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O99 ICD-10-CM Code: Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

ICD-10-CM Code View

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 guidance

Other 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

Official
O9Other obstetric conditions, not elsewhere classified (O94-O9A)
O99Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

Inclusion Terms

Official

ICD-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

Official
O99.0Anemia complicating pregnancy, childbirth and the puerperium
O99.1Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy, childbirth and the puerperium
O99.2Endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium
O99.3Mental disorders and diseases of the nervous system complicating pregnancy, childbirth and the puerperium
O99.4Diseases of the circulatory system complicating pregnancy, childbirth and the puerperium

Includes

Official
  • conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O99 in this effective period.

Code First

Official

ICD-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

Official

ICD-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

  • when the reason for maternal care is that the condition is known or suspected to have affected the fetus (O35-O36)

Use Additional Code

  • code to identify specific condition

Child Codes

Code Hierarchy

O99Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
O99Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

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