Micro-Invasive Glaucoma Surgery (MIGS)

Covered: one FDA‑cleared MIGS device per eye is considered reasonable and necessary only per device-specific indications — trabecular stents (e.g., iStent family, Hydrus) when implanted with cataract surgery for adults with mild–moderate OAG on ocular hypotensive therapy, and subconjunctival/trabecular standalone stents (e.g., XEN45, iStent Infinite) for refractory glaucoma (prior failed filtering/cilioablative procedure OR progressive damage or mean diurnal medicated IOP ≥20 mmHg on maximally tolerated medical therapy, typically ≥4 classes). Excluded/limits: multiple MIGS procedures or combining MIGS with other glaucoma surgeries or more devices than cleared (including “stent dosing”) on the same eye/day are non‑covered; XEN45 requires an ophthalmologist experienced in trabeculectomy/bleb management, and claims must include documentation of prior surgeries, MTMT, IOP/progression, and appropriate provider credentials per the related Billing & Coding Article.