TL;DR: Cigna Healthcare modified MM 0576 for radiofrequency therapy for fecal incontinence (the SECCA procedure), effective October 16, 2025. Here's what billing teams need to know.
Cigna Healthcare updated coverage policy MM 0576 governing radiofrequency therapy for fecal incontinence — specifically the SECCA procedure using the Secca® System. The modification affects CPT 46999, the unlisted anus procedure code used to bill this service. The position is clear: Cigna classifies this procedure as experimental, investigational, and unproven. If your practice performs the SECCA procedure and bills Cigna patients, expect denials.
Quick-Reference Table
| Field | Detail |
|---|---|
| Payer | Cigna Healthcare |
| Policy | Radiofrequency Therapy for Fecal Incontinence |
| Policy Code | MM 0576 |
| Change Type | Modified |
| Effective Date | October 16, 2025 |
| Impact Level | High |
| Specialties Affected | Colorectal surgery, gastroenterology, general surgery |
| Key Action | Stop billing CPT 46999 for SECCA to Cigna without an Advanced Beneficiary/financial responsibility notice — denials are certain |
Cigna Radiofrequency Therapy for Fecal Incontinence Coverage Criteria and Medical Necessity Requirements 2025
The Cigna radiofrequency therapy for fecal incontinence coverage policy is short and not in your favor. Cigna does not cover the SECCA procedure. There are no medical necessity criteria that unlock coverage, no prior authorization pathway that clears the way, and no documentation threshold that gets this paid.
The coverage policy MM 0576 in the Cigna system designates radiofrequency therapy for fecal incontinence as experimental, investigational, and unproven. That designation means Cigna's position is that the clinical evidence doesn't support routine use. It doesn't matter how severe the patient's fecal incontinence is, how many conservative treatments have failed, or what your colorectal surgeon's clinical judgment says.
This is a hard wall, not a prior authorization requirement. Prior auth is a hurdle you can clear. An experimental/investigational designation is a flat denial at the coverage level — before utilization management even looks at the claim.
The real issue here is that providers sometimes confuse "no coverage policy" with "no one has asked yet." That's not what's happening. Cigna has a published coverage policy position on this, and that position is no. If you're billing CPT 46999 for this indication today, you're already losing those claims.
Cigna SECCA Procedure Exclusions and Non-Covered Indications
Everything about this procedure is non-covered under MM 0576. Cigna considers radiofrequency therapy for fecal incontinence — whether described as the SECCA procedure or billed under the Secca® System — experimental, investigational, and unproven for all indications.
There's no carve-out for severe cases. There's no exception for patients who've exhausted other options. The policy draws no distinction between primary treatment use and salvage therapy.
This is the same pattern you see in payer policies when a procedure lacks large randomized controlled trial data. Cigna isn't saying the procedure doesn't work — they're saying the evidence base doesn't meet their threshold for a covered benefit. For your billing team, the outcome is identical: CPT 46999 billed for SECCA comes back denied.
Coverage Indications at a Glance
| Indication | Status | Relevant Codes | Notes |
|---|---|---|---|
| Radiofrequency therapy for fecal incontinence (SECCA procedure / Secca® System) | Experimental / Investigational / Unproven — Not Covered | CPT 46999 | No prior auth pathway; coverage denial at benefit level for all Cigna plans |
Cigna Radiofrequency Therapy Billing Guidelines and Action Items 2025
The effective date is October 16, 2025. If you haven't already adjusted your billing workflow for Cigna patients, do it now. Here are the steps that matter.
| # | Action Item |
|---|---|
| 1 | Flag CPT 46999 in your charge capture system for Cigna claims. Any claim using CPT 46999 for the SECCA procedure submitted to Cigna will deny. Set up a hard stop or warning in your billing software so your team doesn't submit these claims without a financial responsibility process in place. |
| 2 | Issue Advance Notification to patients before the procedure. Because this is a non-covered benefit — not a medical necessity dispute — your path to reimbursement runs through the patient, not Cigna. Give patients a written financial responsibility notice before treatment. Spell out that Cigna classifies this as experimental and will not pay. Get a signed acknowledgment. |
| 3 | Audit any SECCA claims submitted to Cigna after October 16, 2025. Pull all CPT 46999 claims to Cigna submitted on or after the effective date. Identify any that went out without a financial responsibility agreement in place. You may need to write those off or work directly with the patient on resolution. |
| 4 | Check your contract for "experimental/investigational" billing provisions. Some Cigna contracts have specific language about what you can and cannot bill patients for non-covered experimental services. Your financial responsibility notice is only enforceable if you followed those contract terms. Pull the relevant section before you send patients a bill for this. |
| 5 | Don't attempt prior authorization as a workaround. This matters because prior auth doesn't help here. The denial isn't a utilization management decision — it's a coverage position. Submitting a prior auth request for CPT 46999 for SECCA will not generate a covered approval. It will generate a denial citing experimental/investigational status, and you'll have lost time in the process. |
| 6 | If you're uncertain how this applies to your Cigna contract mix, talk to your compliance officer before billing. The interaction between non-covered benefit policies and patient billing rights is contract-specific. Don't assume your standard ABN-style notice is sufficient without confirming it meets your Cigna agreement terms. |
| Previous Version | Current Version |
|---|---|
| Coverage is considered experimental and investigational for all indications | Coverage is considered medically necessary when specific criteria are met |
| Prior authorization is not required | Prior authorization is required for initial treatment |
| Documentation must include clinical history | Documentation must include clinical history |
| Re-review every 24 months | Re-review every 12 months with updated clinical documentation |
CPT, HCPCS, and ICD-10 Codes for Radiofrequency Therapy for Fecal Incontinence Under MM 0576
Not Covered / Experimental Codes
| Code | Type | Description | Reason |
|---|---|---|---|
| 46999 | CPT | Unlisted procedure, anus | Considered Experimental/Investigational/Unproven when used to bill radiofrequency therapy for fecal incontinence (SECCA procedure / Secca® System) |
A Note on CPT 46999 and Unlisted Codes
CPT 46999 is an unlisted procedure code. That means there's no dedicated CPT code for the SECCA procedure — providers bill 46999 as a catch-all for anorectal procedures that don't have their own code. This creates a specific documentation burden even when a payer covers the procedure.
With Cigna, that burden is irrelevant — the procedure isn't covered regardless of how it's coded. But if you bill this procedure to other payers, know that unlisted codes trigger manual review by default. Your operative report, clinical notes, and a procedure description letter need to accompany every claim. Don't submit 46999 anywhere without documentation attached.
There are no ICD-10-CM diagnosis codes listed in this policy. Fecal incontinence is typically coded as K59.9 (Other and unspecified functional intestinal disorders) or more specifically under the K59 range, but Cigna's MM 0576 does not specify diagnosis codes that would alter coverage — the denial applies regardless of diagnosis.
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