O98.512
BillableOther viral diseases complicating pregnancy, second trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.512 an HCC code?
No. O98.512 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
O98.512 is the ICD-10-CM diagnosis code for other viral diseases complicating pregnancy, second trimester. A viral infection other than rubella, cytomegalovirus, or hepatitis that occurs during the fourth through sixth months of pregnancy. O98.512 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).
O98.512 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.
Ensure accurate trimester assignment based on last menstrual period or ultrasound dating.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.512 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure accurate trimester assignment based on last menstrual period or ultrasound dating
- •Document the specific viral pathogen to support medical necessity and clinical decision-making