O99.345
BillableOther mental disorders complicating the puerperium
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O99.345 an HCC code?
No. O99.345 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
O99.345 is the ICD-10-CM diagnosis code for other mental disorders complicating the puerperium. A woman has a mental health disorder (other than depression or anxiety) during the postpartum recovery period that complicates her recovery after delivery. O99.345 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).
O99.345 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.
The puerperium covers approximately 6 weeks after delivery; confirm timing in documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O99.345 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The puerperium covers approximately 6 weeks after delivery; confirm timing in documentation
- •Document postpartum psychiatric symptoms and any treatment initiated or adjusted postpartum