2026 #420 MIPS Measure Varicose Vein Treatment with Saphenous Ablation: Outcome Survey

2026 COLLECTION TYPE:

MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS) CLINICAL QUALITY MEASURE (CQM)

‌MEASURE TYPE:Patient Reported Outcome -Based Performance Measure – High Priority

‌Description:

Percentage of patients treated for varicose veins (CEAP C2-S) who are treated with saphenous ablation (with or without adjunctive tributary treatment) that report an improvement on a disease specific patient reported outcome survey instrument after treatment.

‌Instructions:

Reporting Frequency:
This measure is to be submitted each time a denominator eligible procedure as defined in the denominator criteria is performed.

Intent and Clinician Applicability:
This measure is intended to reflect the quality of services provided for patients who undergo a saphenous ablation procedure for the treatment of varicose veins. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions as defined by the numerator based on the services provided and the measure-specific denominator coding.

Measure Strata and Performance Rates:
This measure contains one strata defined by a single submission criteria.
This measure produces a single performance rate.

Implementation Considerations:
For the purposes of MIPS implementation, this procedure measure is submitted each time a procedure is performed during the performance period.

Telehealth:
NOT TELEHEALTH ELIGIBLE: This measure is not appropriate for nor applicable to the telehealth setting. This measure is procedure based and therefore doesn’t allow for the denominator criteria to be conducted via telehealth. It would be appropriate to remove these patients from the denominator eligible patient population. Telehealth eligibility is at the measure level for inclusion within the denominator eligible patient population and based on the measure specification definitions which are independent of changes to coding and/or billing practices.

‌Measure Submission :

The quality data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this collection type for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. The coding provided to identify the measure criteria: Denominator or Numerator, may be an example of coding that could be used to identify patients that meet the intent of this clinical topic. When implementing this measure, please refer to the ‘Reference Coding’ section to determine if other codes or code languages that meet the intent of the criteria may also be used within the medical record to identify and/or assess patients. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

‌Denominator:

All patients who are treated for varicose veins with saphenous ablation and who receive an outcomes survey within 180 days after treatment.

Denominator Criteria (Eligible Cases):

All patients, regardless of age

AND

Diagnosis for varicose veins (ICD-10-CM): I83.811, I83.812, I83.813, I83.819

AND

Patient procedure during the performance period (CPT): 36465, 36473, 36475, 36478, 36482

‌Numerator:

Patients whose outcome survey score improved when assessed within 180 days following treatment.

Definition:

Outcome Survey – A normalized and validated “outcome survey” developed for the patient reported outcomes for saphenous vein ablation. The disease specific standardized outcome survey utilized must be documented in the medical record. Examples of outcome surveys include, but are not limited to:

Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL)
Chronic Venous Insufficiency Questionnaire (CIVIQ)
Aberdeen Varicose Veins Questionnaire (AVVQ)
Specific Quality of Life and Outcome Response – Venous (SQOR-V)
Varicose Veins Symptom Questionnaire (VVSymQ)
Venous Clinical Severity Score (VCSS)

Numerator Options:

Performance Met: Patient survey score improved from baseline following treatment (G9603)

Denominator Exception: Documentation of at least two attempts to follow up with patient within 180 days of treatment (M1463)

Performance Not Met: Patient survey score did not improve from baseline following treatment (G9605)

Performance Not Met: No documentation of at least two attempts to follow up with patient within 180 days of treatment (M1464)

Performance Not Met: Patient follow up more than 180 days after treatment (M1465)

RATIONALE:

Surrogate measures to measure the success of varicose vein treatment with saphenous ablation have numerous flaws. The ultimate measure of success of saphenous ablation for varicose veins is an improved quality of life. This quality measure motivates physicians to assess changes in quality of life after as compared with before an ablation using one of several standardized survey instruments. This enables objective quantification of the improvement in quality of life that saphenous vein ablation provides patients with CEAP C2 disease.

Most trials show pain drops fairly quickly but that it plateaus off at about 6 months. There seems to be most improvement by 3 months and some more improvement by 6 months. Therefore, the best time to assess is 3-6 months following treatment (1).