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O80 ICD-10-CM Code: Encounter for full-term uncomplicated delivery

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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Encounter for delivery (O80-O82)

O80

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

Encounter for full-term uncomplicated delivery

A normal, uncomplicated vaginal delivery at full-term pregnancy without any maternal or fetal complications.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

HCC 209

Varies by metal level

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
O8Encounter for delivery (O80-O82)
O80Encounter for full-term uncomplicated delivery

Inclusion Terms

Official
  • Delivery requiring minimal or no assistance, with or without episiotomy, without fetal manipulation [e.g., rotation version] or instrumentation [forceps] of a spontaneous, cephalic, vaginal, full-term, single, live-born infant. This code is for use as a single diagnosis code and is not to be used with any other code from chapter 15.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O80 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under O80 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for O80 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O80 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O80 in this effective period.

Use Additional

Official
  • code to indicate outcome of delivery (Z37.0)

Code Also

Official

ICD-10-CM does not list Code Also instructions for O80 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
This code should only be used when delivery is truly uncomplicated with no additional codes for complications
Do not use if any complications are documented during labor, delivery, or postpartum period

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is O80 an HCC code?

No. O80 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

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

O80 is the ICD-10-CM diagnosis code for encounter for full-term uncomplicated delivery. A normal, uncomplicated vaginal delivery at full-term pregnancy without any maternal or fetal complications. O80 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering encounter for delivery (o80-o82).

O80 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 code should only be used when delivery is truly uncomplicated with no additional codes for complications.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O80 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code should only be used when delivery is truly uncomplicated with no additional codes for complications
  • Do not use if any complications are documented during labor, delivery, or postpartum period

Use Additional Code

  • code to indicate outcome of delivery (Z37.0)

Code Hierarchy

O80Encounter for full-term uncomplicated delivery
O80Encounter for full-term uncomplicated delivery

Work O80 in HCC Buddy

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