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Thursday Oct 04, 2018

How to code for immunization refusal

Documenting and coding for patients' immunization refusal may be necessary for quality initiatives and continuity of care. Several HCPCS and ICD-10 codes are relevant and may be used appropriately depending on specific payer and practice guidance for coding immunization refusal:

• For influenza vaccine refusal when the reason is documented, HCPCS code G8483, "Influenza immunization was not administered for reasons documented by clinician."

• For pneumococcal vaccine refusal when the reason is documented, HCPCS code G8866, "Documentation of patient reason(s) for not administering or previously receiving pneumococcal vaccine."

• For immunization refusal due to religious belief or group pressure, ICD-10 code Z28.1, “Immunization not carried out because of patient decision for reasons of belief or group pressure.”

• For immunization refusal due to another reason, such as the discomfort of injections, ICD-10 code Z28.21, “Immunization not carried out because of patient refusal.”

• For immunization refusal by a parent or other caregiver for a child, ICD-10 code Z28.82, “Immunization not carried out because of caregiver refusal.”

Read answers to readers’ Coding & Documentation questions in every issue of FPM.

 

Posted at 10:00AM Oct 04, 2018 by FPM Editors

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