Percutaneous and Subcutaneous Tibial Nerve Stimulation

This policy covers percutaneous tibial nerve stimulation (PTNS) for treatment of overactive bladder (OAB) and related non‑neurogenic voiding dysfunctions, with an initial recommended course of 12 weekly office‑based PTNS treatments and individualized monthly maintenance allowed if clinical improvement is demonstrated. Coverage is limited to patients with significant OAB symptoms who have failed conservative behavioral therapy and trials of two medication classes (unless contraindicated), is restricted to once‑weekly administration for up to 12 weeks, and excludes PTNS for stress urinary incontinence, interstitial cystitis, neurogenic or obstructive retention, fecal incontinence, continued PTNS without documented benefit, and implantable/subcutaneous tibial nerve stimulators (e.g., eCoin) which are considered experimental and not covered.

"Percutaneous tibial nerve stimulation (PTNS) for treatment of overactive bladder (OAB)."