CPT C1820: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT C1820 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT C1820 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 |
|---|---|
| N30.10 | Interstitial cystitis (chronic) without hematuria |
| N30.11 | Interstitial cystitis (chronic) with hematuria |
| N32.81 | Overactive bladder |
| N36.44 | Muscular disorders of urethra |
| N39.41 | Urge incontinence |
| N39.42 | Incontinence without sensory awareness |
| N39.46 | Mixed incontinence |
| N39.490 | Overflow incontinence |
| N39.492 | Postural (urinary) incontinence |
| N39.498 | Other specified urinary incontinence |
| R15.9 | Full incontinence of feces |
| R32 | Unspecified urinary incontinence |
| R33.0 | Drug induced retention of urine |
| R33.8 | Other retention of urine |
| R33.9 | Retention of urine, unspecified |
| R35.0 | Frequency of micturition |
| R39.11 | Hesitancy of micturition |
| R39.14 | Feeling of incomplete bladder emptying |
| R39.15 | Urgency of urination |
| R39.191 | Need to immediately re-void |
| R39.192 | Position dependent micturition |
| T85.111A | Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter |
| T85.111D | Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), subsequent encounter |
| T85.111S | Breakdown (mechanical) of implanted electronic neurostimulator of peripheral nerve electrode (lead), sequela |
| T85.113A | Breakdown (mechanical) of implanted electronic neurostimulator, generator, initial encounter |
| T85.113D | Breakdown (mechanical) of implanted electronic neurostimulator, generator, subsequent encounter |
| T85.113S | Breakdown (mechanical) of implanted electronic neurostimulator, generator, sequela |
| T85.121A | Displacement of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter |
| T85.121D | Displacement of implanted electronic neurostimulator of peripheral nerve electrode (lead), subsequent encounter |
| T85.121S | Displacement of implanted electronic neurostimulator of peripheral nerve electrode (lead), sequela |
| T85.123A | Displacement of implanted electronic neurostimulator, generator, initial encounter |
| T85.123D | Displacement of implanted electronic neurostimulator, generator, subsequent encounter |
| T85.123S | Displacement of implanted electronic neurostimulator, generator, sequela |
| T85.191A | Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), initial encounter |
| T85.191D | Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), subsequent encounter |
| T85.191S | Other mechanical complication of implanted electronic neurostimulator of peripheral nerve electrode (lead), sequela |
| T85.193A | Other mechanical complication of implanted electronic neurostimulator, generator, initial encounter |
| T85.193D | Other mechanical complication of implanted electronic neurostimulator, generator, subsequent encounter |
| T85.193S | Other mechanical complication of implanted electronic neurostimulator, generator, sequela |
| T85.732A | Infection and inflammatory reaction due to implanted electronic neurostimulator of peripheral nerve, electrode (lead), initial encounter |
| T85.732D | Infection and inflammatory reaction due to implanted electronic neurostimulator of peripheral nerve, electrode (lead), subsequent encounter |
| T85.732S | Infection and inflammatory reaction due to implanted electronic neurostimulator of peripheral nerve, electrode (lead), sequela |
| T85.734A | Infection and inflammatory reaction due to implanted electronic neurostimulator, generator, initial encounter |
| T85.734D | Infection and inflammatory reaction due to implanted electronic neurostimulator, generator, subsequent encounter |
| T85.734S | Infection and inflammatory reaction due to implanted electronic neurostimulator, generator, sequela |
| T85.840A | Pain due to nervous system prosthetic devices, implants and grafts, initial encounter |
| Z45.42 | Encounter for adjustment and management of neurostimulator |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT C1820?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 47 ICD-10 diagnosis codes that support medical necessity for CPT C1820. 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 C1820 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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