# Z23 when vaccine was just ordered?



## kbrooks15 (Jul 7, 2016)

I'm wondering what diagnosis I can use instead of Z23 when a vaccine was just ordered for that visit. I can't use Z23 because the vaccine was not given. 
Should I use one of the Z28 codes stating that it wasn't given for another reason?


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## DeniMCharlotte (Aug 1, 2016)

Was there a specific reason the vaccine wasn't administered (patient or parent declined etc.)?


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## danskangel313 (Aug 4, 2016)

Z28- has several options to explain the reason the immunization was not carried out. 

But as previously mentioned, if you could provide more information here, that'd be helpful. You can't just bill a Z28- code because that doesn't specify the reason for the encounter.


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## kbrooks15 (Feb 7, 2017)

My question is when the provider orders for a vaccine to be given but it needs to be ordered from a local pharmacy, the providers use the Z23 diagnosis often to attach to the order being put into the pharmacy. My understanding is that Z23 shouldn't be reported when no vaccine is given. I have been thinking that Z28.89 can be used to explain that it was not given in the encounter but it is noted that it was ordered to be given on a later date since the clinic does not stock the vaccines. 

Is this correct?


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## Cynthia Hughes (Feb 22, 2017)

kbrooks15 said:


> My question is when the provider orders for a vaccine to be given but it needs to be ordered from a local pharmacy, the providers use the Z23 diagnosis often to attach to the order being put into the pharmacy. My understanding is that Z23 shouldn't be reported when no vaccine is given. I have been thinking that Z28.89 can be used to explain that it was not given in the encounter but it is noted that it was ordered to be given on a later date since the clinic does not stock the vaccines.
> 
> Is this correct?



I would say that Z23 is correct because as the ICD-10-CM guidelines point out, a procedure code is required to indicate the vaccine was administered and the type of vaccine given. The physician and patient have apparently agreed to the need for immunization and that was a condition addressed at the encounter as indicated by the prescription for the vaccine. It is unfortunate that the descriptor for Z23 is "encounter for" rather than "need for" as that would more clearly imply the patient's condition. 

I would also report code Z28.29 because the vaccine was not given due to other circumstances (vaccine had to be ordered). 

Cindy


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## thomas7331 (Feb 22, 2017)

I'd add too that if this diagnosis is only on the order, it isn't actually considered 'reporting' a diagnosis.  'Reporting' generally refers to the reporting on a claim form of the services that were provided.  You're just giving the pharmacy information on the order for their use in the event that they need to bill a claim directly to the payer, which should be the indication for a service or material that is ordered - you're not reporting your provider's services by doing this.  If the pharmacy submits a claim for the vaccine serum, they would use your Z23 as the diagnosis, which would be correct.


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## mitchellde (Feb 22, 2017)

I would just use the Z code for the allergy status.  Such as a z91 code to indicate the patient has that status which would indicate a need for the serum.


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