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O34.5 ICD-10-CM Code: Maternal care for other abnormalities of gravid uterus

O34.5 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)

O34.5

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Maternal care for other abnormalities of gravid uterus

Maternal care for other abnormalities of gravid uterus

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
O34Maternal care for abnormality of pelvic organs
O34.5Maternal care for other abnormalities of gravid uterus

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O34.5 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O34.5 in this effective period.

Related Child Codes

Official
O34.51Maternal care for incarceration of gravid uterus
O34.52Maternal care for prolapse of gravid uterus
O34.53Maternal care for retroversion of gravid uterus
O34.59Maternal care for other abnormalities of gravid uterus

Includes

Official
  • the listed conditions as a reason for hospitalization or other obstetric care of the mother, or for cesarean delivery before onset of labor

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O34.5 in this effective period.

Code First

Official
  • any associated obstructed labor (O65.5)

Use Additional

Official
  • code for specific condition

Code Also

Official

ICD-10-CM does not list Code Also instructions for O34.5 in this effective period.

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 →

Code
O34.5
Description
Maternal care for other abnormalities of gravid uterus
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

O34.5 is the ICD-10-CM diagnosis code for maternal care for other abnormalities of gravid uterus. O34.5 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).

Header codes like O34.5 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at O34.5's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O34.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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