O34.513 ICD-10-CM Code: Maternal care for incarceration of gravid uterus, third trimester
O34.513 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy 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)
O34.513
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMaternal care for incarceration of gravid uterus, third trimester
Pregnant patient whose uterus has become trapped or stuck in an abnormal position during the third trimester, requiring medical care.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 211
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O34.513 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O34.513 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O34.513 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O34.513 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O34.513 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O34.513 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O34.513 in this effective period.
Buddy Documentation Tip
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 O34.513 an HCC code?
No. O34.513 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- O34.513
- Description
- Maternal care for incarceration of gravid uterus, third 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
O34.513 is the ICD-10-CM diagnosis code for maternal care for incarceration of gravid uterus, third trimester. Pregnant patient whose uterus has become trapped or stuck in an abnormal position during the third trimester, requiring medical care. O34.513 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).
O34.513 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.
Third trimester incarceration may necessitate urgent intervention or cesarean delivery; document management plan clearly.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O34.513 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Third trimester incarceration may necessitate urgent intervention or cesarean delivery; document management plan clearly
- •Coordinate coding with delivery codes if delivery occurs during the same encounter