Billing and Coding: Posterior Tibial Nerve Stimulation for Voiding Dysfunction

PTNS is covered for patients with overactive bladder syndrome (OBS/OAB) per ICS criteria when the condition is non-neurogenic and non-stress and the patient has documented inadequate response to first- and second-line therapies. Medical records must document OBS (not stress or neurogenic incontinence), include minimum 3-day voiding/compliance diaries before and during treatment, and a 12-week initial PTNS course should be periodically evaluated; relapse treatments should generally be limited to about 1–2 sessions every 1–2 months. Claims must include a valid ICD-10-CM diagnosis code and, when required, the referring/ordering physician name and NPI, and providers should confirm applicable NCCI/OPPS billing edits.

"Posterior tibial nerve stimulation (PTNS) is covered for patients with overactive bladder syndrome (OBS)/overactive bladder (OAB) per the International Continence Society definition (urinary urgenc..."