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O34.12

Billable

Maternal care for benign tumor of corpus uteri, second trimester

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

Is O34.12 an HCC code?

No. O34.12 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

O34.12 is the ICD-10-CM diagnosis code for maternal care for benign tumor of corpus uteri, second trimester. A pregnant woman in her second trimester receives care for a non-cancerous tumor in the main body of the uterus. O34.12 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).

O34.12 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.

Second trimester is weeks 14-27; tumors may grow during pregnancy due to hormonal changes.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O34.12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Second trimester is weeks 14-27; tumors may grow during pregnancy due to hormonal changes
  • Coordinate with imaging studies and obstetric management to assess impact on pregnancy

Code Hierarchy

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