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  6. 2024 ICD-10-CM Code Z28.20

2024 ICD-10-CM Diagnosis Code Z28.20

Immunization not carried out because of patient decision for unspecified reason

ICD-10-CM Code:
Z28.20
ICD-10 Code for:
Immuniz not crd out bec patient decision for unsp reason
Is Billable?
Yes - Valid for Submission
Code Navigator:

Code Classification

  • 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)

Z28.20 is a billable diagnosis code used to specify a medical diagnosis of immunization not carried out because of patient decision for unspecified reason. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

This code 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.

Unspecified diagnosis codes like Z28.20 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

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

  • Booster meningitis C vaccination declined
  • Did not attend 2nd DTP, Hib and polio vaccination
  • Did not attend 3rd DTP, Hib and polio vaccination
  • Did not attend DTaP, polio and MMR booster
  • Did not attend DTP, Hib and polio vaccination
  • Herpes zoster vaccination declined
  • Immunization consent not given
  • Immunization invitation - not attended
  • Immunization invitation status
  • Meningitis C immunization declined
  • Meningococcal vaccination declined
  • No consent - BCG
  • No consent - diphtheria immunization
  • No consent - influenza immunization
  • No consent - measles immunization
  • No consent - pertussis immunization
  • No consent - polio immunization
  • No consent - pre-school vaccinations
  • No consent - rubella immunization
  • No consent - school exit vaccinations
  • No consent - tetanus immunization
  • No consent - Tetanus/low dose diphtheria vaccine
  • No consent DT immunization
  • No consent DTP immunization
  • No consent for any immunization
  • No consent for any primary immunization
  • No consent for Haemophilus influenzae type b immunization
  • No consent for meningitis C immunization
  • No consent for MMR
  • No consent for MMR1
  • No consent for MMR2
  • No consent for MR - Measles/rubella vaccine
  • No consent for third Haemophilus influenzae type b vaccine booster
  • No consent pneumococcal immunization
  • Temporal finding
  • Tetanus diphtheria and acellular pertussis vaccination declined

Clinical Classification

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM 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)

Z28.20 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 IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z28.20 to ICD-9-CM

  • ICD-9-CM Code: V64.09 - No vaccination NEC
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.