Adjustable Continence Therapy - (0573)

Adjustable Continence Therapy (ACT/ProACT) is considered experimental, investigational, or unproven for all indications and is not covered under this policy, with CPT codes 53451 and 53452 specifically listed as not covered. Providers must bill with appropriate covered codes or the claim will be denied, and final coverage is determined by the member’s benefit plan and applicable laws (note: an FDA PMA exists for a limited male post‑prostate procedure indication but the policy still denies coverage).

"None — policy statement: "Adjustable Continence Therapy is considered experimental, investigational or unproven for all indications."

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