O98.213
BillableGonorrhea complicating pregnancy, third trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.213 an HCC code?
No. O98.213 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
O98.213 is the ICD-10-CM diagnosis code for gonorrhea complicating pregnancy, third trimester. A pregnant woman in her third trimester (weeks 21 through delivery) has gonorrhea that is complicating her pregnancy. O98.213 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).
O98.213 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.
Third trimester begins at week 21 and continues through delivery; confirm timing in documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.213 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Third trimester begins at week 21 and continues through delivery; confirm timing in documentation
- •Gonorrhea in late pregnancy increases risk of preterm labor and neonatal infection