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O34.511 ICD-10-CM Code: Maternal care for incarceration of gravid uterus, first trimester

O34.511 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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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)

O34.511

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Maternal care for incarceration of gravid uterus, first trimester

Pregnant patient whose uterus has become trapped or stuck in an abnormal position during the first trimester, requiring medical care.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

HCC 211

Varies by metal level

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
O34.5Maternal care for other abnormalities of gravid uterus
O34.51Maternal care for incarceration of gravid uterus
O34.511Maternal care for incarceration of gravid uterus, first trimester

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O34.511 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O34.511 in this effective period.

Related Child Codes

Official
O34.512Maternal care for incarceration of gravid uterus, second trimester
O34.513Maternal care for incarceration of gravid uterus, third trimester
O34.519Maternal care for incarceration of gravid uterus, unspecified trimester

Includes

Official

ICD-10-CM does not list Includes notes for O34.511 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O34.511 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O34.511 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for O34.511 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for O34.511 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Incarceration of gravid uterus is a rare condition; ensure documentation clearly describes the uterine entrapment and its clinical significance
This condition may require intervention; document any treatment provided or planned

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 →

Is O34.511 an HCC code?

No. O34.511 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
O34.511
Description
Maternal care for incarceration of gravid uterus, first trimester
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
Yes
Payment year
2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

O34.511 is the ICD-10-CM diagnosis code for maternal care for incarceration of gravid uterus, first trimester. Pregnant patient whose uterus has become trapped or stuck in an abnormal position during the first trimester, requiring medical care. O34.511 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).

O34.511 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.

Incarceration of gravid uterus is a rare condition; ensure documentation clearly describes the uterine entrapment and its clinical significance.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O34.511 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Incarceration of gravid uterus is a rare condition; ensure documentation clearly describes the uterine entrapment and its clinical significance
  • This condition may require intervention; document any treatment provided or planned

Child Codes

Code Hierarchy

Work O34.511 in HCC Buddy

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