Medicare AdvantageBilling CodesLow impact
MA11.028l, Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for the Control of Incontinence
Independence Blue Cross·Urology, Gastroenterology, General Surgery +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA11.028l on 01/21/2026 to communicate the company's continuing position on Sacral Nerve Stimulation (SNS) and Posterior Tibial Nerve Stimulation (PTNS) for incontinence control. Two new experimental/investigational CPT codes (0988T and 0989T) were added effective 01/01/2026 and are NOT covered. No changes to existing coverage criteria or medically necessary procedures.
Action Required
By 01/01/2026: Billing team must update claims processing system to deny or reject any claims submitted with CPT codes 0988T and 0989T, as these codes are marked experimental/investigational and not covered by Independence Blue Cross Medicare Advantage plans. Flag these codes in billing software as 'not billable' or require manual review with coverage denial. Educate providers that these codes should not be used for Medicare Advantage beneficiaries. Existing SNS/PTNS procedures using codes 64561, 64566, 64581, 64585, 64590, 64595 and associated HCPCS codes remain covered when medical necessity criteria are met. No other action required—all other coverage criteria remain unchanged.