Coding and coverage · ICD-10-CM

Z53 Persons encountering health services for specific procedures and treatment, not carried out

Not billable (header)Chapter 21

Report one of the more specific codes below.

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Codes under this one

  • Z53.0 Procedure and treatment not carried out because of contraindicationHeader
  • Z53.1 Procedure and treatment not carried out because of patient's decision for reasons of belief and group pressure
  • Z53.2 Procedure and treatment not carried out because of patient's decision for other and unspecified reasonsHeader
  • Z53.3 Procedure converted to open procedureHeader
  • Z53.8 Procedure and treatment not carried out for other reasons
  • Z53.9 Procedure and treatment not carried out, unspecified reason

Instructional notes

Chapter 21

Notes
  • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
  • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Section Z40-Z53

Excludes2Not included here: the patient may have both; report both when both are present.
  • follow-up examination for medical surveillance after treatment (Z08-Z09)
Inclusion terms
  • Categories Z40-Z53 are intended for use to indicate a reason for care. They may be used for patients who have already been treated for a disease or injury, but who are receiving aftercare or prophylactic care, or care to consolidate the treatment, or to deal with a residual state

Chapter 21: Factors influencing health status and contact with health services · Z40-Z53 Encounters for other specific health care (Z40-Z53)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.