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O23.13 ICD-10-CM Code: Infections of bladder in pregnancy, third trimester

ICD-10-CM Code View

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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Other maternal disorders predominantly related to pregnancy (O20-O29)

O23.13

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

Infections of bladder in pregnancy, third trimester

A bladder infection that develops during the third trimester (weeks 28 to delivery) of pregnancy.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

HCC 212

Varies by metal level

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
O23Infections of genitourinary tract in pregnancy
O23.1Infections of bladder in pregnancy
O23.13Infections of bladder in pregnancy, third trimester

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O23.13 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O23.13 in this effective period.

Related Child Codes

Official
O23.10Infections of bladder in pregnancy, unspecified trimester
O23.11Infections of bladder in pregnancy, first trimester
O23.12Infections of bladder in pregnancy, second trimester

Includes

Official

ICD-10-CM does not list Includes notes for O23.13 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O23.13 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O23.13 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for O23.13 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for O23.13 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Third trimester infections may increase risk of preterm labor; document any labor-related complications
Coordinate coding with delivery codes if infection occurs near time of delivery

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 O23.13 an HCC code?

No. O23.13 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
O23.13
Description
Infections of bladder in pregnancy, third 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

O23.13 is the ICD-10-CM diagnosis code for infections of bladder in pregnancy, third trimester. A bladder infection that develops during the third trimester (weeks 28 to delivery) of pregnancy. O23.13 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering other maternal disorders predominantly related to pregnancy (o20-o29).

O23.13 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.

Third trimester infections may increase risk of preterm labor; document any labor-related complications.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O23.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Third trimester infections may increase risk of preterm labor; document any labor-related complications
  • Coordinate coding with delivery codes if infection occurs near time of delivery

Child Codes

Code Hierarchy

Work O23.13 in HCC Buddy

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