O22.00 Insurance Policy Changes

ICD-10 O22.00 is officially defined as "Varicose veins of lower extremity in pregnancy, unspecified trimester." code O22.00 is referenced in 3 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code O22.00 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 12, 2026Medium impact
AcuTect Scintigraphic Imaging for Detection of Lower Limb Deep Vein Thrombosis (CPB 0414, reviewed 2026-07-09)
Aetna considers AcuTect scintigraphic imaging for detection and localization of lower extremity deep vein thrombosis experimental, investigational, or unproven, because its clinical value in managing suspected DVT has not been clearly established. CPT 78456 is listed as not covered for the indications in this bulletin. Other related codes listed are CPT 75820, 75822, 78457, 78458 and HCPCS A9504.
Aetna · Identified Aug 12, 2026Medium impact
Varicose Veins (CPB 0050, reviewed 2026-08-03)
Aetna considers ligation, stripping, radiofrequency, endovenous laser and cyanoacrylate closure of the saphenous veins medically necessary when incompetence at the saphenofemoral or saphenopopliteal junction is documented by ultrasound performed within the past 6 months, with junctional reflux of 500 milliseconds or greater, a vein at least 4.5 mm in diameter below the junction, and the symptom criteria in the policy are met. Liquid or foam sclerotherapy (for example Varithena) is medically necessary for symptomatic saphenous veins, varicose tributaries, accessory veins and perforator veins that are 2.5 mm or greater in diameter when the criteria are met, and ambulatory phlebectomy is medically necessary as adjunctive treatment under the same size and symptom criteria. Treatment of veins less than 2.5 mm is considered cosmetic, endovenous ablation of varicose tributaries and accessory veins other than the accessory saphenous vein is considered experimental, investigational or unproven, and sclerotherapy for reflux at the saphenofemoral or saphenopopliteal junction is considered experimental.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Treatment of Varicose Veins/Venous Insufficiency
Blue Cross Blue Shield Association policy 7.01.124 (BCBSMS policy A.7.01.124) states that treatment of great or small saphenous veins, accessory saphenous veins, varicose tributaries, and perforator veins may be considered medically necessary for symptomatic varicose veins or venous insufficiency when specific criteria are met, and that saphenous vein treatment not meeting those criteria is considered cosmetic and investigational. The policy history shows an update dated 09/22/2026 that changed the policy description, made minor changes to the statements for great or small saphenous veins, accessory saphenous veins, and perforator veins, and re-worded the concurrent treatment statements for accessory saphenous veins and symptomatic varicose tributaries for clarity. Telangiectasia treatment is considered cosmetic and investigational.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code O22.00?

There are 3 tracked policy changes affecting code O22.00, including updates from Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code O22.00?

Payers that have issued tracked updates for code O22.00 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code O22.00 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code O22.00. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code O22.00?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

All billing codes J3590 C9399 J3490 99215 99213 99202

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AcuTect Scintigraphic Imaging for Detection of Lower Limb Deep Vein Thrombosis (CPB 0414, reviewed 2026-07-09)

Varicose Veins (CPB 0050, reviewed 2026-08-03)

Treatment of Varicose Veins/Venous Insufficiency

What insurance policy changes affect code O22.00?

Which payers have updated policy for code O22.00?

How do I get notified when code O22.00 policy changes?

Why do payers change policies for code O22.00?