O98.03 ICD-10-CM Code: Tuberculosis complicating the puerperium
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)
O98.03
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceTuberculosis complicating the puerperium
A woman has tuberculosis during the recovery period after childbirth (typically the first 6 weeks postpartum).
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
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Code Book Path
Inclusion Terms
Official- Conditions in A15-A19
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O98.03 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O98.03 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O98.03 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O98.03 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O98.03 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O98.03 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 O98.03 an HCC code?
No. O98.03 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
O98.03 is the ICD-10-CM diagnosis code for tuberculosis complicating the puerperium. A woman has tuberculosis during the recovery period after childbirth (typically the first 6 weeks postpartum). O98.03 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).
O98.03 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.
The puerperium period extends approximately 6 weeks after delivery; verify timing in documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The puerperium period extends approximately 6 weeks after delivery; verify timing in documentation
- •Code the specific TB manifestation separately to capture the full clinical picture