O9A.43
BillableSexual abuse complicating the puerperium
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is O9A.43 an HCC code?
No. O9A.43 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.43 is the ICD-10-CM diagnosis code for sexual abuse complicating the puerperium. Sexual abuse that occurs during the recovery period after childbirth (typically the first 6 weeks postpartum). This code documents trauma and abuse during a vulnerable time in a woman's life. O9A.43 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.43 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.
Always use this code when sexual abuse is documented during the puerperium period; consider adding codes for physical injuries or psychological effects.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for O9A.43 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always use this code when sexual abuse is documented during the puerperium period; consider adding codes for physical injuries or psychological effects
- •Coordinate with social work and consider mandatory reporting requirements based on jurisdiction