2022 ICD-10-CM Code Z28.04
Immunization not carried out because of patient allergy to vaccine or component
Code Classification
Z28.04 is a billable diagnosis code used to specify a medical diagnosis of immunization not carried out because of patient allergy to vaccine or component. The code Z28.04 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z28.04 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
Entries in the Index to Diseases and Injuries with references to Z28.04
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z28.04 are found in the index:
- - Immunization - See Also: Vaccination;
- - not done (not carried out) - Z28.9
- - because (of)
- - allergy to vaccine (or component) - Z28.04
- - because (of)
- - not done (not carried out) - Z28.9
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Present on Admission (POA)
Z28.04 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert Z28.04 to ICD-9 Code
- V64.04 - No vaccin-allergy to vac
Related Codes
ICD Code | Description | Valid for Submission |
---|---|---|
Z28 | Immunization not carried out and underimmunization status | NON-BILLABLE CODE |
Z28.0 | Immunization not carried out because of contraindication | NON-BILLABLE CODE |
Z28.01 | Immunization not carried out because of acute illness of patient | BILLABLE CODE |
Z28.02 | Immunization not carried out because of chronic illness or condition of patient | BILLABLE CODE |
Z28.03 | Immunization not carried out because of immune compromised state of patient | BILLABLE CODE |
Z28.09 | Immunization not carried out because of other contraindication | BILLABLE CODE |
Z28.1 | Immunization not carried out because of patient decision for reasons of belief or group pressure | BILLABLE CODE |
Z28.2 | Immunization not carried out because of patient decision for other and unspecified reason | NON-BILLABLE CODE |
Z28.20 | Immunization not carried out because of patient decision for unspecified reason | BILLABLE CODE |
Z28.21 | Immunization not carried out because of patient refusal | BILLABLE CODE |
Z28.29 | Immunization not carried out because of patient decision for other reason | BILLABLE CODE |
Z28.3 | Underimmunization status | BILLABLE CODE |
Z28.8 | Immunization not carried out for other reason | NON-BILLABLE CODE |
Z28.81 | Immunization not carried out due to patient having had the disease | BILLABLE CODE |
Z28.82 | Immunization not carried out because of caregiver refusal | BILLABLE CODE |
Z28.83 | Immunization not carried out due to unavailability of vaccine | BILLABLE CODE |
Z28.89 | Immunization not carried out for other reason | BILLABLE CODE |
Z28.9 | Immunization not carried out for unspecified reason | BILLABLE CODE |
Code History
- 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 (First year ICD-10-CM implemented into the HIPAA code set)