O99.842
BillableBariatric surgery status complicating pregnancy, second trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O99.842 an HCC code?
No. O99.842 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
O99.842 is the ICD-10-CM diagnosis code for bariatric surgery status complicating pregnancy, second trimester. A pregnant woman who has had weight loss surgery (bariatric surgery) and is experiencing complications related to this surgery during the second trimester of pregnancy. O99.842 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).
O99.842 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.
Always verify the trimester is documented as second trimester; if not specified, query the provider for clarification.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O99.842 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always verify the trimester is documented as second trimester; if not specified, query the provider for clarification
- •This code indicates the bariatric surgery status itself is complicating the pregnancy, so document any nutritional deficiencies or absorption issues related to the prior surgery