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O98.412

Billable

Viral hepatitis complicating pregnancy, second trimester

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

Is O98.412 an HCC code?

No. O98.412 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

O98.412 is the ICD-10-CM diagnosis code for viral hepatitis complicating pregnancy, second trimester. Viral hepatitis (inflammation of the liver caused by a virus) occurring during the second trimester of pregnancy that may affect the mother and developing baby. O98.412 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).

O98.412 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.

Document the specific type of viral hepatitis when available to support medical necessity.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.412 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document the specific type of viral hepatitis when available to support medical necessity
  • Second trimester covers weeks 14-20; verify trimester documentation for accurate coding

Code Hierarchy

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