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O47.1

Billable

False labor at or after 37 completed weeks of gestation

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

Is O47.1 an HCC code?

No. O47.1 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

O47.1 is the ICD-10-CM diagnosis code for false labor at or after 37 completed weeks of gestation. Contractions and labor-like symptoms that are not true labor occurring at 37 weeks or later in pregnancy. O47.1 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).

O47.1 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.

At 37 weeks or beyond, pregnancy is considered term; confirm gestational age documentation.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O47.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • At 37 weeks or beyond, pregnancy is considered term; confirm gestational age documentation
  • Document that despite symptoms, no active labor or cervical changes occurred

Code Hierarchy

O47False laborO47.1False labor at or after 37 completed weeks of gestation
O47.1False labor at or after 37 completed weeks of gestation

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