Z28.1 — Immunization not carried out because of patient decision for reasons of belief or group pressure

Billable

Is Z28.1 billable?

Yes — Z28.1 is billable for FY2027. Z28.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z28.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z28.1 at a glance

Code	Z28.1
Description	Immunization not carried out because of patient decision for reasons of belief or group pressure
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to Z28.1?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z28.1 directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does Z28.1 group to?

Z28.1 sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

795Normal Newbornmedical

How is Z28.1 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z28.1. They show the wording a clinician may have documented, which often differs from the Tabular description.

Immunization › not done › because › group pressure
Immunization › not done › because › patient's belief
Immunization › not done › because › religious beliefs of patient

Inclusion terms

Alternative wording in documentation that is classified to Z28.1.

Immunization not carried out because of religious belief

Code also — inherited from Z28

Two codes may be needed to describe the condition fully. Whether Z28.1 is sequenced first depends on the reason for the encounter.

, if applicable, encounter for immunization safety counseling (Z71.85)

How long has Z28.1 existed?

Z28.1 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.