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O11 ICD-10-CM Code: Pre-existing hypertension with pre-eclampsia

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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16)

O11

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Pre-existing hypertension with pre-eclampsia

Pre-existing hypertension with pre-eclampsia

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

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Code Book Path

Official
O1Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16)
O11Pre-existing hypertension with pre-eclampsia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O11 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O11 in this effective period.

Related Child Codes

Official
O11.1Pre-existing hypertension with pre-eclampsia, first trimester
O11.2Pre-existing hypertension with pre-eclampsia, second trimester
O11.3Pre-existing hypertension with pre-eclampsia, third trimester
O11.4Pre-existing hypertension with pre-eclampsia, complicating childbirth
O11.5Pre-existing hypertension with pre-eclampsia, complicating the puerperium

Includes

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

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O11 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O11 in this effective period.

Use Additional

Official
  • code from O10 to identify the type of hypertension

Code Also

Official

ICD-10-CM does not list Code Also instructions for O11 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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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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