Z53.20 ICD-10-CM Code: Procedure 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. A planned medical procedure or treatment was not performed because the patient decided against it, but the specific reason for their decision was not documented or specified. Z53.20 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering encounters for other specific health care (z40-z53).

Z53.20 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Use this code when the patient declined but no clear reason is documented.