O98.012 ICD-10-CM Code: Tuberculosis complicating pregnancy, second trimester
HCC Buddy Code Card
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Other obstetric conditions, not elsewhere classified (O94-O9A)
O98.012
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceTuberculosis complicating pregnancy, second trimester
A pregnant woman has tuberculosis (a serious lung infection) during the second three months of pregnancy.
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 O98.012 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O98.012 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O98.012 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O98.012 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O98.012 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O98.012 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O98.012 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 O98.012 an HCC code?
No. O98.012 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- O98.012
- Description
- Tuberculosis complicating pregnancy, second 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
O98.012 is the ICD-10-CM diagnosis code for tuberculosis complicating pregnancy, second trimester. A pregnant woman has tuberculosis (a serious lung infection) during the second three months of pregnancy. O98.012 sits in the ICD-10-CM chapter for pregnancy, childbirth and the puerperium (o00-o9a), within the section covering other obstetric conditions, not elsewhere classified (o94-o9a).
O98.012 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.
Confirm documentation specifies second trimester; weeks 14-20 typically define this period.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.012 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm documentation specifies second trimester; weeks 14-20 typically define this period
- •Pair with the specific tuberculosis site code to fully capture the diagnosis