O9A.412
BillableSexual abuse complicating pregnancy, second trimester
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O9A.412 an HCC code?
No. O9A.412 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.412 is the ICD-10-CM diagnosis code for sexual abuse complicating pregnancy, second trimester. A pregnant woman is experiencing sexual abuse during the second trimester (weeks 14-20 of pregnancy). This code documents that the sexual abuse is occurring during the middle stage of pregnancy. O9A.412 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.412 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 nature of the sexual abuse and any resulting injuries or complications to the pregnancy.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.412 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific nature of the sexual abuse and any resulting injuries or complications to the pregnancy
- •Consider psychological impact and need for mental health referrals in addition to physical assessment