11.05.16n, Aqueous Shunts, Minimally Invasive Glaucoma Surgeries (including Microstents), Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma

REQUIREMENTS: - By 08/10/2026: Billing team must update billing system to recognize CPT code 1012T as Experimental/Investigational for Minimally Invasive Nasal Trabeculostomy (MIMS and MINT procedures). These codes should trigger denial or require prior authorization denial notifications to providers. - Immediately: Audit current claims billed for aqueous shunt procedures (CPT 66179, 66180, 66183, 66184, 66185) and aqueous stent procedures to ensure ICD-10 diagnosis codes match the covered criteria. Remove any claims using the 40+ deleted ICD-10 codes (particularly H25.xxx, H26.xxx, and H40.xxx codes ending in 9 for unspecified eye) for retroactive claim review, as these conditions no longer support medical necessity for these procedures under Independence Blue Cross. - Before 08/10/2026: Update prior authorization templates and clinical decision support in billing software to reflect the new experimental procedures. Ensure provider education materials clarify that MIMS and MINT (CPT 1012T) are not covered. - Verify that aqueous shunt and stent procedures continue to use medically necessary codes (66179, 66180, 66183, 66184, 66185 for shunts; and the stent codes listed in the policy) only when supported by non-deleted ICD-10 diagnosis codes and appropriate clinical indications per the policy guidelines.