O98.819
BillableOther maternal infectious and parasitic diseases complicating pregnancy, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.819 an HCC code?
No. O98.819 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
O98.819 is the ICD-10-CM diagnosis code for other maternal infectious and parasitic diseases complicating pregnancy, unspecified trimester. A pregnant woman has an infection or parasitic disease (not specified as HIV, TB, malaria, etc.) but the trimester of pregnancy is not documented or specified. O98.819 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).
O98.819 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 this code only when trimester information is unavailable or unclear in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.819 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when trimester information is unavailable or unclear in the medical record
- •Query the provider to determine the trimester if possible, as trimester-specific codes are preferred