O9A.311
BillablePhysical abuse complicating pregnancy, first trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O9A.311 an HCC code?
No. O9A.311 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
O9A.311 is the ICD-10-CM diagnosis code for physical abuse complicating pregnancy, first trimester. A pregnant woman in her first trimester is experiencing physical abuse that is complicating her pregnancy. This includes domestic violence, assault, or other forms of intentional physical harm. O9A.311 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.311 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.
Document the specific type and location of injuries sustained from the abuse.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.311 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific type and location of injuries sustained from the abuse
- •Consider reporting requirements and safety planning; this is a sensitive situation requiring careful documentation