Micro-Invasive Glaucoma Surgery (MIGS)

MIGS (anterior-segment aqueous drainage devices without extraocular reservoirs) are covered when FDA-approved and used within FDA indications: specifically, a single insertion per eye into the trabecular meshwork or supraciliary space when performed with cataract surgery for adults with mild-to-moderate POAG on ocular hypotensive medication, and a single subconjunctival insertion as a standalone treatment for refractory glaucoma after prior filtering/cilioablative failure or uncontrolled IOP (mean diurnal medicated IOP >= 20 mm Hg) on maximally tolerated medical therapy. Coverage excludes non–FDA-approved or recalled devices, use outside FDA indications, suprachoroidal insertions, additional insertions beyond the single-per-eye limits (and limits on delivery systems), and certain concurrent procedures are subject to focused review; providers must document FDA clearance, clinical criteria, and appropriate training.

"A single insertion per eye of an anterior-segment aqueous drainage device without extraocular reservoir via ab interno approach into the trabecular meshwork is medically reasonable and necessary wh..."