Fecal Incontinence

Aetna covers diagnostic tests (anorectal manometry, anorectal ultrasound, rectal sensory testing), conservative treatments (biofeedback, bowel training/defecation programs, diet modification, pharmacotherapy), and surgical options (anal sphincter repair, colostomy) for severe fecal incontinence when patients have failed or are not candidates for medical interventions. The Acticon Neosphincter is covered only for patients ≥18 with severe (weekly or more frequent involuntary loss of solid or liquid stool) fecal incontinence after failure or ineligibility for medical/sphincter repair options, whereas anal slings, the Fenix system, graciloplasty, injectable bulking agents, and use of the Acticon outside its criteria or with listed contraindications are considered experimental/investigational.

"An anal sphincter repair for members with severe fecal incontinence who have failed, or are not candidates for, medical interventions (e."