Medicare Advantage

Electrical Continence Aid
MA05.059

Policy

Electrical continence aids are considered experimental/investigational and, therefore, not covered.

Guidelines

This policy is consistent with Medicare's coverage criteria. The Company's payment methodology may differ from Medicare.

BENEFIT APPLICATION

Subject to the terms and conditions of the applicable Evidence of Coverage, electrical continence aids are not eligible for payment under the medical benefits of the Company's Medicare Advantage products because these devices are considered experimental and, therefore, not covered.

Description

An electrical continence aid is a device consisting of a plastic plug, molded into the shape of the patient's anal canal, which contains two implanted electrodes that are connected by a wire to a small portable generator. An electrical current is produced which stimulates the anal musculature to cause a contraction sufficient to hold the plug in while allowing the patient to ambulate without incontinence.

References

Centers for Medicare and Medicaid Services (CMS). National Coverage Determinations NCD 230.15. Electrical Continence Aid [CMS Web site]. Available at: http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=234&ncdver=1&DocID=230.15&bc=gAAAABAAAAAA&. Accessed January 8, 2021​​.

Coding

CPT Procedure Code Number(s)
N/A

ICD - 10 Procedure Code Number(s)
N/A

ICD - 10 Diagnosis Code Number(s)
N/A

HCPCS Level II Code Number(s)
L8699 Prosthetic implant, not otherwise specified

Revenue Code Number(s)
N/A



Coding and Billing Requirements


Policy History

1/1/2015
1/1/2015
2/24/2021
MA05.059
Medical Policy Bulletin
Medicare Advantage
No