O34.11
BillableMaternal care for benign tumor of corpus uteri, first trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O34.11 an HCC code?
No. O34.11 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
O34.11 is the ICD-10-CM diagnosis code for maternal care for benign tumor of corpus uteri, first trimester. A pregnant woman in her first trimester receives care for a non-cancerous tumor in the main body of the uterus. O34.11 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering maternal care related to the fetus and amniotic cavity and possible delivery problems (o30-o48).
O34.11 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.
Document the specific type of benign tumor (fibroid, adenoma, etc.) in the medical record for clinical clarity.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O34.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific type of benign tumor (fibroid, adenoma, etc.) in the medical record for clinical clarity
- •First trimester is weeks 1-13; monitor for complications such as pain or bleeding