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Anthem Blue Cross Connecticut MED.00103 Automated Evacuation of Meibomian Gland Form

Effective Date

09/27/2023

Last Reviewed

08/10/2023

Original Document

  Reference



This document addresses the use of devices (and associated imaging) which automate the process of applying heat and intermittent pressure for the treatment of meibomian gland dysfunction.

Position Statement

Investigational and Not Medically Necessary:

The use of an automated evacuation device using heat and intermittent pressure, and associated tear film imaging, is considered investigational and not medically necessary for the treatment of meibomian gland dysfunction.