2026 ICD-10-CM Diagnosis Code Z28.82Immunization not carried out because of caregiver refusal
Z28.82 is a billable ICD-10-CM diagnosis code for immunization not carried out because of caregiver refusal. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as administration of blood product declined. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under No immunization or underimmunization.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z28.82.
Present on Admission (POA)Billing
Z28.82 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Administration of blood product declined
- Influenza vaccination declined
- Influenza vaccination declined by caregiver
- Pneumococcal vaccination declined
- Pneumococcal vaccination declined by caregiver
- Respiratory syncytial virus monoclonal antibody declined by parent
- Vaccination declined by caregiver
- Vaccine declined by parent
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Immunization not carried out because of guardian refusal
- Immunization not carried out because of parent refusal
Type 1 Excludes
- immunization not carried out because of caregiver refusal because of religious belief Z28.1
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.
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.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- Immunization - See Also: Vaccination;
- not done (not carried out) - See Also: Underimmunization status; - Z28.9
- caregiver refusal - Z28.82
- guardian refusal - Z28.82
- parent refusal - Z28.82
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Immunization
- not done (not carried out)
- because (of)
- caregiver refusal
- Immunization
- not done (not carried out)
- because (of)
- guardian refusal
- Immunization
- not done (not carried out)
- because (of)
- parent refusal
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert Z28.82 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z28.82Overview
Is Z28.82 (Immunization not carried out for other reason) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report immunization not carried out because of caregiver refusal on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Can Z28.82 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because immunization not carried out because of caregiver refusal describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z28.82 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for immunization not carried out because of caregiver refusal on inpatient claims.
What is the ICD-9 equivalent of Z28.82?
Under the General Equivalence Mappings, immunization not carried out because of caregiver refusal converts to ICD-9-CM V64.05 (no vaccin-caregiv refuse). The mapping is a direct match.
