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O98.211

Billable

Gonorrhea complicating pregnancy, first trimester

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is O98.211 an HCC code?

No. O98.211 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

O98.211 is the ICD-10-CM diagnosis code for gonorrhea complicating pregnancy, first trimester. A pregnant woman in her first trimester (weeks 1-13) has gonorrhea that is complicating her pregnancy. O98.211 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).

O98.211 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 the trimester is documented; first trimester is weeks 1-13 of gestation.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.211 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Confirm the trimester is documented; first trimester is weeks 1-13 of gestation
  • Gonorrhea in pregnancy requires treatment to prevent transmission to the fetus and complications

Code Hierarchy

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