Place of Service (POS) for Vein Ablation, CPT 36475® and 36476

Medical Review (MR) has identified claims billed with inappropriate POS for CPT® 36475 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated) and CPT® 36476 (Subsequent vein(s) treated in a single extremity are used for the treatment of varicose veins caused by venous insufficiency).

Through review of billed claims data, MR has identified the CPT 36475 and 36476 have been billed in the following Place of Service (POS):

  • 01 Pharmacy
  • 02 Telehealth
  • 09 Prison
  • 12 Home
  • 20 Urgent Care Facility
  • 31 Skilled Nursing Facility
  • 55 Residential Substance Abuse Treatment Facility
  • 57 Non-Residential Substance Abuse Treatment Facility
  • 72 Rural Health Clinic

Noridian Medical Review would like to notify providers that the only appropriate POS for performance of CPT® 36475 and 36476 is:

  • 11 Office
  • 19 Office Campus OPPS
  • 22 On Campus OPPS
  • 24 ASC
  • 50 FQHC

To address POS billing errors, local editing will be put in place. For more information on POS please see the Place of Service webpage. More information regarding the billing and coding for Treatment of Varicose Veins of the lower extremity can be found in Local Coverage Article A57707 [PDF].

Last Updated Jan 21, 2020