5 Key Takeaways
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1
In November 2024, five Medicare administrative contractors implemented updated local coverage determinations for microinvasive glaucoma surgery.
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2
The revised policies clarify that MIGS is not a first-line treatment for mild to moderate glaucoma, referencing AAO guidelines for initial therapies.
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3
Coverage for multiple MIGS procedures in a single session is restricted, with claims likely to be denied if more than one procedure is performed.
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4
Proper documentation of patient compliance with ocular hypotensive medications is essential to establish medical necessity for MIGS.
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5
Understanding the differences between MAC and commercial payer policies is crucial for ensuring coverage and reimbursement for MIGS procedures.
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