Pelvic Floor Stimulation as a Treatment of Urinary or Fecal Incontinence

This policy addresses pelvic floor stimulation (electrical or magnetic, including intravaginal/rectal probes, extracorporeal magnetic pulses, and FDA 510(k) nonimplanted stimulators) for treatment of urinary and fecal incontinence. It applies to patients with detrusor/urge, stress, and mixed incontinence (commonly women, including older adults, and select men for pudendal nerve stimulation) but coverage is determined by the member’s benefit plan, evidence is heterogeneous and inconclusive, and many plans or provisions consider PFS experimental/investigational or subject to specific device, setting, and trial limitations.

"Pelvic floor stimulation for treatment of urinary incontinence."

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