O98.119
BillableSyphilis complicating pregnancy, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.119 an HCC code?
No. O98.119 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
O98.119 is the ICD-10-CM diagnosis code for syphilis complicating pregnancy, unspecified trimester. A pregnant woman has syphilis, but the specific stage of pregnancy (trimester) is not documented or specified. O98.119 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).
O98.119 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.
Query the provider to determine the trimester if possible, as more specific codes (O98.111, O98.112, O98.113) are preferred.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.119 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.