Micro-Invasive Glaucoma Surgery (MIGS)
L38299
Medically necessary coverage is allowed for one trabecular aqueous stent per eye for adults with mild-to-moderate open-angle glaucoma undergoing cataract surgery while on ocular hypotensive therapy, and for one subconjunctival or trabecular stent per eye as a standalone treatment for refractory glaucoma (prior filtering/cilioablative failure or uncontrolled IOP, e.g., mean diurnal medicated IOP ≥20 mmHg on maximally tolerated therapy). MIGS is not considered first-line for mild-moderate glaucoma; concurrent MIGS plus an aqueous shunt or multiple MIGS procedures (e.g., stent plus canaloplasty/goniotomy) performed at the same time in the same eye are non-covered, and providers must be appropriately credentialed (XEN45 requires specific trabeculectomy/bleb experience).
"One trabecular aqueous stent device per eye is covered for adults with mild or moderate open-angle glaucoma (OAG) and a cataract when the patient is currently receiving ocular hypotensive medicatio..."