We had a discussion about this a while back.  Basically this test is still experimental (and the protocol quite convoluted/complicated) so you probably should not bill for it unless you have legitimate venous symptoms (ie: swelling or venous insufficiency) and perform a complete UE venous exam (in addition to the reflux hooplah). The specific article and protocol can be found at,  just ask for Zamboni et al.


From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Matthew Wise
Sent: Thursday, May 20, 2010 11:20
To: [log in to unmask]
Subject: CCSVI protocols, billing, etc.

Hey all, one of our MDs is asking us to do a CCSVI exam and I am having trouble finding a protocol or criteria for the exam. Also, I am unsure how to bill for it. I am pretty sure I cannot just do an upper extremity venous and bill accordingly. Can I even bill for this exam at all?

For those who are unfamiliar with this topic (as I was until about 2 weeks ago)..... CCSVI is chronic cerebrospinal venous insufficiency and is suspected to have a strong association with multiple sclerosis. Check out: for a basic overview..

Thank you for any info you have.

Matthew Wise
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