O98.811
BillableOther maternal infectious and parasitic diseases complicating pregnancy, first trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.811 an HCC code?
No. O98.811 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
O98.811 is the ICD-10-CM diagnosis code for other maternal infectious and parasitic diseases complicating pregnancy, first trimester. Various maternal infections or parasitic diseases (other than those specifically categorized) that occur during the first trimester of pregnancy. These conditions require monitoring to protect both mother and fetus. O98.811 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).
O98.811 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.
This is a catch-all code for infections not classified elsewhere; specify the actual infection type in documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.811 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.