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December 19, 2019

Micro-Invasive Glaucoma Surgery (MIGS) L37578 Update

The Micro-Invasive Glaucoma Surgery (MIGS) policy was recently taken back to comment during the Open Meeting on June 26, 2019. This policy had some additional information added for coverage and non-coverage of new surgical procedures for glaucoma. The updated policy is currently in notice and will become active on December 30, 2019.
There is a billing and coding article A56491 Billing and Coding: Micro-Invasive Surgery (MIGS) that gives additional information as far as coding information for MIGS procedures. In this article it gives information on how to bill for the iStent and iStent inject as these are billed with the same codes, 0191T. CGS is asking providers to include a note on the claim line to state either iStent or iStent inject so we can distinguish which technique was used for the procedure.

The article also gives the list ICD-10 codes that support medical necessity for 0191T and 0449T. The ICD-10 group is no longer the same for both procedures but each has its own list of codes that supports medical necessity. This article also includes a list of codes that are considered non- covered based on the policy.

Please review policy L37578 and its billing and coding article for updates that become effective December 30, 2019.


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