Criteria for referral to public hospital specialist clinic services

• Symptomatic varicose vein with a CEAP* classification of C3, C4, C5 or C6. That is varicose veins with these clinical characteristics:
  • oedema
  • pigmentation, eczema, lipodermatoscerleosis, atrophie blanche
  • healed venous ulcer
  • active venous ulcer.

Information to be included in the referral

Information that must be provided:

• Symptoms
• Description of oedema.

Provide if available:

• Current and previous imaging results.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

* CEAP classification: clinical findings, etiological factors, anatomical cause, pathophysiological cause

Note the indications for varicose vein procedures in the Elective Surgery Access Policy 2015:

Venous conditions with the following symptoms:

• Chronic leg swelling/oedema
• Chronic dermatitis/eczema
• Bleeding
• Leg ulcers or infections
• Superficial thrombophlebitis.

Venous disorders in patients less than 16 years old

Excluded as indications for surgery are:

• Venous conditions which are unlikely to lead to the conditions listed above
• Cosmetic veins in patients greater than 16 years old
• Spider veins in patients greater than 16 years old.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Spider veins
• Varicose veins without symptoms or complications
• CEAP classification of C0, C1 or C2. That is varicose veins with these clinical characteristics:
  • no visible or palpable signs of venous disease
  • telangiectasias or reticular veins
  • varicose veins.