marandee
Networker
When ICD coding for hernia doesn't quite capture the significance of LOSS OF DOMAIN
and Loss of Domain does not have a specific or unspecified or for that matter a NEC ICD-10-CM code.
So, what’s a coder to do?
Short answer: (which I know many prefer), follow the guidelines for what you understand about the condition. This will lead you right back to HERNIA. So, what is herniated? The gastrointestinal tract –
Note: see Hernia, abdomen – Hernia, abdomen K46.9 (Tabular lists Intestinal Hernia)
I’m using this code (K46.9) as well as incisional hernia and any other documented hernias which co-exist… in order to give the full picture of the patient’s condition (s) and severity of loss of domain for medical necessity of abdominal reconstruction with hernia repair.
– KEEP reading because there is another code I use as well.
I do not code Injury, abdominal or intestinal because this is not what occurred.
I do not code Open wound either and you can beg to differ here, but the protrusion is an internal evisceration of the Intestines and not Abdominal Wall Evisceration. An Abdominal Wall evisceration occurs with an open wound, if I understand that correctly. So, I tried Evisceration, intestines and got a red light because only subterms listed under the main term are:
Birth injury
And
Traumatic NEC
It is not ALWAYS traumatic when an intestinal evisceration occurs, as providers sometimes call it, but a loss of domain. We cannot code that anyway because ICD-10-CM doesn’t even give a potential code. Why? Because Trauma, NEC is coded to actual injury(s).
Loss of domain exists when the ratio of the volume of the hernia sac to the volume of the abdominal cavity is ≥0.5 abdominalkey.com/massive-ventral-hernia-with-loss-of-domain
I tried many different possible conditions to code Loss of Domain… from Weak Muscle to Protrusion to Post Op complications and bottom line….
I code for NON Traumatic, Loss of Domain (Abdominal):
K46.9, Intestinal Hernia WITH K91.89 Other Postprocedural Complications and disorders of digestive system. (when provider documents recurrent hernia, previous major abdominal surgeries and correlation).
Would love some feedback…
DM
and Loss of Domain does not have a specific or unspecified or for that matter a NEC ICD-10-CM code.
So, what’s a coder to do?
Short answer: (which I know many prefer), follow the guidelines for what you understand about the condition. This will lead you right back to HERNIA. So, what is herniated? The gastrointestinal tract –
Note: see Hernia, abdomen – Hernia, abdomen K46.9 (Tabular lists Intestinal Hernia)
I’m using this code (K46.9) as well as incisional hernia and any other documented hernias which co-exist… in order to give the full picture of the patient’s condition (s) and severity of loss of domain for medical necessity of abdominal reconstruction with hernia repair.
– KEEP reading because there is another code I use as well.
I do not code Injury, abdominal or intestinal because this is not what occurred.
I do not code Open wound either and you can beg to differ here, but the protrusion is an internal evisceration of the Intestines and not Abdominal Wall Evisceration. An Abdominal Wall evisceration occurs with an open wound, if I understand that correctly. So, I tried Evisceration, intestines and got a red light because only subterms listed under the main term are:
Birth injury
And
Traumatic NEC
It is not ALWAYS traumatic when an intestinal evisceration occurs, as providers sometimes call it, but a loss of domain. We cannot code that anyway because ICD-10-CM doesn’t even give a potential code. Why? Because Trauma, NEC is coded to actual injury(s).
Loss of domain exists when the ratio of the volume of the hernia sac to the volume of the abdominal cavity is ≥0.5 abdominalkey.com/massive-ventral-hernia-with-loss-of-domain
I tried many different possible conditions to code Loss of Domain… from Weak Muscle to Protrusion to Post Op complications and bottom line….
I code for NON Traumatic, Loss of Domain (Abdominal):
K46.9, Intestinal Hernia WITH K91.89 Other Postprocedural Complications and disorders of digestive system. (when provider documents recurrent hernia, previous major abdominal surgeries and correlation).
Would love some feedback…
DM