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Aqueous Shunts and Stents for Glaucoma

Blue Cross & Blue Shield of Mississippi·MS · Ophthalmology·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

This is a comprehensive medical policy establishing coverage criteria for aqueous shunts and stents used in glaucoma surgery. The policy outlines FDA-approved devices including iStent, XEN gel stent, Ahmed shunts, and other aqueous drainage devices, providing detailed background on glaucoma treatment options from medications to minimally invasive procedures.

Action Required

Action needed
Review policy A.9.03.21 for aqueous shunts and stents for glaucoma to understand coverage criteria for FDA-approved devices including iStent, XEN gel stent, Ahmed, Baerveldt, and EX-PRESS shunts. Ensure documentation supports medical necessity when these devices are used for refractory glaucoma or in conjunction with cataract surgery as specified in policy guidelines.

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