CG-SURG-124 Viscocanalostomy

- Policy addresses: Viscocanalostomy, a nonpenetrating glaucoma surgery that unroofs and dilates Schlemm’s canal. - Coverage: Not medically necessary and therefore not covered for all indications, including treatment of primary open-angle glaucoma (POAG). - Key limitations: There are no covered indications under this policy; related claims may be reported with HCPCS/CPT code 66999.

"Viscocanalostomy is considerednot medically necessaryfor all indications, including but not limited to the treatment of primary open-angle glaucoma (POAG)."

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