January 4, 2018

Question:
I’m not sure I understand the new vein surgery codes in the 2018 CPT manual. Can you explain what “non- compounded” means?

Answer:
The new 2018 coded, 36465, 36466 describe injection(s) of a non-compounded foam sclerosant into an extremity truncal vein (eg, great saphenous vein, accessory saphenous using ultrasound-guided compression of the junction of the central vein (saphenofemoral junction or saphenopopliteal junction). The sclerosant comes ready to use, it does not need to be compounded (prepared or mixed) by the provider. Note that these new codes also include ultrasound—guided compression. Code 76942 for ultrasound guidance would not be separately reported

The existing sclerotherapy codes, for example, 36470, sclerotherapy injection of sclerosant, single incompetent vein (other than telangiectasia), describe a sclerosant solution that is mixed  (compounded ) by  the provider prior to injection.

The codes for non-compounded (36465-36466) and compounded (36470-36471) sclerotherapy are shown below.

CPT Code	Description	Global Days
36465	Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein) New in 2018	10
36466	multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg   New in 2018	10
36470	Injection of sclerosing solution; single vein	10
36471	multiple veins, same leg	10

*This response is based on the best information available as of 01/04/18.