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Glaucoma Surgery (CPB 0484, reviewed 2026-07-14)
Aetna·Effective Jul 14, 2026
Aetna has updated its Glaucoma Surgery clinical policy (CPB 0484, effective 2026-07-14) clarifying coverage for multiple surgical techniques including laser trabeculoplasty, FDA-approved shunt implants, micro-bypass stents (iStent, Hydrus), XEN system, and goniotomy/trabeculotomy procedures. The policy establishes specific medical necessity criteria, contraindications, and experimental/investigational determinations that will affect billing, prior authorization requirements, and claim adjudication for glaucoma surgeries.