Sclerotherapy has been around for many years. It’s used in multiple situations. Sclerotherapy can be used to treat an inner vein in the leg such as the saphenous vein or deeper varicose veins. If we use Sclerotherapy on internal veins, we have to use ultrasound guidance. The ultrasound imaging technology allows us to visualize abnormal veins in the leg and then we can direct the needle and syringe inside of the vein and deliver the drug.
Sclerotherapy can also be used for surface veins such as spider veins. In this case ultrasound is not required because we can visualize a needle entering the vein right on the skin. As far as insurance coverage for sclerotherapy, it is somewhat problematic. Sclerotherapy, because it’s been around for so long and because it was primarily used for surface spider veins, it really had a cosmetic connotation. It’s only with the adventive imaging technology that we can now visualize internal veins and treat them. So it’s incumbent upon the physician to generate a report to the insurance company prior to foam sclerotherapy telling a story that this is a medically necessary procedure. If these veins go untreated bad things can occur, such as blood clots or ulceration. If that story is told to the insurance company and they authorize it, sometimes foam sclerotherapy will be reimbursed. The procedures that are being submitted, as soon as they see the word Sclerotherapy they think cosmetic and they do deny a lot of these procedures beforehand.
Sclerotherapy—one of the most established and versatile venous treatments—is still misunderstood and scrutinized by insurance companies. Why, you might ask, is such a traditional method still at risk of not being covered?
Insurance companies tend to only cover treatments for medical issues. Different than cosmetic issues, medical venous disorders occupy the end of the spectrum deemed more severe. Spider veins and varicose veins live on the more benign segment of the spectrum, making them rarely covered by insurance.
Sclerotherapy’s’ versatility, albeit excellent for patients suffering from a wide range of venous issues, makes it hard for insurance companies to peg. The method is used for deep veins as well as more superficial veins. The more superficial the treated vein is, the more likely it is to be in the aesthetic category (e.g., spider veins.) Conversely, the deeper the vein the more severe (or medical) the issue.
Sclerotherapy works by injecting a (usually salt-based) solution into the malfunctioning vein. The solution then erodes the lining of the blood vessel, causing it to breakdown and close up.
For deeper vein issues, an ultrasound is used to visualize the vein. When it comes to superficial veins, ultrasound is not needed because they are visible beneath the surface of the skin.
The same method can thus be used for issues of varying severity. It therefore becomes important for doctors to describe a patient’s condition in detail. When insurance companies are explained the ramifications of a malfunctioning deep vein, they are likely to reimburse for the procedure. Otherwise, they are often left to assume that the concern is aesthetic and thus not worthy to be covered.
If you are looking for sclerotherapy in Miami, contact us at the Miami Vein Center to receive a consultation. Our patients are extremely satisfied with their results as we ensure the highest quality treatment and care.