Alcon announced that the unique Current Procedural Terminology (CPT) code 0474T issued by the American Medical Association for the newly launched CyPass Micro-Stent is now effective. The CyPass Micro-Stent is a minimally invasive glaucoma surgical (MIGS) device that treats adult patients with mild-to-moderate primary open-angle glaucoma in conjunction with cataract surgery.
“The positive response from the payer community makes it possible for millions of patients living with cataracts and glaucoma to access Alcon’s unique MIGS technology,” Nancy Tuffin, Head, Government Policy and U.S. Reimbursement, Alcon, said in a company news release. “The CyPass Micro-Stent offers a less invasive means of lowering IOP than traditional glaucoma surgery, with the goal of lowering the patient’s dependence on topical glaucoma medication. We are excited that surgeons and the patients they serve now have greater coverage from Medicare and commercial payers.”
The new CPT code became effective July 1, 2017 after a 6-month implementation period. It is a category 3 code, similar to those assigned to other emerging technologies. The positive feedback from the MACs means that the CyPass Micro-Stent will be covered by Medicare in all 50 states. This extends coverage for the device to qualifying patients among the 40 million people who are covered by Medicare. In addition, the CyPassc Micro-Stent is now included in leading national commercial payers’ plans, ensuring coverage for qualifying patients among the 55 million people covered by those plans, according to Alcon.