Valid for Submission
Z28.89 is a billable code used to specify a medical diagnosis of immunization not carried out for other reason. The code is valid for the year 2020 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 Z28.89 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 for other reason|
|Long Description:||Immunization not carried out for other reason|
This code was replaced in the 2020 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2019. This code was replaced for the FY 2020 (October 1, 2019 - September 30, 2020).
- Z28.83 - Immunization not crd out due to unavailability of vaccine
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 Z28.89 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.
Present on Admission (POA)
Z28.89 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 Z28.89 to ICD-9
- V64.09 - No vaccination NEC (Approximate Flag)
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