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O09.A3

Billable

Supervision of pregnancy with history of molar pregnancy, third trimester

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is O09.A3 an HCC code?

No. O09.A3 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

O09.A3 is the ICD-10-CM diagnosis code for supervision of pregnancy with history of molar pregnancy, third trimester. Medical supervision of a pregnant patient with a history of molar pregnancy during the third trimester (weeks 28 and beyond). O09.A3 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.A3 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.

The fifth character '3' indicates third trimester; patients with molar pregnancy history require ongoing surveillance throughout pregnancy.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O09.A3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • The fifth character '3' indicates third trimester; patients with molar pregnancy history require ongoing surveillance throughout pregnancy
  • Document any additional monitoring or interventions performed due to the molar pregnancy history to justify high-risk classification

Code Hierarchy

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