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v1.0.0
ICD-10 Guide
ICD-10 CodesZ28.311

Z28.311

Partially vaccinated for COVID-19

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z28.311 is a billable code used to indicate a diagnosis of partially vaccinated for covid-19.

Key Diagnostic Point:

Z28.311 is used to indicate that an individual has received some, but not all, doses of a COVID-19 vaccine. This status can significantly influence health outcomes and access to healthcare services. Factors such as socioeconomic status, education, and access to healthcare can affect vaccination rates and health status. Individuals who are partially vaccinated may require additional preventive care, such as follow-up appointments for completing their vaccination series. Understanding social determinants of health is crucial, as they can impact an individual's decision to get vaccinated and their overall health. Preventive care measures, including education on the importance of completing vaccinations, are essential for this population. Screening for COVID-19 symptoms and aftercare for those who may have contracted the virus despite partial vaccination are also critical components of care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of vaccination status
  • Variability in vaccine types and dosing schedules
  • Potential for confusion with fully vaccinated status
  • Impact of social determinants on vaccination uptake

Audit Risk Factors

  • Inadequate documentation of vaccination history
  • Misclassification as fully vaccinated
  • Failure to document follow-up care plans
  • Inconsistent use of Z codes across providers

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation should include vaccination history, patient education on completing the vaccination series, and any follow-up appointments scheduled.

Common Clinical Scenarios

Routine checkups where vaccination status is assessed, follow-up visits for completing vaccinations, and discussions about preventive measures.

Billing Considerations

Consideration of social determinants such as access to healthcare, education level, and community resources that may affect vaccination completion.

Public Health

Documentation Requirements

Documentation should include population-level vaccination data, outreach efforts, and tracking of vaccination rates in specific demographics.

Common Clinical Scenarios

Epidemiological studies assessing vaccination rates, community health initiatives aimed at increasing vaccination uptake, and public health campaigns.

Billing Considerations

Focus on health equity and addressing barriers to vaccination in underserved populations.

Coding Guidelines

Inclusion Criteria

Use Z28.311 When
  • Z codes are used to indicate factors influencing health status and contact with health services
  • 311 should be sequenced appropriately, often as a secondary diagnosis, following any primary diagnosis related to the patient's visit
  • Payer requirements may vary, so it's essential to check specific guidelines

Exclusion Criteria

Do NOT use Z28.311 When
No specific exclusions found.

Related CPT Codes

90471CPT Code

Immunization administration (first or only component)

Clinical Scenario

Used when administering the first dose of a COVID-19 vaccine.

Documentation Requirements

Documentation of vaccine type, dose administered, and patient education provided.

Specialty Considerations

Primary care providers should ensure follow-up for the second dose.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding vaccination statuses, improving the ability to track and manage public health initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding vaccination statuses, improving the ability to track and manage public health initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding vaccination statuses, improving the ability to track and manage public health initiatives.

Resources

Clinical References

  • •
    CDC COVID-19 Vaccination Guidance

Coding & Billing References

  • •
    CDC COVID-19 Vaccination Guidance

Frequently Asked Questions

What documentation is required for Z28.311?

Documentation should include the number of doses received, the type of vaccine, patient education on the importance of completing the vaccination series, and any follow-up appointments scheduled.