25 - other international versions of ICD-10 I70. Toggle navigation. CPT code 37241 is not appropriate for reporting of vein ablation for the treatment of chronic venous insufficiency of the lower extremities and is incorrect coding. 2 [convert to ICD-9-CM] Venous insufficiency (chronic) (peripheral) Dermatitis stasis; Diabetes type 2 with statis ulcer; Peripheral venous insufficiency; Stasis dermatitis; Stasis dermatitis without varicosities; Stasis ulcer due to type 2 diabetes mellitus; Stasis ulcer of leg. ↓ See below for any exclusions, inclusions or special notations. 311 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Chronic venous insufficiency (CVI) refers to functional changes that may occur in the lower extremity due to persistent elevation of venous pressures. Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity. ICD-10-CM Diagnosis Code I87. 622 - other international versions of ICD-10 E11. The 2024 edition of ICD-10-CM I87. Disorder of vein, unspecified Billable Code. The 2024 edition of ICD-10-CM I89. Treatment of venous insufficiency begins with an accurate diagnosis and finding the source of the venous reflux. Venous ulcer of lower extremity due to chronic peripheral venous hypertension; ICD-10-CM I87. Applicable To. 303 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. In. I96 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Because SD is both a possible indication of underlying vascular. 403. ICD-10-CM I83. A Doppler ultrasound is a noninvasive test that uses sound waves to look at blood flow through the valves in the veins. Chronic venous insufficiency ( CVI) is a medical condition in which blood pools in the veins, straining the walls of the vein. restlessness. Learn about chronic venous insufficiency symptoms. The 2024 edition of ICD-10-CM I87. The 2024 edition of ICD-10-CM I87. I83. Introduction. The term chronic venous insufficiency most often refers to venous valvular incompetence in the superficial, deep, perforating and/or the nonsaphenous veins of the lower limb. Various treatment methods have been tried with. ICD-10-CM I77. Chronic venous htn w inflammation of bilateral low extrm; Peripheral vein htn, chronic, inflamed, bilateral; Stasis dermatitis of bilateral lower extremities due to chronic peripheral venous hypertension. 8 - other international versions of ICD-10 I87. This is the American ICD-10-CM version of I87. Symptoms. 0): 299 Peripheral vascular disorders with mcc; 300 Peripheral vascular disorders with cc; 301 Peripheral vascular disorders without cc/mcc; Convert. 9. code to specify site and severity of ulcer (L97. Varicose veins of lower extremities (I83) Varicose veins of lower extremities with other complications (I83. The ICD code I872 is used to code Chronic venous insufficiency. 311. CPT Codes. Chronic venous hypertension (idiopathic) with ulcer and inflammation of unspecified lower extremity. 813. Methods This was a single-centre prospective cohort study of 25 patients with suspected venous disease in the. Providers should select the most appropriate code(s) and modifier(s) with the highest level of detail to describe the service(s). ICD 10 code for Other disorder of circulatory system. Lesion of sciatic nerve, right lower limb. 9 Unspecified Edema, Lipoedema. 13 Rationale: • The stasis ulcer caused by venous insufficiency is captured first with the code for underlying disease (459. 2 [convert to ICD-9-CM] Venous insufficiency ( chronic) (peripheral) Dermatitis stasis; Diabetes type 2 with statis ulcer; Peripheral venous insufficiency; Stasis dermatitis; Stasis dermatitis without varicosities; Stasis ulcer due to type 2 diabetes mellitus; Stasis ulcer of leg. Prevalence of DVI is around 10-15% and is more common in women. 43 became effective on October 1, 2023. Search All ICD-10 Toggle Dropdown. . 009 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. 224 Varicose veins of left lower extremity with b. e. Showing 1-25: ICD-10-CM Diagnosis Code I87. 8 Varicose veins of lower extremities with other complications. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . ICD-10-PCS - Upper Extremity Veins, Bilateral - Enhance your medical coding efficiency with our up-to-date and reliable resource. 311 is a valid billable ICD-10 diagnosis code for Chronic venous hypertension (idiopathic) with ulcer of right lower extremity . 0. 339. -) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms. 9 is a valid billable ICD-10 diagnosis code for Disorder of vein, unspecified . 0): 299 Peripheral vascular disorders with mcc; 300 Peripheral vascular disorders with cc; 301 Peripheral vascular disorders without cc/mcc; Convert I87. Search All ICD-10 Toggle Dropdown. The 2024 edition of ICD-10-CM R22. A benign vascular lesion characterized by the presence of a complex network of communicating arterial and venous vascular structures. varicose veins of lower extremities (I83. 90 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Deep venous thrombosis (DVT), the formation of blood thrombus in the deep veins, remains a serious and growing public health problem (). I00–I99 - Diseases of the circulatory system. The aims of management are to correct the under-Deep Venous Insufficiency occurs as a result of a failure of the venous system, characterised by valvular reflux, venous hypertension and obstruction*. 013 became effective on October 1,. I87. It is found in the 2024 version of the ICD. Injection sclerotherapy is a minimally invasive percutaneous technique using chemical irritants to close unwanted superficial veins []. Showing 26-50: ICD-10-CM Diagnosis Code I87. 0. 813 became effective on. I87. 319 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity. I83. Type 1 Excludes. Do I really lose. Venous stasis ulcer of lower limb; Venous stasis ulcer with edema and inflammation; Venous stasis ulcer with edema of lower leg; ICD-10-CM L97. Foot. I83. Short description: Chronic venous hypertension w ulcer of bilateral low extrm. DVT is the primary cause of pulmonary embolism. 1 Less common etiologies for lower extremity ulcerations include arterial insufficiency; prolonged pressure. 81 M1022b Ulcer of ankle 707. It is commonly caused by chronic venous insufficiency in superficial venous system, and great saphenous vein (GSV). The lower extremity venous system includes the superficial, deep, and perforating veins. I85. Unspecified atherosclerosis of native arteries of extremities, bilateral legs. ICD-10-CM Codes. ICD-10-CM Diagnosis Code I87. I87. 9 may differ. 90 became effective on October 1, 2023. This is caused by: Incompetent venous valves. The 2024 edition of ICD-10-CM I83. 403 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. 411 became effective on October 1, 2023. This Billing and Coding Article provides billing and coding guidance for Proposed Local Coverage Determination (LCD) DL33693 Peripheral Venous Ultrasound. US with Doppler is a useful first-line imaging test. Risk factors include chronic cough, constipation, family history of venous disease, female sex, obesity. The antegrade flow of blood within these veins is ensured by a system of muscular venous pumps and bicuspid valves. I87. 813 is a billable diagnosis code used to specify a medical diagnosis of varicose veins of bilateral lower extremities with pain. The code I87. ICD 10 code for Varicose veins of unspecified lower extremity with inflammation. I75. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . This is the American ICD-10-CM version of I75. 891 Varicose veins of right lower extremity with other complications. In venous insufficiency states, venous blood escapes from its normal antegrade path of flow and refluxes backward down the veins into an already congested leg. Postthrom syndrome w ulcer and inflam of unsp low extrm; Postthrombotic ulcer with inflammation; Stasis. 3 - other international versions of ICD-10 L85. 0, E16-E31, E34. :846. ICD 10 code for Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral. 622 became effective on October 1, 2023. I83. Use ICD-10-CM code Z01. Recurrent lower limb venous insufficiency is often a challenge in clinical practice and is most commonly due to incompetent perforators. This is the American ICD-10-CM version of I70. 022 Atheroembolism of left lower extremity . 309 is a billable/specific ICD-10-CM code that can be used to indicate a. 309. Billing and Coding: Duplex Scan of Lower Extremity Arteries. M1020a Venous (peripheral) insufficiency, unspecified 459. Q82. 2. Venous insufficiency (chronic) (peripheral) I87. E05. unexplained exhaustion. Like other vein diseases, superficial venous insufficiency is often a. The skin. Venous stasis ulcer with edema of bilateral lower limbs; Venous ulcer of bilateral lower extremities due to chronic peripheral venous hypertension. [ Read More. Showing 1-25: ICD-10-CM Diagnosis Code I87. varicose veins complicating pregnancy (. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code I82. Venous ulcers (venous insufficiency ulceration, stasis ulcers, stasis dermatitis, varicose ulcers, or ulcus cruris) are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs (hence leg ulcers). Chronic venous htn w ulcer and inflam of bilateral low extrm; Peripheral vein htn, chronic, ulcer. 329 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. 5A1, M62. 81) followed by the code for the location of the ulcer (707. I87. 93 may differ. Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified. I83. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling,. There are various causes of varicose veins in the lower extremities. Varicose veins of lower extremities (I83) Asymptomatic varicose veins of bilateral lower extremities (I83. ICD 10 code for Chronic venous hypertension (idiopathic) with ulcer of right lower extremity. The 2024 edition of ICD-10-CM I83. A type 1 excludes note indicates that the code excluded should never be used at the same time as I82. Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral I83. INTRODUCTION. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024. 37765 Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions 37766 Stab phlebectomy of varicose veins, one extremity; more than 20 incisions 37780 Ligation and division of short saphenous vein at saphenopopliteal junction 37785 Ligation, division, and/or excision of varicose vein cluster(s), one leg 76942Introduction. B54DZZA Ultrasonography of Bilateral Lower Extremity Veins, Guidance. 5A2, M62. ICD-10-CM1 Descriptor I70. Asymptomatic varicose veins of unspecified lower extremity. Diseases of the circulatory system. This is the American ICD-10-CM version of R60. I83. The code is valid during the current fiscal year for. Impaired venous blood flow or venous return (venous stasis), usually caused by inadequate venous valves. I87. Varicose veins of. Code HistoryAbstract. A means there are no symptoms, while B means symptoms are present. 0 may differ. I am only finding I87. This chapter reviews the indications, limitations, and interpretation of a lower extremity venous reflux study. The Wound, Ostomy and Continence Nurses (WOCN) Society charged a task force with updating the venous leg ulcer (VLU) algorithm to include the addition of lymphedema with the new title of “Compression for Lower Extremity Venous Disease and Lymphedema (CLEVDAL). Code the scenario in ICD-10: Primary and Secondary Diagnoses M1025. Varicose veins are typically asymptomatic but may cause a sense of fullness, pressure, and pain or hyperesthesia in the legs. 3 may differ. 33 for Chronic venous hypertension (idiopathic) with ulcer and inflammation is a medical classification as listed by WHO under the ran. restlessness. Immobility including lack of physical exercise and paralysis. Edema of bilateral lower eyelids; Edema, bilateral lower eyelids; Edema, left lower eyelid. Varicose veins of lower extremities with other complications. CPT code 37241 is not appropriate for reporting of vein ablation for the treatment of chronic venous insufficiency of the lower extremities and is incorrect coding. 401 Unspecified atherosclerosis of autologous vein bypass graft(s) of the extremities, right leg I70. C5 - Healed leg or ankle ulcer; C6 - Active leg or ankle ulcer; Treatments for venous insufficiency. 2 may differ. Another subset of patients may have a chronic history of upper extremity venous insufficiency that has caused persistent or progressive limitations in activity over a period of many months to several years. Acute deep venous thrombosis of bilateral calves; ICD-10-CM I82. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code I87. This is the American ICD-10-CM version of L85. 3. 4. 2 Chronic venous Insufficiency. What is the ICD-10 code for chronic venous insufficiency? ICD-10 code: I87. 93 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 37765 Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions 37766 Stab phlebectomy of varicose veins, one extremity; more than 20 incisions 37780 Ligation and division of short saphenous vein at saphenopopliteal junction 37785 Ligation, division, and/or excision of varicose vein cluster(s), one leg HCPCS Codes HCPCS codes:I87. 339. ICD-10-CM Diagnosis Code I87. Non-Invasive Extremity Venous Studies (Including Digits) CPT. Chronic venous insufficiency (CVI) of the lower extremities manifests itself in various clinical spectrums, ranging from asymptomatic but cosmetic problems to severe symptoms, such as venous ulcer. This is the American ICD-10-CM version of I87. The following are key points to remember from this review on the diagnosis and treatment of lower extremity venous thromboembolism (VTE): Lower extremity VTE is common, with incidence estimates between 88-112 per 100,000 person-years. Short description: Postthrombotic syndrome w ulcer of bilateral lower extremity; The 2024 edition of ICD-10-CM I87. Coding Guidance. This is the American ICD-10-CM version of I89. 32. Toggle navigation. Note. ICD 10 code for Embolism and thrombosis of superficial veins of lower extremities, bilateral. 2. It is characterized by lower extremity edema, lower extremity discomfort, and accompanying skin trophic changes . pain or ache. 9 - other international versions of ICD-10 I73. 1,2 Varicose veins of the lower extremities are a manifestation of chronic venous disease (CVD) and are a common disorder in the United States. This is the American ICD-10-CM version of I83. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. As is well. 89 became effective on October 1, 2023. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . 313 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. I83. Venous insufficiency often occurs in the legs, and is associated with EDEMA and sometimes with VENOUS STASIS ULCERS at the ankle. ICD-10-CM Diagnosis Code I87. . Varicose veins of left lower extremity with ulcer of calf. Less common causes include: deep venous compression. Am Fam Physician. 10 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Chronic embolism and thrombosis of unspecified deep veins of right lower extremity: I82502: Chronic embolism and thrombosis of unspecified deep veins of left lower extremity: I82503: Chronic embolism and thrombosis of unspecified deep veins of lower extremity, bilateral: I82509The 2024 edition of ICD-10-CM I83 became effective on October 1, 2023. Sep 8, 2016. I82593. The highly variable venous anatomy requires that operators use sound judgment to expand on protocol. 1 became effective on October 1, 2023. I87. 0): 299 Peripheral vascular disorders with mcc;ICD 10 code for Chronic embolism and thrombosis of deep veins of upper extremity. Venous stasis dermatitis occurs when blood pools in the lower legs and puts pressure on the skin. Limb ischemia; Pain of bilateral lower limbs co-occurrent and due to ischemia;. Dysfunction of the system may result from degeneration of the vein wall, post-thrombotic valvular damage, chronic venous obstruction, or. ”. 8. The device is used primarily to treat insufficiency of the axial veins (ie, great, small, accessory saphenous veins), but perforator veins can also be treated with a specialized. 9 is a valid billable ICD-10 diagnosis code for Disorder of vein, unspecified . Code Classification: Diseases of the circulatory system (I00–I99) Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89) Other. Elevation: documented in the notes. . 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. ®. The resulting venous hypertension causes an increase of leukocytes within the veins, which then migrate into surrounding tissue. Rates of recurrent VTE range from 20% to 36% during the 10 years after an initial event. For example, if your legs are swollen without pain. 899 became effective on October 1, 2023. ICD-10-CM Coding Rules. Over time, the increased pressure of the extra blood can cause the symptoms of this condition. CPT code 37241 is not appropriate for reporting of vein ablation for the treatment of chronic venous insufficiency of the lower extremities and is incorrect coding. 2 became effective on October 1, 2023. Chronic peripheral venous hypertension with complication of lower extremity; Chronic venous hypertension with complication; ICD-10-CM I87. I87. Stasis dermatitis of lower extremity due to chronic peripheral vascular hypertension; ICD-10-CM I87. LCD revised and published on 10/05/2017 effective for dates of service on and after 10/01/2017 to reflect the ICD-10 Annual Code Updates. 322 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with inflammation of left lower extremity. Probably more than 500,000 people in the USA suffer from these painful and debilitating ulcerations. Chronic venous insufficiency has been clinically linked to sustained. 50. Chronic peripheral venous hypertension with complication of bilateral lower extremities; Peripheral vein htn, chronic, w complic, bilateral; ICD-10-CM I87. It is characterized by chronic pelvic pain of more than six months duration with no evidence of inflammatory disease. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. ICD-10-CM/PCS MS-DRG v40. The right lower extremity in a morbidly obese patient with stasis dermati-tis has an ill-defined erythematous plaque with overlying pigment changes and super-ficial desquamation, as well as nonpitting edema. Venous ulcer of lower extremity due to chronic peripheral venous hypertension; ICD-10-CM I87. muscle cramps. Location can be upper or lower extremities depending on the underlying cause. Hierarchy Tree View. Postthrom syndrome w ulcer and inflam of unsp low extrm; Postthrombotic ulcer with inflammation; Stasis. Areas of darker skin color in the lower leg, ankle or foot are called Hemosiderin deposits. Right thigh cellulitis. I87. 813 - other international versions of ICD-10 I83. Postthrombotic syndrome, defined as persistent symptoms, signs of chronic venous insufficiency, or. This most commonly results from venous reflux due to faulty valve function developing as a long-term sequela of deep vein thrombosis (DVT) and recanalization, and may also develop due to. Varicose veins of bilateral lower extremities with other complications: I83899:. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. 313 is a valid billable ICD-10 diagnosis code for Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity . ICD 10 code for Chronic venous hypertension (idiopathic) with other complications. Interventional Radiology (IR) is a medical specialty that uses image guidance to perform minimally invasive, often life-saving, procedures that are an alternative to surgery. In: ICD-10-CM. ICD-10. Diagnosis is by physical examination. Applicable To Stasis dermatitis Use Additional I83. Chronic venous insufficiency is the cause of ulcerations in 60% to 80% of patients with chronic leg ulcers. CPT codes: 93985. Superficial venous insufficiency manifests across the entire clinical spectrum from dilated veins (telangiectasias, reticular veins, varicose veins) to chronic venous stasis skin changes or venous leg ulceration. code to specify site and severity of ulcer (L97. 1 - other international versions of ICD-10 I87. 90 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code I87. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. Applicable To. Stasis dermatitis typically affects both lower extremities. This allows blood to collect in the veins, which causes them to swell. M1020a Venous (peripheral) insufficiency, unspecified 459. 81-) Phlebitis and thrombophlebitis;Venous ulcer of right lower extremity due to chronic peripheral venous hypertension ICD-10-CM I87. According to Medi-Cal (CA Medicaid) guidelines for custom compression stockings (A6549), a patient must have symptomatic venous insufficiency or lymphedema to meet the criteria for coverage. Chronic venous insufficiency of the lower extremities ranges from asymptomatic to severely symptomatic []. Stasis dermatitis as well as chronic venous insufficiency Chronic Venous Insufficiency and Postphlebitic Syndrome Chronic venous insufficiency is impaired venous return, sometimes causing lower extremity discomfort, edema, and skin changes. 93 is applicable to adult patients aged 15 -. I89. 4 Aneurysm of artery of lower extremity ICD-10-CM DIAGNOSIS CODES I73. The skin of the lower extremities needs to be thoroughly examined. 32) I87. The lower extremity venous system includes the superficial, deep, and perforating veins. ICD-10-CM I83. 9 indicates arterial insufficiency and should lead to further investigation by a vascular surgeon. 331. MeSH. Chronic venous hypertension (idiopathic) with ulcer. 2 Venous insufficiency (chronic)(peripheral). The superficial VVs typically show a venous reflux and backflow of blood that is maintained for a time period greater than half a second. Disability related to chronic venous insufficiency contributes to a diminished quality of life and loss of work productivity. This is the American ICD-10-CM version of I73. 8 is a valid billable ICD-10 diagnosis code for Other specified disorders of veins . 33 - other international versions of ICD-10 I87. CMS Manual Explanations URLs. 8. ICD-10 code I87. Hemosiderin staining can also occur after. But when these valves don’t. chronic venous insufficiency is the inciting factor figure 1. Unfortunately for clinicians and patients, the treatment of these two forms of leg edema are completely different and, therefore, mistaken diagnoses and treatments can be problematic to our entire health. Background To explore the diagnostic performance of triggered angiography non-contrast-enhanced magnetic resonance imaging (TRANCE-MRI) for the evaluation of venous pathology of the lower extremity. The decrease in blood supply may be caused by underlying peripheral arterial disease (PAD) that results from narrowing of the arteries to the legs (atherosclerosis), or may be caused by other non. Signs of venous insufficiency may include: Swelling due to blood pooling; Colour changes; Dry, flaking skin; Firm induration (described as a ‘tethered down’ appearance)I83. Search All ICD-10 Toggle Dropdown. 2 A recent study found that telangiectasias occur in 43% of men and 55% of women, and varicose. 333 [convert to ICD-9-CM] Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity. It also evaluates the clinical criteria used to identify venous insufficiency in pathological and nonpathological veins. 2 - Venous Insufficiency (chronic) (peripheral) [Internet]. Thin, pliable valves normally present in all peripheral veins normally prevent retrograde flow of blood. 0 - other international versions of ICD-10 I89. 322 to ICD-9-CM. I87. I87. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Chronic venous insufficiency is a prevalent disease process. Stasis ulcers are most likely caused by inadequate venous circulation in the area, so that is why it's classified this way. 2. Your organs and tissues rely on this. Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified. Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral I83. This is the American ICD-10-CM version of I87. I75. 3 : I00-I99 Diseases of the. ICD 10 code for Varicose veins of left lower extremity with ulcer other part of foot. I87. 2 Venous insufficiency (chronic) (peripheral) Code Version: 2022 ICD-10-CM. ”As part of the process, the task force was charged to develop consensus. Venous insufficiency syndromes are most commonly caused by valvular incompetence in the low-pressure superficial venous system but may also be caused by. 13). The diagnosis can be narrowed by categorizing the edema according to its duration, distribution, and accompanying symptoms. Venous insufficiency is a cause of substantial morbidity and medical expenditures.