Valid for Submission
Z28.82 is a billable code used to specify a medical diagnosis of immunization not carried out because of caregiver refusal. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z28.82 might also be used to specify conditions or terms like influenza vaccination declined, influenza vaccination declined by caregiver, pneumococcal vaccination declined, pneumococcal vaccination declined by caregiver, refusal of treatment by parents, vaccination declined by caregiver, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z28.82 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.
|Short Description:||Immunization not carried out because of caregiver refusal|
|Long Description:||Immunization not carried out because of caregiver refusal|
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z28.82:
Inclusion Terms Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Immunization not carried out because of guardian refusal
- Immunization not carried out because of parent refusal
Type 1 Excludes Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- immunization not carried out because of caregiver refusal because of religious belief Z28.1
Index to Diseases and Injuries
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 Z28.82 are found in the index:
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.
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Influenza vaccination declined
- Influenza vaccination declined by caregiver
- Pneumococcal vaccination declined
- Pneumococcal vaccination declined by caregiver
- Refusal of treatment by parents
- Vaccination declined by caregiver
- Vaccine refused by parent
Present on Admission (POA)
Z28.82 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 Z28.82 to ICD-9
- V64.05 - No vaccin-caregiv refuse
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)
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
(First year ICD-10-CM implemented into the HIPAA code set)
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020