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Official Description

Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Telangiectasia, commonly known as spider veins, are small, dilated blood vessels that appear as red, blue, or purple lines on the skin, often resembling a spider's web. These veins are typically found on the legs or trunk and can be a cosmetic concern for many individuals. The condition arises from various factors, including genetics, hormonal changes, and prolonged standing or sitting. The procedure associated with CPT® Code 36468 involves the injection of a sclerosant, a solution that irritates the lining of the blood vessels. This irritation causes the vein walls to stick together and eventually close off, leading to a reduction in the visibility of the spider veins over time as the body reabsorbs the treated tissue. The procedure is generally performed in an outpatient setting, and the physician may document the extent of the condition through photographs prior to treatment. Proper skin preparation, including cleansing with an antiseptic, is essential to minimize the risk of infection during the injection process. The physician typically administers multiple injections, ranging from 5 to 40, in a single session to effectively treat the affected areas.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 36468 is indicated for the treatment of spider veins, also known as telangiectasia. The following conditions may warrant the use of this procedure:

  • Spider Veins The presence of small, dilated blood vessels on the skin, particularly on the legs or trunk, which may cause cosmetic concerns for the patient.

2. Procedure

The procedure for the injection of sclerosant for spider veins involves several key steps to ensure effective treatment and patient safety.

  • Step 1: Patient Preparation Before the procedure begins, the physician will prepare the patient by discussing the treatment plan and obtaining informed consent. The affected areas will be photographed to document the condition's extent and to provide a reference for post-treatment evaluation.
  • Step 2: Skin Cleansing The skin over the spider veins is thoroughly cleansed with an antiseptic solution to reduce the risk of infection. This step is crucial for maintaining a sterile environment during the injection process.
  • Step 3: Skin Tautening The physician will stretch the skin taut using one hand to create a stable surface for the injection. This technique helps to minimize discomfort and ensures accurate placement of the sclerosant.
  • Step 4: Injection of Sclerosant With the other hand, the physician will inject the sclerosant directly into the spider veins. The sclerosant solution irritates the vein walls, causing them to become inflamed and stick together, ultimately leading to their closure.
  • Step 5: Multiple Injections Depending on the extent of the spider veins, the physician may perform anywhere from 5 to 40 injections during a single session. Each injection targets specific areas to achieve optimal results.

3. Post-Procedure

After the procedure, patients may experience some mild discomfort, swelling, or bruising at the injection sites, which typically resolves within a few days. It is important for patients to follow any post-procedure care instructions provided by the physician, which may include avoiding strenuous activities and sun exposure for a specified period. The physician may also recommend wearing compression garments to support the treated areas and enhance the effectiveness of the treatment. Follow-up appointments may be scheduled to assess the results and determine if additional treatments are necessary.

Short Descr NJX SCLRSNT SPIDER VEINS
Medium Descr INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK
Long Descr Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk
Status Code Restricted Coverage
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator STV-Packaged Codes
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6A - Minor procedures - skin
MUE 2
CCS Clinical Classification 63 - Other non-OR therapeutic cardiovascular procedures
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CS Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2018-01-01 Changed Long medium and short descriptions changed. AMA guidelines changed.
2015-01-01 Changed Code description changed.
2011-01-01 Changed Short description changed.
1990-01-01 Added First appearance in code book in 1990.
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