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

Medicare allows billing for select MIGS insertion codes only when medically reasonable and necessary per LCD L38223, generally limiting reimbursement to one unit per eye per date of service for CPTs 66989, 66991 (trabecular meshwork devices) and 0449T (subconjunctival devices). CPT 0450T (additional device insertion) is not covered, multiple devices implanted in the same eye on the same date are billed as a single unit, and CPT 0671T should not be reported with specified cataract codes. Complete, legible medical records that support the selected ICD-10-CM and CPT/HCPCS codes and demonstrate medical necessity must be maintained and provided upon request.

"Medicare may cover 1 unit per eye per date of service of CPT 66989 or 66991 for insertion of glaucoma drainage device(s) into the trabecular meshwork (e."

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