O98.311
BillableOther infections with a predominantly sexual mode of transmission complicating pregnancy, first trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.311 an HCC code?
No. O98.311 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
O98.311 is the ICD-10-CM diagnosis code for other infections with a predominantly sexual mode of transmission complicating pregnancy, first trimester. A pregnant woman in her first trimester has a sexually transmitted infection (other than syphilis or gonorrhea, such as chlamydia or mycoplasma) that is complicating her pregnancy. O98.311 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).
O98.311 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.
Identify the specific organism in the documentation to ensure accurate coding of the infection type.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.311 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Identify the specific organism in the documentation to ensure accurate coding of the infection type
- •First trimester is weeks 1-13; verify this timeframe is supported by the clinical record