O09.00 ICD-10-CM Code: Supervision of pregnancy with history of infertility, unspecified trimester
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Supervision of high risk pregnancy (O09)
O09.00
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSupervision of pregnancy with history of infertility, unspecified trimester
A pregnant woman is being monitored because she has a history of difficulty becoming pregnant, but the specific trimester is not specified.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 212
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O09.00 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O09.00 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O09.00 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O09.00 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O09.00 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O09.00 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O09.00 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is O09.00 an HCC code?
No. O09.00 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- O09.00
- Description
- Supervision of pregnancy with history of infertility, unspecified trimester
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
O09.00 is the ICD-10-CM diagnosis code for supervision of pregnancy with history of infertility, unspecified trimester. A pregnant woman is being monitored because she has a history of difficulty becoming pregnant, but the specific trimester is not specified. O09.00 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering supervision of high risk pregnancy (o09).
O09.00 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.
This code is used for routine prenatal supervision of women with prior infertility issues.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O09.00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.