Question 1

What is ICD-10 code O30.219?

Accepted Answer

O30.219 is the ICD-10-CM diagnosis code for Quadruplet pregnancy with two or more monochorionic fetuses, unspecified trimester. A pregnancy with four fetuses where at least two of them share a single placenta, and the specific trimester is not documented. O30.219 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. O30.219 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Question 2

Is O30.219 an HCC code?

Accepted Answer

No. O30.219 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is O30.219 billable?

Accepted Answer

Yes. O30.219 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. O30.219 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for O30.219?

Accepted Answer

O30.219 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards O30.219 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting O30.219?

Accepted Answer

Avoid this unspecified trimester code by thoroughly reviewing the medical record for dating information or ultrasound reports If trimester cannot be determined, document this limitation in the coding notes for quality assurance purposes

O30.219

Is O30.219 an HCC code?

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Open O30.219 in the Interactive Encoder