AMA CPT® Assistant - 2018 Issue 7 (July)
Minimally Invasive Glaucoma Surgery (July 2018)
July 2018 pages 3-6 Minimally Invasive Glaucoma Surgery A number of minimally invasive surgical procedures for the treatment of glaucoma have been developed to improve patient outcomes and lessen side effects from glaucoma surgery. As a group, these procedures are termed minimally invasive glaucoma surgery (MIGS). In these procedures, the surgeon either inserts small stents or dissects the trabecular meshwork open to drain aqueous fluid from the eye, thereby, lowering the intraocular pressure and reducing the chance of damage to the eye and blindness from glaucoma. This article provides an overview of the MIGS procedures that reflect typical clinical...
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Article Overview
This article explains the scope of minimally invasive glaucoma surgery (MIGS), the broad procedural categories involved, and how related CPT reporting is organized for common glaucoma surgery situations. It is aimed at coders, ophthalmology practices, and clinicians who need to distinguish among external and internal approaches, device-based procedures, and related reporting considerations. The article also includes clinical examples and procedure descriptions to illustrate the coding context without covering every possible future variation.
Why This Topic Matters
MIGS continues to evolve, and coding for these procedures depends on understanding surgical approach, device placement, and the anatomic target involved. Accurate classification helps support consistent ophthalmology reporting and keeps practices aligned with CPT guidance as techniques change.
Article Sections
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July 2018 pages 3-6
Introductory material describing the scope of minimally invasive glaucoma surgery and the coding context for the procedures discussed in the article.
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Anterior Segment
An overview of anterior segment procedures associated with MIGS and the related CPT reporting framework.
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Coding MIGS
General considerations for classifying MIGS procedures based on approach, implant characteristics, and drainage pathway.
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External Surgical Approach
Discussion of external glaucoma surgery concepts and how they relate to MIGS versus non-MIGS reporting.
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Internal Surgical Approach
Discussion of internal glaucoma surgery concepts, including device placement patterns and related MIGS classification issues.
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Clinical Example (65820) / Description of Procedure (65820)
A paired example and procedure description illustrating the surgical context for a glaucoma-related code.
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Clinical Example (66183) / Description of Procedure (66183)
A paired example and procedure description illustrating the surgical context for an anterior segment drainage device code.
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Clinical Example (0191T) / Description of Procedure (0191T)
A paired example and procedure description illustrating the surgical context for an internal approach device insertion code.
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Clinical Example (0376T) / Description of Procedure (0376T)
A paired example and procedure description illustrating the context for an additional-device reporting scenario.
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Clinical Example (0474T) / Description of Procedure (0474T)
A paired example and procedure description illustrating the surgical context for a supraciliary-space procedure.
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Clinical Example (0449T) / Description of Procedure (0449T)
A paired example and procedure description illustrating the surgical context for a subconjunctival device procedure.
What You Will Learn
- How MIGS is broadly categorized in glaucoma surgery reporting
- How surgical approach and implant placement affect CPT classification
- Which article sections provide clinical examples and procedure descriptions
- How the article frames coding considerations for evolving glaucoma procedures
Who Should Read This
- Medical coders
- Ophthalmology practices
- Physicians
- Revenue cycle staff
- Clinical documentation specialists
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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