O98.63
BillableProtozoal diseases complicating the puerperium
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.63 an HCC code?
No. O98.63 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
O98.63 is the ICD-10-CM diagnosis code for protozoal diseases complicating the puerperium. A parasitic infection caused by protozoa that develops or is present during the postpartum period (the weeks following delivery). This occurs after the baby is born but while the person is still recovering from pregnancy and childbirth. O98.63 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).
O98.63 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.
The puerperium typically extends 6 weeks postpartum; ensure the infection timing aligns with this period.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.63 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The puerperium typically extends 6 weeks postpartum; ensure the infection timing aligns with this period
- •Document whether the infection was present during pregnancy or newly acquired postpartum