O98.919
BillableUnspecified maternal infectious and parasitic disease complicating pregnancy, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O98.919 an HCC code?
No. O98.919 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
O98.919 is the ICD-10-CM diagnosis code for unspecified maternal infectious and parasitic disease complicating pregnancy, unspecified trimester. A pregnant woman has an unspecified infection or parasitic disease that affects her pregnancy, but neither the specific type of infection nor the trimester is documented. O98.919 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).
O98.919 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 is the least specific code in the O98.91 series; use only when both trimester and specific diagnosis are unavailable.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O98.919 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is the least specific code in the O98.91 series; use only when both trimester and specific diagnosis are unavailable
- •Query the provider for both the trimester and specific diagnosis to allow for more precise coding