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

This policy provides coding and billing guidance for Micro-Invasive Glaucoma Surgery (MIGS), specifying appropriate CPT codes for cataract-associated aqueous drainage device insertion (CPT 66991 noncomplex; 66989 complex), goniotomy (CPT 65820) and subconjunctival device insertion (CPT 0449T/0671T), with unlisted CPT 66999 for microgoniotomy/goniopuncture. Coverage is limited to one unit per eye per date of service for specified device insertion codes, certain code combinations are disallowed or bundled (e.g., 65820 with 66174), and combining multiple MIGS procedures with phacoemulsification beyond a single MIGS is non-covered; all services require complete, legible medical record documentation supporting ICD-10 and CPT/HCPCS coding.

"Use CPT 66991 when performing noncomplex cataract removal with intraocular lens implant and concomitant intraocular aqueous drainage device insertion in the same eye on the same date of service, wh..."