O98.812
BillableOther maternal infectious and parasitic diseases complicating pregnancy, second trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.812 an HCC code?
No. O98.812 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
O98.812 is the ICD-10-CM diagnosis code for other maternal infectious and parasitic diseases complicating pregnancy, second trimester. A pregnant woman has an infection or parasitic disease (not specified as HIV, TB, malaria, etc.) during the second trimester (weeks 13-28) that affects her pregnancy. O98.812 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).
O98.812 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 code requires documentation of the specific trimester; verify the patient's gestational age is 13-28 weeks.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.812 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.