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O98.912

Billable

Unspecified maternal infectious and parasitic disease complicating pregnancy, second trimester

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is O98.912 an HCC code?

No. O98.912 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

O98.912 is the ICD-10-CM diagnosis code for unspecified maternal infectious and parasitic disease complicating pregnancy, second trimester. A pregnant woman has an unspecified infection or parasitic disease during the second trimester (weeks 13-28) that affects her pregnancy, but the exact type of infection is not documented. O98.912 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).

O98.912 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.

Verify gestational age is 13-28 weeks to confirm second trimester assignment.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.912 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Verify gestational age is 13-28 weeks to confirm second trimester assignment
  • Review laboratory results and clinical notes to identify the specific infectious agent if possible

Code Hierarchy

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