O99 ICD-10-CM Code: Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
HCC Buddy Code Card
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Other obstetric conditions, not elsewhere classified (O94-O9A)
O99
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOther maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for O99 in this effective period.
Excludes 2
Official- when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)
Related Child Codes
Includes
Official- conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O99 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O99 in this effective period.
Use Additional
Official- code to identify specific condition
Code Also
OfficialICD-10-CM does not list Code Also instructions for O99 in this effective period.
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
- Code
- O99
- Description
- Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
O99 is the ICD-10-CM diagnosis code for other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium. O99 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).
Header codes like O99 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at O99's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O99 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Includes
- conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care
Excludes 2, Not included here, may code separately
Use Additional Code
- code to identify specific condition

