O98.719
BillableHuman immunodeficiency virus [HIV] disease complicating pregnancy, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.719 an HCC code?
No. O98.719 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
O98.719 is the ICD-10-CM diagnosis code for human immunodeficiency virus [hiv] disease complicating pregnancy, unspecified trimester. HIV infection in a pregnant person when the specific stage of pregnancy is not documented or specified. This code is used when trimester information is unavailable. O98.719 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).
O98.719 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.
Use only when trimester cannot be determined from documentation; query provider if possible for more specific code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.719 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use only when trimester cannot be determined from documentation; query provider if possible for more specific code
- •This is a less specific code; attempt to obtain trimester information for accurate coding