O98.913
BillableUnspecified maternal infectious and parasitic disease complicating pregnancy, third trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.913 an HCC code?
No. O98.913 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
O98.913 is the ICD-10-CM diagnosis code for unspecified maternal infectious and parasitic disease complicating pregnancy, third trimester. A pregnant woman has an unspecified infection or parasitic disease during the third trimester (weeks 29 to delivery) that affects her pregnancy, but the exact type of infection is not documented. O98.913 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).
O98.913 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) before assigning this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.913 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) before assigning this code
- •Check for any culture results, imaging findings, or clinical symptoms that might identify the specific pathogen