O9A.219 ICD-10-CM Code: Injury, poisoning and certain other consequences of external causes complicating pregnancy, unspecified trimester
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FY 2026 Apr update / Pregnancy, childbirth and the puerperium (O00-O9A) / Other obstetric conditions, not elsewhere classified (O94-O9A)
O9A.219
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceInjury, poisoning and certain other consequences of external causes complicating pregnancy, unspecified trimester
A pregnant woman has been injured, poisoned, or experienced another harmful external event that is complicating her pregnancy, but the specific trimester is not documented or unknown.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 212
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 O9A.219 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for O9A.219 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for O9A.219 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for O9A.219 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for O9A.219 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for O9A.219 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for O9A.219 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is O9A.219 an HCC code?
No. O9A.219 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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
O9A.219 is the ICD-10-CM diagnosis code for injury, poisoning and certain other consequences of external causes complicating pregnancy, unspecified trimester. A pregnant woman has been injured, poisoned, or experienced another harmful external event that is complicating her pregnancy, but the specific trimester is not documented or unknown. O9A.219 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).
O9A.219 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.
Use this code only when the trimester cannot be determined from the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.219 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the trimester cannot be determined from the medical record
- •Query the provider if possible to determine the correct trimester for more specific coding