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CommercialCoverageMedium impact

Pelvic Floor Electrical Stimulation as a Treatment for Urinary or Fecal Incontinence 1.01.19

Excellus BlueCross BlueShield·Urology, OB-GYN, PM&R (Physical Medicine & Rehab) +1 more·Urinary System (Genitourinary)
Effective date
Mar 19, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Excellus BlueCross BlueShield has updated their policy to classify pelvic floor electrical stimulation (PFES) as not medically necessary for treating urinary or fecal incontinence. This affects specific CPT and HCPCS codes that will now be denied for incontinence-related diagnoses.

Action Required

Action needed
Before March 19, 2026: Billing team must update system to flag CPT codes 97014, 97032, G0283 and HCPCS codes E0740, E0715 as non-covered when billed with incontinence diagnosis codes N39.3, N39.41-N39.498, R15.0-R15.9, and R32 for Excellus BlueCross BlueShield patients. Update encounter forms to alert providers that PFES treatments will be denied for these conditions. Claims will be denied as not medically necessary.

Affected Billing Codes

97014
97032
E0740
E0715
G0283
N39.3
N39.41
N39.498
R15.0
R15.9
R32