O43.023 ICD-10-CM Code: Fetus-to-fetus placental transfusion syndrome, third trimester
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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)
O43.023
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceFetus-to-fetus placental transfusion syndrome, third trimester
An abnormal transfer of blood occurs between twins or multiples through a shared placenta during the third trimester of pregnancy.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 210
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 O43.023 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O43.023 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O43.023 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O43.023 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O43.023 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O43.023 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O43.023 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 O43.023 an HCC code?
No. O43.023 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- O43.023
- Description
- Fetus-to-fetus placental transfusion syndrome, 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
O43.023 is the ICD-10-CM diagnosis code for fetus-to-fetus placental transfusion syndrome, third trimester. An abnormal transfer of blood occurs between twins or multiples through a shared placenta during the third trimester of pregnancy. O43.023 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).
O43.023 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.
This is the most common trimester for diagnosis of twin-to-twin transfusion syndrome.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O43.023 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is the most common trimester for diagnosis of twin-to-twin transfusion syndrome
- •Document ultrasound findings such as polyhydramnios and oligohydramnios in the affected twins