“Dr. Hammond and her entire staff were wonderful during this whole process. I have felt very cared for and would highly recommend SVC to anyone looking to get work done on their veins.”
~Andrew H.
Does Dr. Hammond do the procedure in the office?
No, Dr. Hammond does the VNUS closure procedure at Rose Medical Center, and includes phlebectomy when needed.
What type of anesthesia is used?
The anesthesia used is general anesthesia or IV sedation.
Is Dr. Hammond contracted with my insurance?
As part of HealthONE, Dr. Hammond is contracted with most insurance companies. If you have a specific question about your particular insurance, please call our office at (720) 475-8750.
Will my insurance pay for my initial consultation and ultrasound?
Yes, if we are contracted with your insurance, the consultation and ultrasound would be a covered benefit.
Will my insurance pay for varicose vein treatment?
Insurance coverage is determined based on medical necessity, and if you have the benefit on your insurance plan. After your initial consultation, if you are a candidate for surgery, we will obtain all necessary authorizations from your insurance company.
Will my insurance pay for VV treatment?
Insurance coverage is determined based on medical necessity, and if you have the benefit on your insurance plan.
Does insurance cover lymphedema treatment and management?
Most insurance companies will cover the assessment and initial treatment of lymphedema. Many of them will limit the frequency and amount of visits. Our office will help you navigate those benefits as they differ between companies and plans.
What is Lymphedema?
Lymphedema is an accumulation of protein rich fluid in the interstitial tissues and a condition that results from impaired flow of the lymphatic system.
What causes Lymphedema?
Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema.
What are the symptoms of Lymphedema?
Symptoms of lymphedema include swelling in one or more of the extremities, feeling heavy or full, achiness, and skin changes.
How is lymphedema assessed?
Lymphedema is assessed by one of our providers. They will collect your medical history, look at your legs and possibly order an ultrasound or CT scan to rule out any other reason for the swelling of your legs.
How is lymphedema treated?
Lymphedema is treated with Complete Decongestive Therapy, which is a combination of Manual Lymph Drainage, compression bandaging, skin care, exercise, and instructions for self-care. Initially, this involves daily visits with the certified lymphedema therapist (CLT) for the best results, with progression toward independent management of the condition later in the process.
Does insurance cover lymphedema treatment and management?
Most insurance companies will cover the assessment and initial treatment of lymphedema. Many of them will limit the frequency and amount of visits. Our office will help you navigate those benefits as they differ between companies and plans.
What should I expect at a new patient appointment?
You will meet with Dr. Hammond. She will go over your medical history and your symptoms. An extremity venous duplex/ultrasound will be done. You will watch a video about the closure procedure. Dr. Hammond will go over the findings of the ultrasound. She will then discuss with you if you’re a candidate for the closure procedure.
How long will my appointment take?
Please allow 90 minutes for your initial new patient appointment with Dr. Hammond or the nurse practitioner. The pre-operative appointment with the ultrasound technologist will take 30 minutes. The post-operative appointment with the medical assistant and the ultrasound technologist will take 30 minutes.
What should I bring to my appointment?
At your initial new patient appointment you will need to bring your completed paperwork, a photo ID and your insurance card.
How long until my legs look better (after a procedure) and until the veins are gone?
Most patients notice healthier changes even the day after surgery, and one month later they notice their leg or legs feel like they did when they were younger. However, it can take 8-12 month before the body absorbs the closed veins.
Does vein treatment cause any damage or side effects?
With any surgical procedure there are risks involved. We have chosen the VNUS radio frequency ablation for treatment of varicose veins due to the low risk of side effects and high success rate for patients.
How much does surgery cost?
Unfortunately, this is a more complicated question to answer than it seems. Dr Hammond performs the surgical procedures at the Ambulatory Surgery Center at Rose Medical Center. The patient will be billed from 3 providers: Specialized Vein Care, Rose Medical Center and Colorado Anesthesia Consultants. The cost is determined by the contractual amount between the providers and the patient’s insurance company, and the patient’s specific benefit plan. We can provide an educated estimate after an evaluation with one of our providers.
What are the possible complications?
As with any surgical procedure, there are possible complications from the VNUS closure and phlebectomy. To keep those complications at a minimum, Dr Hammond insists on performing the procedures in the Ambulatory Surgery Center at Rose Medical Center with Board Certified Anesthesiologists. Potential complications from the VNUS closure itself include, but are not limited to: thrombosis, pulmonary embolism, phlebitis, hematoma, paresthesia and skin burn.
What is pre-op mapping?
Pre-op mapping is a limited use of the ultrasound equipment to assist the ultrasound tech in appropriately marking, or “mapping” the leg in preparation for the VNUS closure procedure. Since the saphenous veins are not visible through the skin, our tech will map the vein with a temporary marker on the skin. The marks should stay on for a few days but tend to fade quickly. Once you have been mapped try not to soak in water. Showers are fine – just no scrubbing that area with soap!
What happens if I need bypass surgery in the future, and the saphenous vein has been removed?
A surgeon looking to do bypass surgery will not choose a diseased vein – one that is dilated with non-working valves. They will choose a healthy vein elsewhere in the body to have the most successful result.
What should I expect after vascular surgery for my varicose veins?
After surgery, you may experience some drainage, swelling, cramping and mild foot pain. Superficial numbness is normal and can last for many days. Nausea and throat soreness can occur from the anesthesia.
Where is the surgery done?
Surgery is done at Rose Medical Center, in the Wolf building in the ambulatory department as an outpatient procedure.
How long does Phlebectomy surgery take?
Patients should arrive at the outpatient surgery center 2 hours before the scheduled surgery. Surgery takes approximately 45 minutes to 1 hour. Patients will be in post-operative recovery for about 1-2 hrs. We tell patients to expect to spend a total of 5 hours in the surgery center.
Are there any pre-operation restrictions?
Patients may have nothing to eat or drink after midnight the night before surgery, and may not eat or drink again until after surgery.
How many procedures has Dr. Hammond done?
Dr. Hammond has performed thousands and thousands of VNUS closure procedures over her long career. You can find out more about her credentials and experience on the About Page.
What does an ultrasound of my leg show?
The initial ultrasound will demonstrate if the valves in your leg veins are functioning properly and venous reflux is present.
The pre-operative ultrasound allows the sonographer to correctly mark and map the veins for surgery.
The post-operative ultrasound documents that the surgical veins are closed and the deep veins are patent.
How long has Dr. Hammond been a vascular surgeon?
Dr. Hammond has been a vascular surgeon for over 23 years.
What is VNUS Closure? (Venefit Closure)
VNUS Closure is a trademarked endovenous ablation procedure that uses radiofrequency (heat) energy. Endovenous thermal ablation is a minimally invasive treatment that involves the insertion of a thin, flexible tube called a catheter. The catheter is inserted into a diseased vein to seal it shut using heat. Over time, the treated vein shrinks and is absorbed by the body. This is not laser surgery, but it is similar because we use heat in laser surgery as well.
Is the loss of a vein (through ablation) a problem?
No, because we have more veins in our legs than anywhere else in our bodies. The veins treated by ablation are usually weakened because of venous insufficiency and are best removed.
Can varicose veins be prevented?
No, but you may be able to slow down the progression of symptoms by wearing compression stockings on the affected legs with a compression of 20-30 mm Hg (millimeters of Mercury–the standard unit for pressure) during the day.
What happens if I don’t treat the veins?
Your symptoms can worsen over time, and there is a chance of changes in skin color and texture. In the most severe stage you may develop ulcers at the ankles and may also have a higher risk of developing a blood clot.
Will the treated veins reappear?
Approximately 5% of patients treated by radio frequency ablation have a reoccurrence of varicose veins. There is a small percentage of people that don’t respond to the solution used for treating spider veins.
Which doctors treat varicose veins?
Traditionally varicose veins have been treated by Vascular Surgeons, but in recent years there are many different specialties that have entered the field, including General Surgery, Radiology, Family Medicine and Cardiology. Always do your research and choose a surgeon with experience in the surgery you’re seeking.
Is varicose vein treatment only cosmetic?
Varicose vein treatment is not just a cosmetic concern if the patient has bad valves in their superficial veins. Many patients have severe symptoms or develop skin changes, ulcers, or clots.
How do I know if my veins are varicose veins?
The best way for a confirmed diagnosis is to make an appointment to see Dr. Hammond. The Specialized Vein Care team will look at the appearance of the veins and family history, as well as your symptoms, to get us closer to making a diagnosis.
Which veins can be injected?
The most common veins suitable for injection are reticular veins and spider veins.
What factors are associated with the appearance of varicose veins?
Most commonly, varicose veins are associated with a family history; they can also be exacerbated during or after pregnancy, by obesity and by injury.
Who is a candidate for ablation?
Any patient with proven superficial venous insufficiency and reflux, shown by Doppler ultrasound, is a candidate for ablation.
How does the foam injection work?
It works because the foam sits on the inside wall of the vein causing it to become irritated. The vein wall collapses, closing the vein off.
How long until my legs look better (after a procedure) and until the veins are gone?
Most patients notice healthier changes even the day after surgery, and one month later they notice their leg or legs feel like they did when they were younger. However, it can take 8-12 month before the body absorbs the closed veins.
If the stockings don’t make my veins go away, why do I need them?
While compression stockings won’t “cure” your vein problem – chronic venous insufficiency – the stockings can alleviate some of the symptoms. Graduated compression stockings provide “graduated” pressure against the leg. The pressure should be highest at the foot and ankle and decrease gradually as the stocking moves up the leg. The reason for this is to make it easier for the body to pump the blood up to the heart and make it harder for gravity to allow blood to move downward and create a “pooling” (swelling) effect. For many people, the compression stockings help them manage the discomfort well enough that they can function within their regular activities. Many insurance companies require a trial period of compression stocking use – time varies between companies – to help you determine if the stockings are enough to help you manage with everyday life. If your symptoms persist despite the use of stockings, surgical intervention may then be deemed medically necessary.
What is Ambulatory Phlebectomy?
Ambulatory Phlebectomy (also known as Microphlebectomy) is the medical term for the removal of a large or medium sized varicose vein through a tiny stab-incision in the leg. The tiny stab-incision allows the doctor to “fish out” the vein, and close the pinpoint hole with a small Steri-Strip. Any scarring would be about the size of a freckle.
Does vein disease affect women and men equally?
Venous disease affects more women than men, although a family history of varicose veins is the primary risk factor.
What happens to my vein after it has been treated?
After your vein is treated with the VNUS closure, it is important to walk and stretch your legs. The vein will eventually be absorbed by the body.
Does vein treatment cause any damage or side effects?
With any surgical procedure there are risks involved. We have chosen the VNUS radio frequency ablation for treatment of varicose veins due to the low risk of side effects and high success rate for patients.
What are the three main categories of veins?
Deep veins are the veins that bring the majority of blood to the heart and are found deep, close to bone. Superficial veins are closer to the skin surface and help transport blood. Perforator veins connect the deep and superficial vein systems.
What is the main difference between arteries and veins?
Arteries bring oxygenated blood from the heart to the body. Veins bring blood back from the body to the heart.
What is microphlebectomy?
Microphlebectomy (also known as ambulatory phlebectomy) is the medical term for the removal of a large or medium sized varicose vein through a tiny incision in the leg. The tiny incision allows the doctor to “fish out” the vein, no matter the variance in size, and close the incision with a small Steri-Strip. Any scarring would be about the size of a freckle.
Wouldn’t closing varicose veins just redirect flow into normal veins and make them become varicose?
Varicose veins do not contribute to the cause of more varicose veins. Closing a diseased vein – a vein that has dilated due to backflow of blood, or venous reflux – will redirect flow to normal veins that are not diseased and have working valves. The circulation in the legs then becomes more efficient.
Who is at risk for varicose veins?
Women tend to be more at risk of getting varicose veins than men, but varicose veins are primarily caused from heredity factors. Risk factors that can contribute to their formation are: obesity, pregnancy, aging, menopause, prolonged standing or leg injury.
What are venous leg ulcers?
Venous leg ulcers occur in the lower part of the legs, normally on the inside above ankle and below calf. These develop when the blood in the veins is unable to efficiently move toward the heart and “pools” in the vein, causing venous insufficiency. Blood then leaks from the vein into the tissues of the skin. The skin becomes more fragile and can form a small wound. The skin can become thick, dry and itchy. The wounds often become larger and take more time to heal completely. Some wounds become infected and without proper care will increase in size.
What is the short term treatment for varicose veins?
Short term treatment of varicose veins would include the regular use of compression stockings, elevation of legs several times a day above heart level, regular use of NSAIDS such as Ibuprofen. Regular exercise is recommended for cardiovascular health but not supported by thorough research on the effect it has on vein health. Walking, however, does improve the venous blood return to the heart by contracting the calf muscles.
What is venous reflux?
Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. As a result, vein valves do not close properly, allowing blood to “pool” in the legs and leading to the symptoms of varicose veins: leg pain, swollen limbs, leg heaviness and fatigue, skin changes and skin ulcers. Superficial venous reflux disease is progressive; symptoms can worsen over time if left untreated.
What are varicose veins (VV)?
Varicose veins are enlarged swollen veins frequently linked to faulty valves in the superficial system of veins.
What is Superficial Venous Insufficiency?
Superficial Venous Insufficiency is a condition caused by weakness of valves in the superficial veins located under the skin on your legs. These veins are called the greater and lesser saphenous veins.
What is Deep Venous Insufficiency?
Deep Venous Insufficiency is a condition caused by weakness of valves in the deep veins located within the muscles of your leg.
What are reticular veins?
Reticular veins are larger and deeper than spider veins, but smaller than varicose veins. They are usually flat and will twist and turn. Reticular veins will not appear in a straight line. They are blue and green veins that can be seen beneath the skin surface.
What are spider veins?
Spider veins are small, dilated veins near the surface of the skin. Spider veins can be red, blue, purplish or green in color.
What is Telangiectasia?
Telangiectasia is a dilation of small blood vessels on the surface of the skin. Telangiectasia frequently occurs on the facial area, but can occur on other parts of the body.
What should I expect after vascular surgery for my varicose veins?
After surgery, you may experience some drainage, swelling, cramping and mild foot pain. Superficial numbness is normal and can last for many days. Nausea and throat soreness can occur from the anesthesia.
What is the VNUS Closure recovery period?
The recovery time can be immediate, though most patients will need 1-2 days to get back to normal activities. Patients should refrain from very strenuous activities, heavy lifting, and prolonged periods of standing for about 2 weeks after surgery. Most patients can return back to work within 1-2 days after a vascular surgery.
Does Dr. Hammond do the VNUS Closure procedure in the office?
No, Dr. Hammond does not do the procedure in the Specialized Vein Care office. The VNUS Closure procedure is done at Rose Medical Center, and includes phlebectomy when needed.
What is Chronic Venous Insufficiency (CVI)?
Chronic venous insufficiency (CVI) is when your leg veins cannot pump enough blood back to your heart due to weakened or damaged valves.
Why treat Chronic Venous Insufficiency (CVI) and the accompanying varicose veins?
CVI and varicose veins can lead to more serious health problems. Superficial blood clots (thrombophlebitis) can occur. Also, the skin over the veins becomes thin and easily injured, which can lead to sores, ulcers, and bleeding.
How does Dr. Hammond treat Chronic Venous Insufficiency (CVI)?
Dr. Hammond treats CVI with a procedure called the VNUS Closure Procedure (also known as the Venefit Closure Procedure). The VNUS Closure procedure is a minimally invasive procedure that uses heat to “close” the malfunctioning veins. The blood is automatically rerouted through the remaining healthy veins.
What is Phlebectomy?
Phlebectomy is a minimally invasive procedure that removes the visible varicose veins on the surface of the leg. It is performed in conjunction with the VNUS Closure, which treats chronic venous insufficiency (CVI), the underlying cause of the varicose veins.
How long does Phlebectomy surgery take?
Patients should arrive at the outpatient surgery center 2 hours before the scheduled surgery. Surgery takes approximately 45 minutes to 1 hour. Patients will be in post-operative recovery for about 1-2 hrs. We tell patients to expect to spend a total of 5 hours in the surgery center.
How is Venous Insufficiency assessed?
To assess Venous Insufficiency, there are a variety of factors that are examined. They include varicose veins, family history, and symptoms in your legs, ankles or feet. Pain, aching or cramping are also factors. To complete an assessment, you may be asked to stand for long periods, and a Doppler ultrasound of the lower extremities may be performed.
How many procedures has Dr. Hammond done?
Dr. Hammond has performed thousands and thousands of VNUS closure procedures over her long career. You can find out more about her credentials and experience on the About Page.
What is phlebology?
Phlebology is the branch of medicine that studies veins, vein diseases, and the treatment of veins.
What is RVT? Why is it important?
RVT is a registered vascular technologist. This means the sonographer has an advanced knowledge of the vascular system and the skill competencies to provide the highest standard of care in ultrasound practices.
What are compression stockings?
Compression stockings are specialized leg wear that can help relieve symptoms of venous disease, such as venous insufficiency, varicose veins, leg swelling and pain, leg heaviness and fatigue, lymphedema, skin changes and skin ulcers. Wearing compression stockings can also help in preventing the progression of varicose vein and spider vein symptoms.
How do compression stockings work?
Compression stockings have the highest amount of pressure (mmHg) at the ankle, and the pressure decreases as it goes further up the leg. By applying this pressure to the lowest part of the extremity, it helps to limit the amount of blood that is stored in the calf muscle. This improves the circulation in your legs and helps to efficiently return blood from the lower legs back to the heart.
What CPT codes are typically used?
CPT codes for VNUS Closure (Radiofrequency Ablation):
- First vein 36475
- 2nd and additional veins 36476
- Stab Phlebectomy: Fewer than twenty incisions 37765
- Stab Phlebectomy Greater than twenty incisions 37766
How are labial varicose veins treated?
Dr. Hammond will assess the labial varicosities at your initial appointment, and if possible she will remove them during surgery.
What is ablation?
Venous ablation is a minimally invasive procedure to treat venous reflux disease in the legs. By inserting a catheter into the specific vein, thermal energy is delivered to close the diseased vein. Once this vein is closed, blood is re-routed to healthy, functional veins.
What is the difference between RFA and laser?
Radiofrequency Ablation (RFA) uses radiofrequency waves in 20 second bursts via a catheter inserted in the diseased vein. This energy targets and heats the collagen in the vein wall, causing the vein to shrink around the catheter and close. The physician is able to treat segments of the vein at a time until the vein has been sealed. This distributes consistent heat to the entire length of the non-functioning vein. Over time, the closed vein is absorbed by the body.
Endovenous Laser Ablation (EVLT) uses a laser heating element via a laser optic fiber inserted in the diseased vein. Variable frequencies of energy are delivered to the vein wall which then contracts and collapses. This type of closure causes clotting of the vein, which in turn closes the vein.
What diagnosis codes are typically used?
“454.1 Varicose veins with inflammation” and “729.5 Pain in limb.”