VALENCIA, Calif.July 17, 2023 /PRNewswire/ — Valencia Technologies Corporation announced today that the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), published the 2024 Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule with information relevant to the eCoin system procedure. The eCoin® system is a pioneering, leadless tibial neurostimulator for the treatment of urgency urinary incontinence (UUI).

Earlier in 2023, Valencia Technologies collaborated with the American Urological Association (AUA) and other key stakeholders to secure American Medical Association CPT Editorial Panel approval for Category III CPT® code X129T, effective on January 1, 2024. This code will be used to report the insertion or replacement of an integrated tibial neurostimulation system for treating bladder dysfunction, such as urgency urinary incontinence (UUI). Thus, beginning on January 1, 2024, physicians, hospitals, and ambulatory surgery centers (ASCs) will report outpatient eCoin® neurostimulator procedures to Medicare, Medicare Advantage, and commercial health plans using CPT® code X129T.

In the Proposed Rule issued Thursday, July 13, 2023, CMS proposes that Category III code X129T is assigned to Hospital Outpatient Prospective Payment System Ambulatory Payment Classification (APC) 5464 for Calendar Year 2024 with a proposed unadjusted national average payment rate of US$21,376.53 as referenced in the Addendums A and B of the Proposed Rule.

The eCoin System holds the distinction of being the first and only US Food and Drug Administration (FDA) approved implantable medical device to target the tibial nerve for treatment of urgency urinary incontinence.

“The APC assignment determination made by CMS marks a significant milestone for the eCoin system procedure and will ensure that our innovative technology has a continued reimbursement path into 2024 and beyond. Given the widespread prevalence of urgency urinary incontinence, Valencia Technologies is quite pleased to see our innovation contribute to the treatment and recognition of a typically underserved medical condition,” stated Ann Decker, VP of Reimbursement for Valencia Technologies. “These coding and payment decisions are consistent with the strong, published clinical evidence demonstrating the safety and effectiveness of the eCoin device for the treatment of urgency urinary incontinence.”

According to the Urology Care Foundation as many as 30% of men and 40% of women in the United States live with overactive bladder (OAB) symptoms.1 UUI is the most bothersome symptom of OAB syndrome.2 40M+ women in the US suffer from UUI.3 Most remain untreated for this chronic problem that dramatically impairs quality of life.2

The eCoin® device is a coin-sized neurostimulator which is implanted subcutaneously in the lower leg during a minimally invasive, outpatient procedure utilizing local anesthetic. The eCoin® device contains a primary battery, and once activated, automatically delivers intermittent stimulation to the tibial nerve twice weekly to reduce UUI symptoms without patient involvement. The procedure is less invasive than traditional sacral neuromodulation surgery for treating UUI which typically requires a multi-phase approach, need for sedation or general anesthesia, and patient management of a remote and possibly other recharging components.

The eCoin system received FDA premarket approval (PMA) in the USA in March 2022 and is currently available throughout the United States.

Physicians interested in offering eCoin® therapy to their patients may register for the eCoin® Physician Qualification training program using the eCoin® physician website at Patients are encouraged to visit Valencia’s patient website at for more information about this novel therapy for UUI.

Forward-looking Statements

Statements made in this press release that relate to future plans, events, prospects or performance are forward-looking statements as defined under the Private Securities Litigation Reform Act of 1995. Words such as “planned,” “expects,” “believes,” “anticipates,” “designed,” and similar words are intended to identify forward-looking statements. While these forward-looking statements are based on the current expectations and beliefs of management, such forward-looking statements are subject to a number of risks, uncertainties, assumptions and other factors that could cause actual results to differ materially from the expectations expressed in this press release. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. Except as required by law, Valencia undertakes no obligation to update or revise any forward-looking statements to reflect new information, changed circumstances or unanticipated events.

CPT® codes and descriptions are copyright 2022 American Medical Association (AMA). All rights reserved. CPT® is a registered trademark of the American Medical Association. Applicable FARD/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT®, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

  2. Valencia 2019 Survey of Women with OAB.
  3. Patel UJ, MD, Godecker AL, Giles DL, Brown HW. Updated prevalence of urinary incontinence in women. Female Pelvic Med Reconstr Surg. January 12, 2022.

CMS Final Rule resource

Federal Register :: Public Inspection: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Payment for Intensive Outpatient Services in Rural Health Clinics, Federally Qualified Health Centers, and Opioid Treatment Programs; Hospital Price Transparency; Changes to Community Mental Health Centers Conditions of Participation, Proposed Changes to the Inpatient Prospective Payment System Medicare Code Editor; Rural Emergency Hospital Conditions of Participation Technical Correction

Important Safety Information

The eCoin Peripheral Neurostimulator (“eCoin”) is part of the eCoin Peripheral Neurostimulator System (“eCoin System”) including device accessories. Indications: The eCoin is intended to be used to treat urgency urinary incontinence in patients intolerant to or having an inadequate response to other more conservative treatments or who have undergone a successful trial of percutaneous tibial nerve stimulation.

Contraindications: The eCoin is contraindicated for the following patients: Poor Surgical Candidates: The eCoin should not be implanted in patients who are poor surgical candidates. Poor surgical candidates include those who have open wounds or sores on the lower leg or foot; had prior surgery in the implant area; had previous, unhealed trauma in the implant area; pitting edema (≥2+) in the lower leg; venous disease/insufficiency in the lower leg; arterial disease/insufficiency in the lower leg; vasculitis or dermatologic conditions in the lower leg, infections near the implantation site in the lower leg. Patient cannot properly operate the Patient Controller Magnets and paper tape for use in the event of unintended or unwanted stimulation.

Warnings: Diathermy should not be used on patients implanted with the eCoin. The eCoin is MRI Conditional. It is not safe to have a patient’s lower leg placed in an MRI machine. Other medical procedures that may affect the eCoin System and should not be used in the implant area include: Monopolar electrosurgery; Microwave and Radiofrequency (RF) ablation; Radiation therapy over the eCoin; Ultrasound or scanning equipment. Electromagnetic Interference (EMI) generated by equipment found at home, work, or in public can interfere with the function of the eCoin System. Walkthrough metal detectors, security wands, or security archways should not affect the eCoin. Full-body security scanners used by the TSA are considered safe in patients that have a stimulator. The eCoin contains battery chemicals that could cause burns if the eCoin case were ruptured or pierced. Precautions: The safety and effectiveness of this therapy has not been established for Pregnant women; Patients under the age of 18; Patients with progressive, systemic neurological diseases; Bilateral stimulation. Potential Adverse Events: Implantation and use of the eCoin System incurs risk beyond those normally associated with surgery, some of which may necessitate intervention. In addition to the risks listed, there is a risk that eCoin therapy may not be effective in relieving symptoms or may cause worsening of symptoms. See the complete eCoin Physician Manual prior to use. RX only.