ICD-10-CM Code Z53.8

Procedure and treatment not carried out for other reasons

Version 2020 Replaced Code Billable Code Unacceptable Principal Diagnosis

Valid for Submission

Z53.8 is a billable code used to specify a medical diagnosis of procedure and treatment not carried out for other reasons. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z53.8 might also be used to specify conditions or terms like 10 year examination not attended, 15 year examination not attended, 18 month examination not attended, 2.5 year examination not attended, 3.5 year examination not attended, 4.5 year examination not attended, etc

The code Z53.8 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:Z53.8
Short Description:Procedure and treatment not carried out for other reasons
Long Description:Procedure and treatment not carried out for other reasons

Replaced Code

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).

  • Z53.31 - Laparoscopic surgical procedure converted to open procedure
  • Z53.32 - Thoracoscopic surgical procedure converted to open procedure
  • Z53.33 - Arthroscopic surgical procedure converted to open procedure
  • Z53.39 - Other specified procedure converted to open procedure

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 Z53.8 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:

  • 10 year examination not attended
  • 15 year examination not attended
  • 18 month examination not attended
  • 2.5 year examination not attended
  • 3.5 year examination not attended
  • 4.5 year examination not attended
  • 8-9 month exam not attended
  • Child 1 year examination not attended
  • Child 21 month examination not attended
  • Child 3 year exam not attended
  • Child 39 month examination not attended
  • Child 6 month examination not attended
  • Child 6 week examination not attended
  • Child 7 month examination not attended
  • Child 8 week examination not attended
  • Child examination at 1 year with explicit context
  • Child examination at 10 years with explicit context
  • Child examination at 15 years with explicit context
  • Child examination at 18 months with explicit context
  • Child examination at 2.5 years with explicit context
  • Child examination at 21 months with explicit context
  • Child examination at 3 years with explicit context
  • Child examination at 3.5 years with explicit context
  • Child examination at 39 months with explicit context
  • Child examination at 4.5 years with explicit context
  • Child examination at 6 months with explicit context
  • Child examination at 6 weeks with explicit context
  • Child examination at 7 months with explicit context
  • Child examination at 8 to 9 months with explicit context
  • Child examination at 8 weeks with explicit context
  • Did not attend - appointment mix-up
  • Doctor walked out
  • Drug discontinued - too expensive
  • Drug not taken - patient lost tablets
  • Drug not taken - problem swallowing
  • Drug not taken - side-effects
  • Drug treatment stopped - patient ran out of tablets
  • ERCP not completed due to anatomical derangements from previous surgery
  • Late for appointment
  • Mammography not attended
  • Medication therapy management recommendation refused by prescriber
  • Neonatal vitamin K adminstration declined by caregiver
  • No antenatal care
  • No antenatal care: not known pregnant
  • No anti-cancer treatment - poor performance status
  • No anti-cancer treatment - significant co-morbidity
  • No anti-cancer treatment - watchful waiting
  • No anti-cancer treatment available
  • No anti-cancer treatment due to unknown primary
  • No history of procedure
  • No smear - benign hysterectomy
  • No smear - no cervix
  • No smear - not sexually active
  • No smear-amputation of cervix
  • Patient on vacation
  • Patient too late
  • Patient unable to contact out of hours doctor
  • Radiographic imaging procedure not carried out
  • Reason for no specific anti-cancer treatment
  • Reason for no specific anti-cancer treatment
  • Reason for no specific anti-cancer treatment
  • Reason for no specific anti-cancer treatment
  • Reason for no specific anti-cancer treatment
  • Reasons for treatment
  • Reasons for treatment
  • Reasons for treatment
  • Reasons for treatment
  • Reasons for treatment
  • Reasons for treatment delay
  • Reasons for treatment delay
  • Recommendations refused
  • Refusal of treatment by parents
  • Tablets too large to swallow
  • Treatment delay - clinical reason
  • Treatment delay - logistic reason
  • Treatment not available
  • Vitamin K prophylaxis declined

Convert Z53.8 to ICD-9

  • V64.3 - No proc for reasons NEC (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