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.