O10.12 ICD-10-CM Code: Pre-existing hypertensive heart disease complicating childbirth
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16)
O10.12
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePre-existing hypertensive heart disease complicating childbirth
A pregnant woman who had high blood pressure with heart disease before pregnancy, and this condition is present during labor and delivery.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 208
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Any condition in I11 specified as a reason for obstetric care during pregnancy, childbirth or the puerperium
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O10.12 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O10.12 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O10.12 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O10.12 in this effective period.
Use Additional
Official- code from I11 to identify the type of hypertensive heart disease
Code Also
OfficialICD-10-CM does not list Code Also instructions for O10.12 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 O10.12 an HCC code?
No. O10.12 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- O10.12
- Description
- Pre-existing hypertensive heart disease complicating childbirth
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
O10.12 is the ICD-10-CM diagnosis code for pre-existing hypertensive heart disease complicating childbirth. A pregnant woman who had high blood pressure with heart disease before pregnancy, and this condition is present during labor and delivery. O10.12 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (o10-o16).
O10.12 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 only during the childbirth episode; use O10.11 for pregnancy and O10.13 for postpartum period.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O10.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.