O99.322 ICD-10-CM Code: Drug use complicating pregnancy, second trimester
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)
O99.322
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDrug use complicating pregnancy, second trimester
Drug use during months 4-6 of pregnancy (second trimester) that causes complications for the mother or fetus.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 211
Varies by metal level
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 O99.322 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O99.322 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O99.322 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O99.322 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O99.322 in this effective period.
Use Additional
Official- code(s) from F11-F16 and F18-F19 to identify manifestations of the drug use
Code Also
OfficialICD-10-CM does not list Code Also instructions for O99.322 in this effective period.
Buddy Documentation Tip
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 →
Is O99.322 an HCC code?
No. O99.322 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- O99.322
- Description
- Drug use complicating pregnancy, second trimester
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
O99.322 is the ICD-10-CM diagnosis code for drug use complicating pregnancy, second trimester. Drug use during months 4-6 of pregnancy (second trimester) that causes complications for the mother or fetus. O99.322 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).
O99.322 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.
Ensure documentation clearly indicates second trimester timing before code assignment.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O99.322 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly indicates second trimester timing before code assignment
- •Link this code to any documented fetal abnormalities or maternal complications for complete coding