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
Independence Blue Cross Medicare Advantage updated policy MA11.105k to MA11.105l, effective October 1, 2025, adding three new ICD-10 diagnosis codes (H40.841, H40.842, H40.843) for neovascular secondary angle closure glaucoma as medically necessary indications for aqueous shunt coverage. This expands coverage eligibility for glaucoma patients with this specific neovascular condition.
Action Required
By October 1, 2025: Billing and clinical teams must update diagnosis code documentation and billing system logic to recognize H40.841, H40.842, and H40.843 as medically necessary indications for aqueous shunt procedures (CPT 66179, 66180, 66183, 66184, 66185 and HCPCS C1783, L8612). Update prior authorization templates and clinical documentation guidelines to reflect that neovascular secondary angle closure glaucoma now qualifies for coverage. Ensure coders apply the correct laterality codes (right eye, left eye, bilateral). Train coding and clinical staff on the expanded coverage criteria. Failure to use updated diagnosis codes may result in claim denials or unnecessary prior authorization delays.