O98.712
BillableHuman immunodeficiency virus [HIV] disease complicating pregnancy, second trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.712 an HCC code?
No. O98.712 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
O98.712 is the ICD-10-CM diagnosis code for human immunodeficiency virus [hiv] disease complicating pregnancy, second trimester. HIV infection in a pregnant person during the second trimester (weeks 14-20 of pregnancy). Management focuses on preventing vertical transmission and monitoring maternal health during mid-pregnancy. O98.712 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).
O98.712 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.
Confirm second trimester is specifically documented in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.712 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm second trimester is specifically documented in the medical record
- •Note any changes in antiretroviral therapy or viral load monitoring during this period