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O11

Non-Billable (Header)

Pre-existing hypertension with pre-eclampsia

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

What This Code Means

O11 is the ICD-10-CM diagnosis code for pre-existing hypertension with pre-eclampsia. O11 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).

Header codes like O11 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at O11's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • conditions in O10 complicated by pre-eclampsia
  • pre-eclampsia superimposed pre-existing hypertension

Use Additional Code

  • code from O10 to identify the type of hypertension

Child Codes

Code Hierarchy

O11Pre-existing hypertension with pre-eclampsia
O11Pre-existing hypertension with pre-eclampsia

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