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O14.90 ICD-10-CM Code: Unspecified pre-eclampsia, unspecified 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)

O14.90

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Unspecified pre-eclampsia, unspecified trimester

Pre-eclampsia is a pregnancy condition characterized by high blood pressure and protein in the urine, but the specific trimester is not documented.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

HCC 211

Varies by metal level

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
O14Pre-eclampsia
O14.9Unspecified pre-eclampsia
O14.90Unspecified pre-eclampsia, unspecified trimester

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O14.90 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O14.90 in this effective period.

Related Child Codes

Official
O14.92Unspecified pre-eclampsia, second trimester
O14.93Unspecified pre-eclampsia, third trimester
O14.94Unspecified pre-eclampsia, complicating childbirth
O14.95Unspecified pre-eclampsia, complicating the puerperium

Includes

Official

ICD-10-CM does not list Includes notes for O14.90 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O14.90 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O14.90 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for O14.90 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for O14.90 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use this code only when the trimester is truly unknown or unspecified; attempt to clarify trimester from clinical documentation
This is a less specific code; prefer codes O14.92, O14.93, or O14.94 when trimester information is available

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 O14.90 an HCC code?

No. O14.90 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
O14.90
Description
Unspecified pre-eclampsia, unspecified trimester
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
Yes
Payment year
2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

O14.90 is the ICD-10-CM diagnosis code for unspecified pre-eclampsia, unspecified trimester. Pre-eclampsia is a pregnancy condition characterized by high blood pressure and protein in the urine, but the specific trimester is not documented. O14.90 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).

O14.90 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 this code only when the trimester is truly unknown or unspecified; attempt to clarify trimester from clinical documentation.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O14.90 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when the trimester is truly unknown or unspecified; attempt to clarify trimester from clinical documentation
  • This is a less specific code; prefer codes O14.92, O14.93, or O14.94 when trimester information is available

Child Codes

Code Hierarchy

Work O14.90 in HCC Buddy

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