Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS)

Medicare allows billing for MIGS procedures when appropriately coded: CPT 66991/66989 for noncomplex/complex cataract removal with concomitant intraocular aqueous drainage device, CPT 65820 for defined goniotomy, CPT 0449T/0671T for subconjunctival device insertion, and 66999 for unlisted microgoniotomy/goniopuncture, provided LCD medical necessity criteria are met. Coverage limits include one unit per eye per date of service for 66991/66989 and 0449T/0671T, prohibition on combining certain angle procedures (e.g., 65820 with stents or 66174), restrictions on combining multiple MIGS with phacoemulsification, and standard documentation and billing requirements (including Part A/B claim fields and bilateral modifier -50 procedures).

"CPT 66991 may be reported for noncomplex cataract removal with intraocular lens (IOL) implant performed with concomitant intraocular aqueous drainage device insertion (e."