Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 155

ICD Coding

• ICD-9-CM Codes: 454, 671, 671.0, 671.03 and 671.04
• ICD-10-AM Codes: 183, O22.0

Brief description

Varicose veins are veins that have become enlarged, elongated, tortuous and easily visible.  They develop when the valves in the veins that prevent blood flowing backwards cease to function correctly.  Varicose veins are most common in the legs but can occur elsewhere.  The SOP is confined to varicose veins of the lower limbs.

Confirming the diagnosis

The diagnosis is made clinically.  No specific investigations are required for diagnosis. Ultrasonography is commonly used to deliniate the extent of the disease.  The relevant medical specialist is a general surgeon, although specialist opinion will not generally be needed.

Additional diagnoses covered by SOP

• Venous ulcers or stasis dermatitis of the lower limbs in the presence of varicose veins

Conditions not covered by SOP

• deep vein thrombosis*
• lipodermatosclerosis,^# use ICD-9 code 459.89
• oesophageal varices,^# ICD-9 codes 456.0 or 456.1
• stasis dermatitis or venous ulcers of the lower limbs not due to varicose veins,^# use ICD-9 code 707.1
• superficial thrombophlebitis,^# ICD-9 code 451.0
• varicocoele*

* another SOP applies

^# non-SOP condition

Clinical onset

Clinical onset will be based on the history of when the varicose veins first became apparent or when limb discomfort, pain or swelling (worse with standing) due to the varicose veins first began.  Medical attention/treatment may not be sought for an extended time (years) after the varicose veins first manifest.

Clinical worsening

Varicose veins will typically slowly worsen if left untreated.  They can be effectively treated by ablation therapy or surgery.  Clinical worsening of varicose veins may be evidenced by a step up in the extent of the disease or by progression to more advanced manifestations such as stasis dermatitis and ulceration.