Pediatric Coding Alert
Nail Down Umbilical Hernia Diagnosis
Question: What is the correct diagnosis code for an umbilical hernia with obstruction? The pediatrician noted gangrene. How will the coding for this condition change with ICD-10?
Answer: The correct ICD-9 code is 551.1 (Umbilical hernia with gangrene). You’ll notice that this code doesn’t mention obstruction.
The code for umbilical hernia with obstruction (552.1, Umbilical hernia with obstruction) doesn’t mention gangrene.
That leaves you to figure out how to report an umbilical hernia with gangrene and with obstruction. That’s where you’ll need to look at the “excludes” and “includes” codes to figure it out.
Under 552.1, the note states, “excludes that with mention of gangrene (551.0-551.9).” The note under 551.1 states “Includes that with gangrene (and obstruction).” Based on the notes you can see that you should use 551.1 to report an umbilical hernia with obstruction and gangrene.
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