O9A.313
BillablePhysical abuse complicating pregnancy, third trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O9A.313 an HCC code?
No. O9A.313 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.313 is the ICD-10-CM diagnosis code for physical abuse complicating pregnancy, third trimester. A pregnant woman is experiencing physical abuse during the third trimester (weeks 21 until delivery). This code documents that the abuse is occurring during this final stage of pregnancy. O9A.313 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.313 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 trimester clearly in the medical record to support accurate code selection.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.313 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the trimester clearly in the medical record to support accurate code selection
- •Consider the impact on both mother and fetus; additional codes may be needed if fetal complications result from the abuse