Billing and Coding: Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach (0192T 66183)

Medicare covers insertion of an anterior segment aqueous drainage device without an extraocular reservoir when performed for progressive glaucoma despite medical or prior surgical therapy, and as an alternative or adjunct for advanced glaucoma patients requiring very low intraocular pressure who are at high risk for hypotony. Coverage requires use of an FDA-approved device and adherence to specific coding and documentation rules (CPT 0192T for 2008-07-01 to 2013-12-31; CPT 66183 effective 2014-01-01), valid ICD-10-CM diagnosis reporting, laterality modifiers (-LT/-RT), and ABN/modifier procedures when denials are anticipated; other indications or non–FDA-approved device use are investigational or not medically necessary.

"Glaucoma filtering surgery, including insertion of an anterior segment aqueous drainage device without extraocular reservoir, is indicated when glaucomatous damage progresses despite pharmacologica..."