O98.319
BillableOther infections with a predominantly sexual mode of transmission complicating pregnancy, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.319 an HCC code?
No. O98.319 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
O98.319 is the ICD-10-CM diagnosis code for other infections with a predominantly sexual mode of transmission complicating pregnancy, unspecified trimester. A sexually transmitted infection (other than those specifically named) complicating pregnancy when the specific trimester is not documented or known. O98.319 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).
O98.319 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.
This is a default code used only when trimester information is unavailable or not specified.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.319 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a default code used only when trimester information is unavailable or not specified
- •Query the provider if trimester can be determined from clinical documentation to assign a more specific code