CPT 51798: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 51798 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 51798 with a diagnosis that isn't covered typically denies as CARC 50 — not medically necessary.
National approximation. Coverage varies by MAC and state — confirm against the specific LCD/NCD and article that applies to your jurisdiction and date of service.
| ICD-10 | Description |
|---|---|
| N31.0 | Uninhibited neuropathic bladder, not elsewhere classified |
| N31.1 | Reflex neuropathic bladder, not elsewhere classified |
| N31.2 | Flaccid neuropathic bladder, not elsewhere classified |
| N31.9 | Neuromuscular dysfunction of bladder, unspecified |
| N32.0 | Bladder-neck obstruction |
| N39.3 | Stress incontinence (female) (male) |
| N39.41 | Urge incontinence |
| N39.42 | Incontinence without sensory awareness |
| N39.43 | Post-void dribbling |
| N39.44 | Nocturnal enuresis |
| N39.45 | Continuous leakage |
| N39.46 | Mixed incontinence |
| N39.490 | Overflow incontinence |
| N39.498 | Other specified urinary incontinence |
| N40.1 | Benign prostatic hyperplasia with lower urinary tract symptoms |
| R30.0 | Dysuria |
| R30.1 | Vesical tenesmus |
| R30.9 | Painful micturition, unspecified |
| R32 | Unspecified urinary incontinence |
| R33.0 | Drug induced retention of urine |
| R33.8 | Other retention of urine |
| R33.9 | Retention of urine, unspecified |
| R34 | Anuria and oliguria |
| R35.0 | Frequency of micturition |
| R35.1 | Nocturia |
| R35.81 | Nocturnal polyuria |
| R35.89 | Other polyuria |
| R36.0 | Urethral discharge without blood |
| R36.9 | Urethral discharge, unspecified |
| R39.0 | Extravasation of urine |
| R39.11 | Hesitancy of micturition |
| R39.12 | Poor urinary stream |
| R39.13 | Splitting of urinary stream |
| R39.14 | Feeling of incomplete bladder emptying |
| R39.15 | Urgency of urination |
| R39.16 | Straining to void |
| R39.191 | Need to immediately re-void |
| R39.192 | Position dependent micturition |
| R39.198 | Other difficulties with micturition |
| R39.2 | Extrarenal uremia |
| R39.81 | Functional urinary incontinence |
| R39.89 | Other symptoms and signs involving the genitourinary system |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 51798?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 42 ICD-10 diagnosis codes that support medical necessity for CPT 51798. The covered codes are listed on this page. Coverage varies by MAC/state — always confirm against the policy that applies to you.
What is a medical-necessity (LCD/NCD) crosswalk?
A claim whose procedure isn't supported by a covered diagnosis denies as "not medically necessary" (CARC 50). CMS coverage policies define which diagnoses justify a procedure; this page is the ICD-10 → CPT 51798 view of that relationship.
More free billing tools: all crosswalks · NCCI edits · Medicare fees · denial codes
Informational only, not coding, billing, or legal advice. Based on CMS Medicare Coverage Database data; verify the current LCD/NCD for your MAC before billing.
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