Nerve Stimulation for Fecal Incontinence - Medicare Advantage

Humana's Medicare Advantage policy considers sacral nerve stimulation (SNS) medically reasonable and necessary for fecal incontinence when criteria are met and contraindications are absent; a successful trial (≥50% symptom improvement) is expected before permanent implantation. Percutaneous tibial nerve stimulation (PTNS) for fecal incontinence is not considered medically reasonable and necessary; removal and replacement of SNS devices are covered when device-related complications occur or devices fail and are out of warranty. Humana follows applicable CMS LCDs (notably L39543) and requires clinical documentation including history/physical, diagnostic testing, and trial stimulation results.

"Sacral nerve stimulation (SNS) for FI will be considered medically reasonable and necessary in the absence of contraindications."

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