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11.02.01u, Treatment of Varicose Veins of the Lower Extremities and Perforator Vein Incompetence

Independence Blue Cross·PA · Vascular Surgery, General Surgery·Medical Policy
Effective date
Jul 28, 2025
We identified it
Jun 19, 2026
Days to comply
—

Summary

Independence Blue Cross updated policy 11.02.01u to 11.02.01v, clarifying TIPP (Trivex System) language in treatment of varicose veins and adding CPT 37799 (Experimental/Investigational) to represent endovenous cryoablation. The policy intent remains unchanged; this is a technical clarification update effective July 28, 2025.

Action Required

Action needed
By July 28, 2025: Billing team must update billing system and claims submission protocols to recognize CPT 37799 as an experimental/investigational code for endovenous cryoablation procedures. Ensure that any claims submitted with CPT 37799 are flagged as experimental and route to appropriate medical necessity review. Update internal documentation to reference policy 11.02.01v (not 11.02.01u). Verify that TIPP procedure descriptions in templates and prior authorization forms include Trivex System as an approved modality. No changes to covered procedure CPT codes (36465, 36466, 36468, 36470, S2202) or ICD-10 diagnosis codes are required. Failure to update system rules may result in improper claim processing or denials for experimental procedures.

Affected Billing Codes

37799
36465
36466
36468
36470
S2202
I80.00
I80.01
I80.02
I80.03
I80.3
I83.001