial phlebitis, stasis dermatitis or pain/swelling that interferes with ADL’s
- Eight weeks of conservative therapy
- Absence of DVT
- Vein diameter equal or greater than 3mm and reflux greater than half a second
Adjunct therapies such as Varithena, sclerotherapy or phlebectomies must meet the same criteria as above and:
- Saphenous veins have been treated first
- Symptoms have failed to resolve after six weeks post saphenous vein treatment
The Aetna is hosting a webinar on Tuesday the 15th of August at 6:00 pm EDT. If Aetna is a somewhat significant portion of your business, you may wish to attend. Click HERE if you’d like to see the webinar information.