iStent is both a stent and MIGS. Absolutely.
However the May24 LCD repeatedly distinguishes stents from other types of MIGS: "e.g., stent and MIGS surgical procedure."
In the Indications they state: stents are considered reasonable when used in conjunction with cataract surgery; and stents will be reimbursed as a standalone in cases of refractory glaucoma.
They then imply in the Limitations that other types of single MIGS can also be used in refractory glaucoma, or in conjunction with cataract surgery, but only in place of (not in addition to) the stent.
And I'm not convinced that ordering is an accident...
Because they then review lots of published evidence, which repeatedly concludes the evidence for stent efficacy is good, while the evidence for microcatheter efficacy is weak.
MACs are not banning reimbursement for OMNI or iTrack, but they're making clear their preference is for stents, and saying surgeons must choose one.
Drops --> Invasive Surgery --> Stents --> Other MIGS
They prefer more invasive surgery to minimally invasive surgery; that's how pauce the evidence base is for Other MIGS.
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