ICD-10-CM Code Z53.1

Procedure and treatment not carried out because of patient's decision for reasons of belief and group pressure

Version 2020 Billable Code Unacceptable Principal Diagnosis

Valid for Submission

Z53.1 is a billable code used to specify a medical diagnosis of procedure and treatment not carried out because of patient's decision for reasons of belief and group pressure. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z53.1 might also be used to specify conditions or terms like administration of blood product declined, blood transfusion declined, drug declined by patient, drug declined by patient - patient beliefs, drug not taken - pat disbelief, procedure refused for religious reason, etc

The code Z53.1 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.

ICD-10:Z53.1
Short Description:Proc/trtmt not crd out bec pt belief and group pressure
Long Description:Procedure and treatment not carried out because of patient's decision for reasons of belief and group pressure

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 Z53.1 are found in the index:


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.

Synonyms

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

  • Administration of blood product declined
  • Blood transfusion declined
  • Drug declined by patient
  • Drug declined by patient - patient beliefs
  • Drug not taken - pat disbelief
  • Procedure refused for religious reason
  • Transfusion of blood product refused for religious reason

Convert Z53.1 to ICD-9

  • V62.6 - Refusal of treatment (Approximate Flag)
  • V64.06 - No vaccination-pt refuse (Approximate Flag)
  • V64.2 - No proc/patient decision (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Encounters for other specific health care (Z40-Z53)
      • Persons encntr hlth serv for spec proc & trtmt, not crd out (Z53)

Code History

  • 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