R39.11: Hesitancy of micturition
R39.11, hesitancy of micturition, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including A4290 (Sacral nerve stimulation test lead, each), C1767 (Generator, neurostimulator (implantable), non-rechargeable), C1778 (Lead, neurostimulator (implantable)). 1 of these codes has a 2026 DMEPOS fee schedule amount; L8678 pays $11.40 to $31.64 depending on the state. The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with R39.11 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| A4290 | Sacral nerve stimulation test lead, each | Carrier judgment | — | 3 |
| C1767 | Generator, neurostimulator (implantable), non-rechargeable | Special coverage instructions apply | — | 3 |
| C1778 | Lead, neurostimulator (implantable) | Special coverage instructions apply | — | 3 |
| C1883 | Adapter/extension, pacing lead or neurostimulator lead (implantable) | Special coverage instructions apply | — | 3 |
| C1897 | Lead, neurostimulator test kit (implantable) | Special coverage instructions apply | — | 3 |
| C1820 | Generator, neurostimulator (implantable), with rechargeable battery and charging system | Special coverage instructions apply | — | 2 |
| L8678 | Electrical stimulator supplies (external) for use with implantable neurostimulator, per month | Carrier judgment | $11.40–$31.64 | 1 |
| L8680 | Implantable neurostimulator electrode, each | Not payable by Medicare | Not covered | 2 |
Medicare policy articles listing R39.11
- A55835: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 6 Level II codes)
- A53359: Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 7 Level II codes)
- A59332: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence (Palmetto GBA (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L39543
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other R39 diagnoses (Other and unspecified symptoms and signs involving the genitourinary system)
- R39.14 — Feeling of incomplete bladder emptying
- R39.15 — Urgency of urination
- R39.191 — Need to immediately re-void
- R39.192 — Position dependent micturition
- R39.89 — Other symptoms and signs involving the genitourinary system
Frequently asked questions
Does Medicare cover R39.11 (Hesitancy of micturition)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list R39.11 as a covered diagnosis for 8 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 R39.11?
The Level II codes from the policies most specific to this diagnosis are A4290 (Sacral nerve stimulation test lead, each, 3 articles); C1767 (Generator, neurostimulator (implantable), non-rechargeable, 3 articles); C1778 (Lead, neurostimulator (implantable), 3 articles); C1883 (Adapter/extension, pacing lead or neurostimulator lead…, 3 articles); C1897 (Lead, neurostimulator test kit (implantable), 3 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with R39.11?
Under the 2026 DMEPOS fee schedule (non-rural state fees): L8678 $11.40 to $31.64. Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list R39.11?
A55835 (Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence); A53359 (Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence); A59332 (Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence).
What is ICD-10-CM code R39.11?
R39.11 is the ICD-10-CM code for hesitancy of micturition, in category R39 (Other and unspecified symptoms and signs involving the genitourinary system), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under A4290
- Watch A4290 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4290
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup