O9A.42
BillableSexual abuse complicating childbirth
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O9A.42 an HCC code?
No. O9A.42 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.42 is the ICD-10-CM diagnosis code for sexual abuse complicating childbirth. A woman is experiencing sexual abuse during the labor and delivery process (childbirth). This code documents sexual abuse that occurs at the time of delivery. O9A.42 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.42 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.
This represents a serious violation during an extremely vulnerable time; ensure thorough documentation of the incident and any injuries.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This represents a serious violation during an extremely vulnerable time; ensure thorough documentation of the incident and any injuries
- •Coordinate with hospital security, law enforcement, and social services as appropriate