Sacral Nerve Stimulation for Urinary and Fecal Indications – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers sacral nerve stimulation (screening trial and permanent implantation) for adults ≥18 with refractory overactive bladder/urge incontinence/nonobstructive urinary retention (bladder capacity ≥100 mL) or chronic fecal incontinence, and considers SNS unproven/not medically necessary for constipation, chronic pelvic pain, and urinary/fecal dysfunction secondary to neurologic disease. Coverage requires documented failure of conservative therapies, absence of mechanical obstruction/secondary causes as applicable, ability to operate the device, a successful screening trial with ≥50% symptom improvement for permanent implantation, specified diagnostic documentation (e.g., bladder capacity/PVR, diaries), and replacements only when the device is nonfunctional/unrepairable or out of warranty.

"- Improvement in reported symptoms of 50% or greater in response to a screening trial of Sacral Nerve Stimulation"