R30.1
BillableVesical tenesmus
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R30.1 an HCC code?
No. R30.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R30.1 is the ICD-10-CM diagnosis code for vesical tenesmus. A persistent urge to urinate even when the bladder is empty or nearly empty, causing discomfort or pain. R30.1 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering symptoms and signs involving the genitourinary system (r30-r39).
R30.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Vesical tenesmus is a symptom, not a diagnosis; investigate underlying causes such as UTI, bladder irritation, or neurological conditions.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R30.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Vesical tenesmus is a symptom, not a diagnosis; investigate underlying causes such as UTI, bladder irritation, or neurological conditions
- •Document whether this occurs during or after urination to help identify the underlying etiology