CommercialAdministrativeMedium impact
11.05.16l, Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Independence Blue Cross·Ophthalmology·Medical Policy
Effective date
Jul 9, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 11.05.16n on 07/09/2025 as part of the annual review process for glaucoma surgical procedures (aqueous shunts, microstents, viscocanalostomy, and canaloplasty). The policy maintains existing coverage criteria for FDA-approved procedures but supersedes the previous version 11.05.16l. Billing teams must verify they are referencing the current policy version 11.05.16n rather than older versions, as superseded versions have been removed from the provider portal.
Action Required
By 07/09/2025: Billing team must update all references and internal documentation to cite policy version 11.05.16n instead of 11.05.16l. Verify that billing system templates, prior authorization workflows, and provider education materials reference only the current policy version. Remove any cached or printed copies of version 11.05.16l to prevent submission of claims based on superseded guidance. Confirm that claims for CPT codes 66179, 66180, 66183, 66184, 66185 and HCPCS codes C1783, L8612 comply with the coverage criteria outlined in 11.05.16n (including requirements for failed medical therapy, mild-to-moderate glaucoma classification, and contraindication screening). Notify providers that old policy versions are no longer available on the IBX portal and directs them to use the updated version.