New diagnosis codes for COVID-19 immunization status

The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services have announced three new diagnosis codes, including two for COVID-19 immunization status. The following codes will be available as of April 1:

ICD-10-CM Description

Z28.310 Unvaccinated for COVID-19

Z28.311 Partially vaccinated for COVID-19

Z28.39 Other under-immunization status

According to ICD-10-CM guidelines, clinicians may assign code Z28.310, “Unvaccinated for COVID-19,” when the patient has not received a dose of any COVID-19 vaccine. Clinicians may assign code Z28.311, “Partially vaccinated for COVID-19,” when the patient has received at least one dose of a multi-dose COVID-19 vaccine regimen, but has not received the doses necessary to meet the CDC definition of “fully vaccinated” at the time of the encounter. (For information on what constitutes “fully vaccinated,” visit the CDC’s website.) New code Z28.39 is for reporting when a patient is not current on other, non-COVID vaccines.

Per the ICD-10-CM table, “These codes should not be used for individuals who are not eligible for the COVID-19 vaccines, as determined by the health care provider.” The index and tabular addenda for the new diagnosis codes are also available on the CDC website.

— Kent Moore, senior strategist for physician payment, American Academy of Family Physicians

Posted on March 7, 2022, by Kent Moore