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| Management Policy Download PDF of Office Managemet Policy Home |
Policy of Venous Disease Management | ||||
| 1. | At the first visit, you will have a consultation with the doctor and it includes a complete history and physical examination. The doctor may order venous test (Color Duplex Scan). |
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| 2. | During the second visit, you will meet our registered ultrasound sonographer. She will perform the venous test (Color Duplex Scan) on your legs, a non-invasive procedure, using the most modern ultrasound equipment. This allows us to visualize the blood flow through your leg veins and see the valves inside your veins to assess their function. Normally, the blood flows in an upward direction through your veins. An abnormal test may show the blood flowing in a downward direction indicating venous insufficiency. This test is usually covered by insurance companies. (Sometimes the venous test is done on the same day the consultation is done.) Our Vascular Laboratory is accredited by ICAVL. |
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| 3. | After the venous test the doctor will discus with you the plan of therapy in detail. It includes various options available along with discussion of the recent literature on the subject of venous disease. If you are interested, we will be glad to provide you references from the recent literature on the subject of venous problems and the current trends in their management |
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| 4. | Photographs of the legs showing the areas of prominent veins are needed for the records; some insurance companies require photos prior to approving any therapy. This allows us to compare the before and after results of the therapy, and provide your insurance company with pictures, if required. Please note that these photographs are taken with state of the art medical camera system. Photos are not covered by your insurance and you are required to pay for them at the time they are taken. Maximum cost is $80, and this includes before, after and any future pictures taken. |
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| 5. | If you are found to have reversal of blood flow in your leg veins, venous insufficiency, we recommend Endogenous Radiofrequency Treatment for Venous Closure of the involved superficial veins (minimally invasive procedure). Please note that this is a minor surgical procedure performed under local anesthesia with minimum of sedation in our office. You will be able to go back to work on the some day if you so desire. If both legs need surgery, the procedures are done in two stages two to three weeks apart. |
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| 6. | Clusters of large visible bulging varicose veins are treated using the modern minimally invasive procedure called ambulatory phlebectomy. This procedure is also done under local anesthesia allowing you to ambulate immediately. There are virtually no scars after this procedure. Depending upon the number of varicose vein clusters to be treated, multiple sessions of surgery may be required. In our experience this causes much less pain and eliminates any chance of post-operative venous thrombosis. |
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| 7. | We will prescribe you compression stockings to aid in the recovery of your venous disease. 0ur office stall-members are certified in compression therapy of the legs. They will help you to purchase the compression stockings at a reasonable price and will also provide you with appropriate instructions. If you decide to purchase through our office you are required to pay in advance. Most insurance companies do not pay for the stockings. However we do recommend that you contact your insurance company to find out what your benefits are for durable medical equipment (DME). Please let our office know in advance if you will be purchasing the stockings through our office or from an outside vendor. You must have your stockings before proceeding to have surgery; it takes 1 week for your stocking to come in. |
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| 8. | We will give you detailed instructions for specific leg exercises that will help to improve the health of of your leg veins by improving the function of various leg muscle pumps. Please ask for details |
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| 9. | The spider and reticular veins are treated with Laser or Intense Pulse Light. These treatments require multiple sessions of therapy; each affected area requires 3 to 4 sessions of therapy 2 to 3 weeks apart. Rarely an area may require more than 4 sessions of therapy. Some insurance companies do pay for these treatments if the spider veins being treated are symptomatic or if there is underlying venous insufficiency causing the spider veins. Our staff members will provide this information to your insurance company. We will bill the insurance company only if your procedures are approved. If the coverage is denied, you will have to pay for these treatment sessions. Please discuss the pricing with our staff members. For your information, recent medical literature has clearly shown that the superficial venous disease causes deep venous valvular insufficiency; and the treatment of superficial venous pathology does improve the deep venous insufficiency. It is also well- documented that the results are better if the treatment is started in the early stages of the disease. Recently published Guidelines of American Venous Forum for the treatment of Class 1 venous disease strongly recommends, “Spider veins when symptomatic should be treated with laser or sclerotherapy and even asymptomatic spider veins should be considered for treatment.” Please ask for the brochure of these guidelines. |
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| 10. | If you are diagnosed to have deep venous insufficiency in addition to superficial venous disease, we recommend 6-month follow up duplex scans for a period of 24 months. 0ur extensive experience has shown that after complete treatment of the superficial venous disease, there is marked improvement not only of the symptoms, but also of the function of the deep venous valves. Repeat duplex scans are therefore necessary to assess the improvement of the deep venous insufficiency; this also helps us decide about the appropriate compression therapy for the future. Our experienced and well-trained staff will welcome any questions or concerns you may have and guide you through this process. Please call (609) 890-2966 or (609) 890-2233 if you have questions. To contact Dr. Ahmad after 5 PM call (609) 658-3889 |
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