Z28.1 vs Z28.82
Z28.1 (Immunization not carried out because of patient decision for reasons of belief or group pressure) compared with Z28.82 (Immunization not carried out because of caregiver refusal), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. Z28.82 carries an Excludes1 note covering Z28.1: “immunization not carried out because of caregiver refusal because of religious belief (Z28.1)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| Z28.1Immunization not carried out because of patient decision for reasons of belief or group pressure | Z28.82Immunization not carried out because of caregiver refusal | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) |
| Definition | Immunization not carried out because of patient decision for reasons of belief or group pressure is a billable ICD-10-CM diagnosis code (Z28.1). | Immunization not carried out because of caregiver refusal is a billable ICD-10-CM diagnosis code (Z28.82). |
| Includes | vaccination not carried out Immunization not carried out because of religious belief | vaccination not carried out Immunization not carried out because of guardian refusal Immunization not carried out because of parent refusal |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources