Medicare AdvantageBilling CodesMedium impact
11.17.04z, Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence
Independence Blue Cross·Urology, General Surgery, Neurosurgery·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 11.17.04z to add two new CPT codes (0988T and 0989T) as experimental/investigational effective 01/01/2026. These codes are excluded from coverage for all Independence Blue Cross products and are not eligible for reimbursement. The policy also reaffirms existing coverage criteria for sacral nerve stimulation (SNS) and posterior tibial nerve stimulation (PTNS) for incontinence treatment.
Action Required
By December 15, 2025: Billing team must update billing system to deny claims for CPT codes 0988T and 0989T with explanation that these codes are experimental/investigational and excluded from coverage under all Independence Blue Cross products. Update denial messaging to reference Policy 11.17.04z. Notify providers that these codes cannot be billed to Independence Blue Cross effective 01/01/2026. Continue billing CPT codes 64561, 64566, 64581, 64585, 64590, 64595 and HCPCS codes A4290, C1767, C1778, C1787, C1883, C1897, C1894, L8678 per existing medical necessity criteria when appropriate ICD-10 diagnosis codes (N31.8, N31.9, N32.81, N36.44, N39.41-N39.46, N39.490, N39.498, R15.0, R15.1) are documented.