A common concern for pediatricians is when parents or caregivers present a refusal to immunize their child. International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes can be used to report the reasons behind the under-immunization of children. These codes provide useful data for understanding any decrease in immunization rates and for follow-up with under-immunized patients.

Capturing the reason an immunization was not carried out begins with a code from ICD-10-CM category Z28, immunization not carried out, and under-immunization status. Under-immunization is reported with code Z28.3. Contraindications to immunization are captured with codes in subcategory Z28.0.

For example, a child presents for a well-child encounter with a temperature of 38.4°C (101.1°F) and is diagnosed with an upper respiratory infection and possible bronchiolitis. The physician decides to delay immunization for 10 days so symptoms of increasing illness are not masked by vaccination reaction. Code Z28.01...

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