O98.73 ICD-10-CM Code: Human immunodeficiency virus [HIV] disease complicating the puerperium
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Other obstetric conditions, not elsewhere classified (O94-O9A)
O98.73
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHuman immunodeficiency virus [HIV] disease complicating the puerperium
HIV infection present or developing during the postpartum recovery period (up to 6 weeks after delivery). This requires ongoing treatment and monitoring during the recovery phase.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O98.73 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O98.73 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O98.73 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O98.73 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O98.73 in this effective period.
Use Additional
Official- code to identify the type of HIV disease:
- Acquired immune deficiency syndrome (AIDS) (B20)
- Asymptomatic HIV status (Z21)
- HIV positive NOS (Z21)
- Symptomatic HIV disease (B20)
Code Also
OfficialICD-10-CM does not list Code Also instructions for O98.73 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is O98.73 an HCC code?
No. O98.73 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
O98.73 is the ICD-10-CM diagnosis code for human immunodeficiency virus [hiv] disease complicating the puerperium. HIV infection present or developing during the postpartum recovery period (up to 6 weeks after delivery). This requires ongoing treatment and monitoring during the recovery phase. O98.73 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).
O98.73 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.
Distinguish between HIV present during pregnancy versus newly diagnosed postpartum.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.73 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between HIV present during pregnancy versus newly diagnosed postpartum
- •Document breastfeeding status, as this affects transmission risk to the newborn