2024 ICD-10-CM Diagnosis Code Z28.21

Immunization not carried out because of patient refusal

ICD-10-CM Code:
Z28.21
ICD-10 Code for:
Immunization not carried out because of patient refusal
Is Billable?
Yes - Valid for Submission
Code Navigator:

Code Classification

  • Factors influencing health status and contact with health services
    (Z00–Z99)
    • Persons with potential health hazards related to communicable diseases
      (Z20-Z29)
      • Immunization not carried out and underimmunization status
        (Z28)

Z28.21 is a billable diagnosis code used to specify a medical diagnosis of immunization not carried out because of patient refusal. 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 is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

This code 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.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • BCG vaccination declined
  • Booster meningitis B vaccination declined
  • First meningitis B vaccination declined
  • Hepatitis A vaccination declined
  • Hepatitis B immunization declined
  • Human papillomavirus vaccination declined
  • Inactivated whole SARS-CoV-2 antigen vaccine declined
  • Influenza A virus subtype H1N1 vaccination declined
  • Influenza vaccination declined
  • Measles, mumps and rubella vaccination declined
  • Meningitis B vaccination declined
  • Meningitis C immunization declined
  • Meningococcal vaccination declined
  • Pertussis vaccination declined
  • Pneumococcal vaccination declined
  • SARS-CoV-2 antigen vaccine declined
  • SARS-CoV-2 DNA plasmid encoding spike protein vaccine declined
  • SARS-CoV-2 mRNA vaccine declined
  • SARS-CoV-2 non-replicating viral vector vaccine declined
  • SARS-CoV-2 recombinant spike protein antigen vaccine declined
  • SARS-CoV-2 vaccination declined
  • SARS-CoV-2 virus-like particle antigen vaccine declined
  • Second dose of inactivated whole SARS-CoV-2 antigen vaccine declined
  • Second dose of SARS-CoV-2 mRNA vaccine declined
  • Second dose of SARS-CoV-2 non-replicating viral vector vaccine declined
  • Second dose of SARS-CoV-2 recombinant spike protein antigen vaccine declined
  • Second dose of SARS-CoV-2 virus-like particle antigen vaccine declined
  • Second meningitis B vaccination declined
  • Tetanus vaccination declined by patient
  • Vaccination declined
  • Vaccination hesitancy by parent
  • Vaccination hesitancy by patient
  • Vaccine declined by patient
  • Varicella zoster vaccination declined by patient

Clinical Classification

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

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:

  • 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)

Z28.21 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 IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z28.21 to ICD-9-CM

  • ICD-9-CM Code: V64.06 - No vaccination-pt refuse
    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.

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.