Medicare Contractors Propose Revised Local Coverage Determination on MIGS

Over the past year, OOSS has worked closely with AAO, ASCRS, and AGS to ensure that Medicare Administrative Contractors (MACs) establish reasonable and appropriate local coverage determinations (LCDs) in Micro-Invasive Glaucoma Surgery (MIGS).  As a result of these efforts, in December, the MACs withdrew a proposed LCD that was troublesome for many reasons.  Last week, Noridian, WPS, NGS, CGS and Palmetto posted identical revisions to their MIGS payment policies. We are pleased that many of the ophthalmology community’s comments have been addressed. 

Under the proposal, there will be no change in current policy for phaco/stents and standalone stents.  Goniotomy and canaloplasty are addressed only by disallowing combinations with stents.  MIGS procedures and aqueous shunts will not be permitted to be performed at the same time of service.

OOSS will continue to work closely with our colleague organizations, and we will keep you abreast of relevant developments. Should you have any questions, please contact OOSS Washington Counsel at mromansky@OOSS.org.

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