O9A.319
BillablePhysical abuse complicating pregnancy, unspecified trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O9A.319 an HCC code?
No. O9A.319 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.319 is the ICD-10-CM diagnosis code for physical abuse complicating pregnancy, unspecified trimester. A pregnant woman is experiencing physical abuse, but the specific trimester when the abuse occurred is not documented or specified in the medical record. O9A.319 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.319 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 documentation; always attempt to clarify with the provider first.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.319 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 documentation; always attempt to clarify with the provider first
- •This is a less specific code and should be avoided if possible by obtaining trimester information