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1. Incompetence of Saphenofemoral or Saphenopopliteal junction should be documented with reflux time >500 ms.
2. Size of the vein should be minimum of 4.5mm ( not a valve diameter at the junction).
3. Three month trial of conservative treatment ( analgesics and prescription gradient support compression stockings) is necessary prior to endovenous ablation procedures. This applies for initial treatment only.
4. Endovenous ablation procedures can be used for treatment of incompetent perforating veins with diameter of 3.5 mm and reflux time >500 ms, located underneath active of healed ulcers.
5.Liquid or foam sclerotherapy is considered medically necessary for treatment of symptomatic tributaries , accessory veins and perforators with minimum diameter of 2.5 mm for persons who met necessary criteria for varicose vein treatment…….
6. Two sessions of injections of sclerosing solution per leg is considered medically necessary.
7. Absolute contraindications to Endovenous laser ablation of saphenous veins are occlusive deep vein thrombosis and pregnancy. Relative contraindications are occlusive arterial disease, hypercoagulability, tortuous veins and inability to ambulate.
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