O98.111
BillableSyphilis complicating pregnancy, first trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.111 an HCC code?
No. O98.111 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
O98.111 is the ICD-10-CM diagnosis code for syphilis complicating pregnancy, first trimester. A pregnant woman has syphilis (a sexually transmitted bacterial infection) during the first three months of pregnancy. O98.111 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).
O98.111 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.
Verify trimester documentation; if unclear, use O98.119 for unspecified trimester.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.111 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.