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O28.8

Billable

Other abnormal findings on antenatal screening of mother

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is O28.8 an HCC code?

No. O28.8 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

O28.8 is the ICD-10-CM diagnosis code for other abnormal findings on antenatal screening of mother. Abnormal test results found during prenatal screening of the mother that don't fit into other specific categories, such as unusual blood work or imaging findings. O28.8 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).

O28.8 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 when specific abnormal findings are documented but don't match more specific O28 codes.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O28.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code when specific abnormal findings are documented but don't match more specific O28 codes
  • Always review the clinical documentation to determine if a more specific code (O28.0-O28.7) applies before assigning this code

Code Hierarchy

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