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Medical Policy Revision: Aqueous Shunts and Stents for Glaucoma

Effective June 11, 2018, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain professional claims based on the guidelines of our revised medical policy, Aqueous Shunts and Stents for Glaucoma.

We encourage you to visit our Medical Policy Manual to review the guidelines of our Aqueous Shunts and Stents for Glaucoma medical policy which identify when services and supplies related to the use of aqueous shunts and/or stents in patients with glaucoma are considered medically necessary.


Based on the guidelines of our medical policy, Aqueous Shunts and Stents for Glaucoma, and the submitted diagnosis code(s), claims for services provided on and after June 11, 2018 plans will be processed as noted below.

  • Claims that include CPT® code 0474T may pend while information required to determine medical appropriateness is requested and reviewed.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims on and after June 11, 2018.

CPT® is a registered mark of the American Medical Association.

Published on: March 12, 2018, 14:42 p.m. ET
Last updated on: March 12, 2018, 14:43 p.m. ET