O11.9
BillablePre-existing hypertension with pre-eclampsia, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O11.9 an HCC code?
No. O11.9 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
O11.9 is the ICD-10-CM diagnosis code for pre-existing hypertension with pre-eclampsia, unspecified trimester. A condition where a pregnant woman with pre-existing high blood pressure develops pre-eclampsia, but the specific timing during pregnancy is not documented. O11.9 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).
O11.9 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.
Use only when trimester is unknown or not documented; otherwise use more specific codes O11.1-O11.5.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O11.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.