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Viscocanalostomy and Canaloplasty
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Canaloplasty may be considered medically necessary as a method to reduce intraocular pressure in individuals with chronic primary open-angle glaucoma when medical therapy has failed to adequately control intraocular pressure and the individual is not a candidate for another intraocular pressure-lowering procedure, such as trabeculectomy or a glaucoma drainage implant, due to a high risk for complications. Canaloplasty is considered investigational under all other conditions, including angle-closure glaucoma. Viscocanalostomy is considered investigational.
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What to do
Action · 5 steps
01REQUIREMENTS: Claims for canaloplasty (CPT 66174 or 66175) for chronic primary open-angle glaucoma need documentation that medical therapy has failed to adequately control intraocular pressure.
02Documentation must also show the individual is not a candidate for trabeculectomy or a glaucoma drainage implant due to a high risk for complications.
03Canaloplasty for other conditions, including angle-closure glaucoma, and viscocanalostomy are considered investigational under this policy.
04Services not documented as medically necessary are not paid, because BCBSMS makes no payment for services not documented to be Medically Necessary.
05For Federal Employee Program members, FDA-approved devices may be assessed only on the basis of medical necessity.
Codes mentioned
6617466175H40.1110H40.1114H40.1120H40.1124H40.1130H40.1134H40.1190H40.1194
Original notice
Viscocanalostomy and Canaloplasty
bcbsms.com · Always check the source before changing claims.