O98.813
BillableOther maternal infectious and parasitic diseases complicating pregnancy, third trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.813 an HCC code?
No. O98.813 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
O98.813 is the ICD-10-CM diagnosis code for other maternal infectious and parasitic diseases complicating pregnancy, third trimester. A pregnant woman has an infection or parasitic disease (not specified as HIV, TB, malaria, etc.) during the third trimester (weeks 29 to delivery) that affects her pregnancy. O98.813 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).
O98.813 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 the patient is in the third trimester (29+ weeks gestation) before assigning this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.813 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm the patient is in the third trimester (29+ weeks gestation) before assigning this code
- •Document the specific infectious or parasitic condition if possible to allow for more specific coding