# Z23 Vaccination Question



## sstep (Sep 30, 2015)

Regarding Z23 for vaccinations, the guidelines in the ICD-10 book say to code this secondary if inoculation was given as a routine part of preventive health care, such as a well baby visit

Under the Z23 code itself in the book, it states to code first any routine childhood examination

What if the inoculations are for adults?

Thank you for your help!


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## heavers (Sep 30, 2015)

Z23 is not an acceptable prinicpal dx.  So it would need to be coded after the routine childhood exam code.


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## klbass (Sep 30, 2015)

heavers said:


> Z23 is not an acceptable prinicpal dx.  So it would need to be coded after the routine childhood exam code.




We split off our Immunization claim from the well child (because we keep the financials separate).. Are you saying we cannot have a Z23 as a primary diagnosis on a claim?
Thanks in Advance..


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## mitchellde (Sep 30, 2015)

Z23 is an allowable first listed code.  There is nothing in the guidelines indicating otherwise.  It is secondary when it is use with a well child code.


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## midnightsun1369 (Oct 2, 2015)

is z23 the correct code for a flu vaccination given to an adult?


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## Pam Brooks (Oct 2, 2015)

Z23 is not acceptable as a first-listed diagnosis for an Inpatient facility claim.  If you are getting your coding information on ICD-10.com, they erroneously listed this as coding guidance for everyone, but after I informed them that their information was misleading, they removed it.  Z23 may be used as a primary diagnosis for immunizations in the OP and physician setting.  

Please get an ICD-10-CM book, and use that for your guidance. Those online resources can be misleading and some are downright unreliable.


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## matcpc (Oct 2, 2015)

*z23*

so in the case below we would have to code it accordingly

56 year old Patient was seen in flu clinic only! Received flu shot

Diagnosis being billed is

z00.00
Z23

and CPT code will
(Flu shot cpt code)
Admin flu shot

Am I understanding this right?


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## Giss3lrivera15 (Oct 2, 2015)

ok I work for a pediatric clinic and we get many well visits with shots and also a lot that just came in to get a shot like flu how do we code this?
well visit + shots
z00129
z23

and for shot only:
z23? no z00129?

I thank you for the help


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## CodingKing (Oct 2, 2015)

matcpc said:


> so in the case below we would have to code it accordingly
> 
> 56 year old Patient was seen in flu clinic only! Received flu shot
> 
> ...



The code first message in the I10 book states code first any routine childhood examination. Since the patient is an adult you don't code a childhood exam Z code. Unless you are billing an E&M code, you would not be reporting a preventive exam DX




Giss3lrivera15 said:


> ok I work for a pediatric clinic and we get many well visits with shots and also a lot that just came in to get a shot like flu how do we code this?
> well visit + shots
> z00129
> z23
> ...



Correct, If the sole reason for their visit was for the immunization you code Z23. If they are also there for their preventive exam (CPT 99381-99397) you would first code the Z00.XXX code followed by the Z23


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## LNader (May 18, 2016)

*Z23 first listed according to book*



Pam Brooks said:


> Z23 is not acceptable as a first-listed diagnosis for an Inpatient facility claim.  If you are getting your coding information on ICD-10.com, they erroneously listed this as coding guidance for everyone, but after I informed them that their information was misleading, they removed it.  Z23 may be used as a primary diagnosis for immunizations in the OP and physician setting.
> 
> Please get an ICD-10-CM book, and use that for your guidance. Those online resources can be misleading and some are downright unreliable.



According to the guidelines (page 72 2016 ICD-10 code book) Z23 is not listed as one that can be used as primary diagnosis. Our Code-correct is warning me every time I try and use this for a immunization only visit. So, I ask, what is the correct answer to this? IS Z23 the correct code to use when the patient is coming in for an immunization only visit or when during an office visit for a DM follow up, they receive it? Thank you in advance.


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## mitchellde (May 18, 2016)

You stated:  "According to the guidelines (page 72 2016 ICD-10 code book) Z23 is not listed as one that can be used as primary diagnosis."
This is not what this page indicates.  what you are looking at on that section is a listing of Z codes and or categories that are ONLY allowed first listed.  Just because Z 23 is not listed there there not mean it cannot be used 1st listed, it can be used either as first or secondary codes.  the codes in the list you are looking are only to be used first listed and never as secondary.


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## a372261 (Dec 16, 2016)

*Z23 is an acceptable primary DX for the immunization line*



heavers said:


> Z23 is not an acceptable prinicpal dx.  So it would need to be coded after the routine childhood exam code.



Z23 is an acceptable primary DX for the immunization line, it is not an acceptable reason to bill an E/M code.
if there is an E/M code billed it would be for a separate reason and therefore the primary reason for that E/M visit would be the primary dx for that E/M visit.


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## driecam@yahoo.com (Dec 23, 2016)

Z23 is the ONLY code I use for ALL of my vaccines...children or adults. It pays without a problem to ALL carriers.


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## sgregoire (Dec 24, 2016)

*Sandy Gregoire, CPC*

For an adult that is coming in for just a flu shot or vaccine, I would use a code from Z20.8, or more specifically Z20.9 (this is a billable code), my second listed code is Z23.  This satisfies that Z23 is not being used as a first-listed code does it not?  I am remembering also that in ICD10 the word 'and' is to be read as, and/or in a title or narrative statement, is that not correct?


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## asincl01 (Dec 27, 2016)

sgregoire said:


> For an adult that is coming in for just a flu shot or vaccine, I would use a code from Z20.8, or more specifically Z20.9 (this is a billable code), my second listed code is Z23.  This satisfies that Z23 is not being used as a first-listed code does it not?  I am remembering also that in ICD10 the word 'and' is to be read as, and/or in a title or narrative statement, is that not correct?



It is not necessary to add dx z20.8/9 as primary for a vaccine only visit, code z23 will support the vaccine.


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