Bulking Agents for Treatment of Urinary or Fecal Incontinence 7.01.22
Summary
Urethral bulking agents may be considered medically appropriate for urinary incontinence when they are FDA-approved and the indication criteria are met. Collagen implants are covered for stress incontinence due to urethral sphincter dysfunction that is unresponsive to conservative therapy, with a listed indication such as congenital or acquired sphincter weakness or biological female patients with abdominal leak point pressure of 100 cm H2O or less. Bulking agents are covered for stress incontinence due to intrinsic sphincter deficiency only in biological female patients unresponsive to conservative therapy. Urethral bulking agents are not medically necessary for urinary retention with overflow incontinence, ectopic ureter, neurogenic bladder dysfunction, urinary fistulas, or psychogenic incontinence. Perianal bulking agents for fecal incontinence are investigational.
Get alerts when payers change rules like this one
We check Excellus BlueCross BlueShield and other payers every day and email you when a change matches your specialty and state.