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O9A.311 ICD-10-CM Code: Physical abuse complicating pregnancy, first 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.311

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

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.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

HCC 212

Varies by metal level

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
O9A.3Physical abuse complicating pregnancy, childbirth and the puerperium
O9A.31Physical abuse complicating pregnancy
O9A.311Physical abuse complicating pregnancy, first trimester

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for O9A.311 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for O9A.311 in this effective period.

Related Child Codes

Official
O9A.312Physical abuse complicating pregnancy, second trimester
O9A.313Physical abuse complicating pregnancy, third trimester
O9A.319Physical abuse complicating pregnancy, unspecified trimester

Includes

Official

ICD-10-CM does not list Includes notes for O9A.311 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for O9A.311 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for O9A.311 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for O9A.311 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for O9A.311 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
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

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 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.

Code
O9A.311
Description
Physical abuse complicating pregnancy, first 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

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

Child Codes

Code Hierarchy

Work O9A.311 in HCC Buddy

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