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

Medicare covers MIGS insertion codes CPT 66989/66991 (trabecular meshwork devices, e.g., iStent) when performed with cataract surgery and CPT 0449T (subconjunctival devices, e.g., XEN45) when LCD medical necessity criteria are met. Billing is limited to one unit per eye per date of service for CPT 66989, 66991, and 0449T regardless of number of devices inserted; CPT 0450T is not covered and CPT 0671T should not be reported with specified cataract surgery codes. Complete, legible medical records supporting medical necessity, ICD-10 coding, and accurate CPT/HCPCS coding must be maintained and furnished to the contractor on request.

"Medicare may cover CPT 66989 or 66991 for insertion of glaucoma drainage device(s) into the trabecular meshwork (e."

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