O92.70 ICD-10-CM Code: Unspecified disorders of lactation
HCC Buddy Code Card
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Complications predominantly related to the puerperium (O85-O92)
O92.70
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified disorders of lactation
An unspecified problem with milk production or breastfeeding that cannot be more specifically categorized.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O92.70 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O92.70 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O92.70 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O92.70 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O92.70 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O92.70 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O92.70 in this effective period.
Buddy Documentation Tip
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 O92.70 an HCC code?
No. O92.70 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
O92.70 is the ICD-10-CM diagnosis code for unspecified disorders of lactation. An unspecified problem with milk production or breastfeeding that cannot be more specifically categorized. O92.70 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering complications predominantly related to the puerperium (o85-o92).
O92.70 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 a non-specific code; review documentation to determine if a more specific lactation disorder code applies.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O92.70 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a non-specific code; review documentation to determine if a more specific lactation disorder code applies
- •Use only when the exact nature of the lactation problem is unclear or not documented