Z53.20Procedure and treatment not carried out because of patient's decision for unspecified reasons

Z53.20 is the ICD-10-CM diagnosis code for procedure and treatment not carried out because of patient's decision for unspecified reasons. It belongs to category Z53 (persons encountering health services for specific procedures and treatment, not carried out), block Z40-Z53 (Encounters for other specific health care) and chapter 21 (factors influencing health status and contact with health services). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Z53.2, choose Z53.20 (because of patient's decision for unspecified reasons) only when documentation doesn't support a more specific option: due to patient leaving prior to being seen by health care provider (Z53.21) and because of patient's decision for other reasons (Z53.29).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 795 (Normal Newborn, relative weight 0.2022) and DRG 951 (Other Factors Influencing Health Status, relative weight 0.5577), in MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period) and MDC 23 (Factors Influencing Health Status and Other Contacts with Health Services), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is not acceptable as the principal diagnosis for an inpatient stay; it may be reported as a secondary diagnosis.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as V64.06 (vaccination not carried out because of patient refusal) and V64.2 (surgical or other procedure not carried out because of patient's decision).