Cigna policy
Sacral Nerve Stimulation for Urinary Voiding Dysfunction, Fecal Incontinence and Constipation
Sacral Nerve Stimulation for Urinary Voiding Dysfunction, Fecal Incontinence and Constipation is a public Cigna policy (policy 0404, effective Nov 15, 2025). It lists 14 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Payer
- Cigna
- Policy number
- 0404
- Effective
- Nov 15, 2025
- Line of business
- Commercial
- Source
- static.cigna.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Cigna policies |
|---|---|
| 64590 | Policies naming 64590 |
| C1767 | Policies naming C1767 |
| C1778 | Policies naming C1778 |
| C1787 | Policies naming C1787 |
| C1820 | Policies naming C1820 |
| C1883 | Policies naming C1883 |
| L8679 | Policies naming L8679 |
| L8680 | Policies naming L8680 |
| L8681 | Policies naming L8681 |
| L8682 | Policies naming L8682 |
| L8685 | Policies naming L8685 |
| L8686 | Policies naming L8686 |
| L8687 | Policies naming L8687 |
| L8688 | Policies naming L8688 |