O14.03 ICD-10-CM Code: Mild to moderate pre-eclampsia, third trimester
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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)
O14.03
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMild to moderate pre-eclampsia, third trimester
A pregnancy complication characterized by high blood pressure and protein in the urine with mild to moderate severity, occurring in the third trimester (weeks 28 to delivery).
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O14.03 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O14.03 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O14.03 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O14.03 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O14.03 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O14.03 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O14.03 in this effective period.
Buddy Documentation Tip
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.
Is O14.03 an HCC code?
No. O14.03 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
O14.03 is the ICD-10-CM diagnosis code for mild to moderate pre-eclampsia, third trimester. A pregnancy complication characterized by high blood pressure and protein in the urine with mild to moderate severity, occurring in the third trimester (weeks 28 to delivery). O14.03 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).
O14.03 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 is the most common presentation of preeclampsia; verify severity criteria are met for mild to moderate classification.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O14.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is the most common presentation of preeclampsia; verify severity criteria are met for mild to moderate classification
- •Document baseline blood pressure and proteinuria levels for comparison