Coding Hernias
According to the Cleveland Clinic, “a hernia occurs when part of your insides bulges through an opening or weakness in the muscle or tissue that contains it. Most hernias involve one of your abdominal organs pushing through one of the walls of your abdominal cavity. Hernias can occur gradually as you get older and regular wear and tear on your muscles begins to add up. They can also result from an injury, surgery, or birth disorder.”
An incisional or ventral hernia may occur either spontaneously or from a prior abdominal incision. Hernias that develop from a prior abdominal incision are the result of thinning, separation, or tear in the fascial closure from prior surgery, or other causes of separation and weakness unrelated to prior surgery. An umbilical hernia is the protrusion of the intestine and/or omentum through the abdominal wall near the navel. This type of hernia normally corrects itself after birth. However, when the hernia doesn’t correct itself, surgical repair may be necessary. Epigastric hernias occur through the linea alba above the umbilicus.
A diagnosis for a hernia is selected based on the anatomic site and whether an obstruction or gangrene is present. The ICD-10-CM codes for inguinal hernias will indicate whether it is unilateral or bilateral, and if it is recurrent. If it is recurrent, it means the patient has had a hernia in the past.
Q: A 49-year-old patient underwent a left femoral hernia repair. The postoperative diagnosis was a recurrent left femoral hernia. What is the ICD-10-CM code for this encounter?
A: K41.91 Rationale: In our ICD-10-CM code book, in the alphabetic Index, we will look at Hernia/femoral/recurrent. We are directed to K41.91. As always, we will want to verify our code selection in the Tabular List.
Reference: FY 2023 ICD-10-CM code book & Cleveland Clinic
