O98.711
BillableHuman immunodeficiency virus [HIV] disease complicating pregnancy, first trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.711 an HCC code?
No. O98.711 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
O98.711 is the ICD-10-CM diagnosis code for human immunodeficiency virus [hiv] disease complicating pregnancy, first trimester. HIV infection in a pregnant person during the first three months of pregnancy. This requires careful management to prevent transmission to the fetus and maintain the pregnant person's health. O98.711 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).
O98.711 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.
Always verify the trimester is documented as first; if unspecified, use O98.719.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.711 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always verify the trimester is documented as first; if unspecified, use O98.719
- •Coordinate with infectious disease specialists and ensure antiretroviral therapy documentation is present