CommercialPrior AuthMedium impact
Prior Approval Required for Temporary (Trial) Sacral Nerve Stimulation Effective May 1, 2020
Medical Mutual of Ohio·Urology, Neurology, Pain Management·In the News
Effective date
May 1, 2020
We identified it
Jun 20, 2026
Summary
Beginning May 1, 2020, Medical Mutual requires prior authorization for all temporary (trial) sacral nerve stimulation procedures. Medical necessity will be determined using Corporate Medical Policy 200616 for trials and MCG Health Care Guidelines for implanted devices.
Action Required
By May 1, 2020: Billing team must update system to require prior authorization for all temporary sacral nerve stimulation procedures before scheduling. Contact Medical Mutual prior approval department for all trial sacral nerve stimulation cases. Update scheduling workflows to allow time for authorization approval. Claims will be denied without proper prior authorization.