The patient could experience nausea, vomiting, and symptoms of bowel obstruction, depending on the incarcerated tissue involved. An excludes 1 note with this category indicates that if an omphalocele Q79. Review of Symptoms Common symptoms of hernia vary, depending on the type. Additional hernia types include lumbar hernia, obturator hernia, pudendal hernia, and others. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition. Umbilical: The fascia of the navel is thinner than in the rest of the abdomen.
For these hernia types, provider documentation must specify whether the hernia is bilateral or unilateral. Femoral hernias are particularly at risk of becoming irreducible and strangulated. Some people are born with weak abdominal muscles and may be more likely to get a hernia. This may include pain or discomfort especially with coughing, exercise, or bowel movements. The obstruction can be complete or partial.
If small, this type of hernia may close by age 2. Additional terms found only in the Alphabetic Index may also be assigned to a code. The herniated contents cannot be manipulated either via manual manipulation or spontaneous reduction back through the fascial defect. Each of the above categories may include specific subcategories e. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Irreducible can be incarcerated or strangulated or gangrenous.
Temporal Parameters Temporal parameters include status of recurrent and not specified as recurrent e. This code category includes hiatal hernia and esophageal or sliding hernia. Depending upon the structures involved in the process, the pathology signs and symptoms shows up. Most hernias are in the abdomen. For asymptomatic hernia, the patient may have swelling or fullness at the hernia site. Incarcerated hernias have painful enlargement of the hernia defect.
Example 3: Susan noticed a bulge in her abdominal wall. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Examples Build Coding Confidence Example 1: A 78-year-old man presented with a two-day history of a painful mass in his right groin. Abdominal examination disclosed mild tenderness in the right lower quadrant. An umbilical hernia occurs when contents protrude from the navel. Irreducible means the protruding herniated structures cannot be pushed back into the abdominal cavity even manually.
A bulging area may occur that becomes larger when bearing down. Strangulated hernia is a hernia so tightly constricted that it compromises the blood supply of the hernia sac, leading to gangrene of the sac and its contents. They can affect men, women, and children. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. If you think you may have a medical emergency, please call your doctor or 911 immediately. Incarceration inseparably adherent can occur in any of the hernia; say the abdominal hernias- be it umbelical, ventral, inguinal or incisional hernia. A type 2 Excludes note represents 'Not included here'.
Does it matter if the fat, omentum or intestine is incarcerated in the hernia to code it as incarcerated? Hernia is a general term to describe a bulge or protrusion of an organ through the structure or muscle that usually contains it. Complicated By Complications of hernia include possible obstruction documentation stating incarcerated, irreducible, or strangulated implies this and the presence of gangrene. Sometimes the pre and post op dx says, i. Wherever such a combination exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the manifestation code. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
The most common are adhesions, hernias, cancers, and certain medicines. The main concern is strangulation, where the blood supply to part of the bowel is blocked. To start viewing messages, select the forum that you want to visit from the selection below. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. Code Categories Hernia codes K40—K46 include acquired hernias, congenital hernias except diaphragmatic or hiatus , and recurrent hernia. If this path is enlarged, it may allow abdominal contents to protrude into the canal.