2024 ICD-10-CM Diagnosis Code O98.712

Human immunodeficiency virus [HIV] disease complicating pregnancy, second trimester

ICD-10-CM Code:
O98.712
ICD-10 Code for:
Human immunodef virus disease comp preg, second trimester
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

Code Classification

  • Pregnancy, childbirth and the puerperium
    (O00-O9A)
    • Other obstetric conditions, not elsewhere classified
      (O94-O9A)
      • Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
        (O98)

O98.712 is a billable diagnosis code used to specify a medical diagnosis of human immunodeficiency virus [hiv] disease complicating pregnancy, second trimester. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

The code O98.712 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
HIV infectionINF006N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Other specified complications in pregnancyPRG028Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Maternity diagnoses - The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
  • Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .

Convert O98.712 to ICD-9-CM

  • ICD-9-CM Code: 647.61 - Oth viral dis-delivered
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
  • ICD-9-CM Code: 647.63 - Oth viral dis-antepartum
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


HIV and Pregnancy

If you are pregnant or planning to get pregnant, it's important to get tested for HIV as soon as possible. If you find out that do have HIV, you can start treatment right away to protect your health and the health of your baby.

If I have HIV, can I pass it on to my baby during pregnancy?

If you are pregnant and have HIV, there is a risk of passing HIV to your baby. It can happen in three ways:

  • During pregnancy
  • During childbirth, especially if it is vaginal childbirth
  • During breastfeeding

But having HIV doesn't mean that you can't have children. Treatment with a combination of HIV medicines can help prevent passing HIV to your baby and protect your own health.

If I have HIV, how can I prevent giving it to my baby?

There are several different steps you can take to help prevent passing HIV to your baby:

  • Taking HIV medicines. HIV medicines reduce the amount of HIV in the body (viral load) to a very low level. The goal is to get your viral load so low that a standard lab test can't detect it. This is called having an "undetectable viral load." Having an undetectable viral load is the best thing you can do to stay healthy and prevent your baby from getting HIV.

    These medicines will also help protect your health. Most HIV medicines are safe to use during pregnancy. They don't usually raise the risk of birth defects. But it is important to talk with your health care provider about the risks and benefits of the different medicines. Together you can decide which medicines are right for you. Then you need to make sure you take your medicines regularly.

  • If needed, having a cesarean delivery. If your viral load is not reduced enough by the medicines, having a cesarean delivery (C-Section) can help prevent passing HIV to your baby.

  • Giving HIV medicines to the baby. Your baby will get HIV medicines as soon as possible after birth. The medicines protect your baby from infection from any HIV that passed from you during childbirth. Which medicine your baby gets depends on several factors, including what your viral load was just before you gave birth. Your baby will need to take medicines for 4 to 6 weeks. He or she will get several HIV tests over the first few months.

  • Not breastfeeding. Breast milk can have HIV in it. In the United States, infant formula is safe and readily available. So the Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend that if you have HIV, you should feed your baby formula instead of breastfeeding.

What if I want to get pregnant and my partner has HIV?

If you are trying to get pregnant, it's important for your partner to also get tested for HIV.

If your partner does have HIV and you do not, talk to your provider about taking PrEP. PrEP stands for pre-exposure prophylaxis. This means taking medicines to prevent HIV. The PrEP helps to protect both you and your baby from HIV.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.