O09.511 ICD-10-CM Code: Supervision of elderly primigravida, first trimester

O09.511 is the ICD-10-CM diagnosis code for supervision of elderly primigravida, first trimester. Medical supervision during the first three months of pregnancy for a woman over 35 years old who is pregnant for the first time. O09.511 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).

O09.511 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 requires documentation of maternal age (typically 35 years or older) and confirmation this is the first pregnancy.