CDC updates guidelines for COVID-19 underimmunization codes

Wednesday, January 26, 2022

The CDC recently released multiple addenda with new tabular and index instructions and updates to the ICD-10-CM Official Guidelines for Coding and Reporting to complement the updated ICD-10-CM code set to become effective April 1.

The new guideline update includes clarification on reporting underimmunization for COVID-19, JustCoding reported. According to the updated guideline:

Code Z28.310, Unvaccinated for COVID-19, may be assigned when the patient has not received at least one dose of any COVID-19 vaccine. Code Z28.311, Partially vaccinated for COVID-19, may be assigned when the patient has received at least one dose of a multi-dose COVID-19 vaccine regimen, but has not received the full set of doses necessary to meet the CDC definition of “fully vaccinated” in place at the time of the encounter. For information, visit the CDC’s website https://www.cdc.gov/coronavirus/2019-ncov/vaccines/.

The updated ICD-10-CM tabular instructions now includes the following information:

  • Z28.3, underimmunization status
    • Use Additional code, if applicable, to identify:
      • immunization not carried out because of contraindication (Z28.0-)
      • immunization not carried out because of patient decision for other and unspecified reason (Z28.2-)
      • immunization not carried out because of patient decision for reasons of belief or group pressure (Z28.1)
      • immunization not carried out for other reason (Z28.8-)
  • Z28.31, underimmunization for COVID-19 status
    • Note: These codes should not be used for individuals who are not eligible for the COVID-19 vaccines, as determined by the healthcare provider.
    • Z28.310, unvaccinated for COVID-19
    • Z28.311, partially vaccinated for COVID-19
  • Z28.39, other underimmunization status
    • Delinquent immunization status
    • Lapsed immunization schedule status

Editor’s note: See additional NAHRI resources on billing and coding for COVID-19 vaccines and vaccine administration here.