Medicare AdvantageCoverageMedium impact
MA11.105k, Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma
Independence Blue Cross·Ophthalmology·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Policy MA11.105k establishes coverage guidelines for aqueous shunts, microstents, viscocanalostomy, and canaloplasty procedures for glaucoma treatment under Medicare Advantage plans effective October 1, 2025. This new policy likely includes specific prior authorization requirements, medical necessity criteria, and billing code guidance for these glaucoma surgical interventions.
Action Required
By October 1, 2025: Billing team must obtain the complete policy text from the provided URL to identify specific CPT/HCPCS codes, prior authorization requirements, and medical necessity documentation standards. Update billing system with any new prior auth rules for glaucoma shunt and microstent procedures. Verify that all providers performing these procedures are familiar with the new coverage criteria. Flag any claims for these procedures submitted before policy review is complete for manual verification. Contact Medicare Advantage plans to confirm their specific requirements under this policy.