ICD-10 · PDGM grouping
Z53 Persons encountering health services for specific procedures and treatment, not carried out
All 12 codes in the Z53 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
12
Can lead a claim
0
Cannot lead a claim
12
What CMS assigns to Z53
None of the 12 codes is assigned a clinical group. None of the 12 is assigned a comorbidity subgroup. None can lead a claim.
Every code in Z53
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| Z53.0 Procedure and treatment not carried out because of contraindication | ||||
| Z53.01 | Procedure and treatment not carried out due to patient smokingCMS: Proc/trtmt not carried out due to patient smoking | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.09 | Procedure and treatment not carried out because of other contraindicationCMS: Proc/trtmt not carried out because of contraindication | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.1 | Procedure and treatment not carried out because of patient's decision for reasons of belief and group pressureCMS: Proc/trtmt not crd out bec pt belief and group pressure | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.2 Procedure and treatment not carried out because of patient's decision for other and unspecified reasons | ||||
| Z53.20 | Procedure and treatment not carried out because of patient's decision for unspecified reasonsCMS: Proc/trtmt not crd out bec pt decision for unsp reasons | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.21 | Procedure and treatment not carried out due to patient leaving prior to being seen by health care providerCMS: Proc/trtmt not crd out d/t pt lv bef seen by hlth care prov | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.29 | Procedure and treatment not carried out because of patient's decision for other reasonsCMS: Proc/trtmt not crd out bec pt decision for oth reasons | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.3 Procedure converted to open procedure | ||||
| Z53.31 | Laparoscopic surgical procedure converted to open procedure | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| Z53.32 | Thoracoscopic surgical procedure converted to open procedure | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| Z53.33 | Arthroscopic surgical procedure converted to open procedure | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| Z53.39 | Other specified procedure converted to open procedure | Cannot lead a claimUnacceptable principal diagnosis, code is not reportable as principal diagnosis | None | None |
| Z53.8 | Procedure and treatment not carried out for other reasons | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| Z53.9 | Procedure and treatment not carried out, unspecified reason | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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