ICD-10 R39.14 is officially defined as "Feeling of incomplete bladder emptying." code R39.14 is referenced in 7 tracked payer policy changes from Health Net, Blue Cross & Blue Shield of Mississippi, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code R39.14 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Health Net updated 22 medical policies in Q4 2019, including new policies for Antithrombin III treatment, implantable hypoglossal nerve stimulation, and video EEG monitoring. Key changes include lowered colorectal cancer screening age to 45, updated bariatric surgery criteria, and multiple billing code additions/removals across various specialties.
Health Net updated 25 medical policies for Q4 2019, affecting prior authorization requirements, billing codes, and coverage criteria across multiple specialties. Key changes include new prior auth requirements for antithrombin III, hypoglossal nerve stimulation, and video EEG, plus updated criteria for bariatric surgery, cardiac risk assessment, and various pain management procedures.
Health Net updated 25+ medical policies in Q4 2019 with significant changes to prior authorization requirements, coverage criteria, and billing codes across multiple specialties. Key changes include updated bariatric surgery criteria, new DNA stool screening age range (45-85), added prior authorization requirements for various procedures, and terminology updates for gender-affirming procedures.
Policy A.7.01.69 states that sacral nerve neuromodulation may be considered medically necessary as a trial for urge incontinence, urgency-frequency syndrome, non-obstructive urinary retention, or overactive bladder when the listed criteria are met, and as a trial for chronic fecal incontinence when its separate criteria are met. Permanent implantation may be considered medically necessary when those criteria are met and a trial stimulation period shows at least 50% improvement in symptoms over at least 48 hours, while chronic constipation, chronic pelvic pain, stress incontinence, and urge incontinence due to a neurologic condition are investigational. The policy was updated on 09/17/2026 to change the device description, renumber the urinary incontinence Criteria A statements, and remove ICD-9 procedure and diagnosis codes from the code reference section.
Aetna covers urinary catheters and external urinary collection devices as medically necessary prosthetics for members with permanent urinary incontinence or permanent urinary retention, where retention is not expected to be medically or surgically corrected within 3 months. Aetna considers one indwelling catheter per month medically necessary for routine catheter maintenance, and the policy lists usual maximum quantities for insertion trays, drainage bags, intermittent catheters, lubricant and external collection devices. The inFlow device is considered medically necessary as an alternative to intermittent catheterization for permanent urinary retention due to impaired detrusor contractility, with one device no more than once every 29 days, and the PureWick urine collection system is considered unproven and not medically necessary for the management of urinary incontinence.
Aetna Clinical Policy Bulletin 0223 on urinary incontinence, reviewed 2026-07-16, considers multi-channel urodynamic studies medically necessary when a member has both symptoms and physical findings of urinary incontinence or voiding dysfunction and the provider is considering invasive, potentially morbid or irreversible treatment after conservative management has failed. It considers medically necessary the artificial urinary sphincter, FDA-cleared peri-urethral bulking agents, permanent sacral nerve stimulators after temporary trial stimulation, percutaneous tibial nerve stimulation, weighted vaginal cones, pessaries, tension-free and transobturator tape procedures, colposuspension and sub-urethral sling procedures when the stated criteria are met. Bilateral permanent sacral nerve stimulator implantation, the Genityte and FemiLift laser procedures, stem cell therapy and many other listed interventions are considered experimental, investigational or unproven.
A trial of sacral nerve neuromodulation, using percutaneous nerve stimulation or a temporarily implanted lead, may be considered medically necessary for urge incontinence, urgency-frequency syndrome, non-obstructive urinary retention, or overactive bladder when the listed criteria are met. Permanent implantation may be considered medically necessary when those criteria are met and a trial stimulation period demonstrates at least 50% improvement in symptoms over at least 48 hours. For chronic fecal incontinence, a trial may be considered for more than 2 incontinent episodes on average per week for more than 6 months, or more than 12 months after vaginal childbirth, after documented failure of conventional conservative therapy. Sacral nerve neuromodulation is considered investigational for chronic constipation, chronic pelvic pain, stress incontinence, and urge incontinence due to a neurologic condition. The 09/17/2026 update revised device descriptions, re-numbered the Criteria A statements for urinary incontinence, and removed ICD-9 procedure and diagnosis codes from the code reference.
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