ICD-10 Coding for Abdominal Wall Hernia(K43.2)
Complete ICD-10-CM coding and documentation guide for Abdominal Wall Hernia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abdominal Wall Hernia
K43-K46Primary Range
Hernia of abdominal cavity
This range includes various types of abdominal wall hernias, including ventral, incisional, and umbilical hernias.
Key Information: ICD-10 code for abdominal wall hernia
Essential facts and insights about Abdominal Wall Hernia
Primary ICD-10-CM Code for abdomen wall hernia
Decision Criteria
clinical Criteria
- No signs of obstruction or gangrene
Applicable To
- Incisional hernia without obstruction
Clinical Validation Requirements
- CT scan showing defect size
- Physical exam noting reducibility
Code-Specific Risks
- Misclassification if obstruction is present but not documented
Coding Notes
- Ensure documentation specifies the absence of obstruction or gangrene.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Removal of infected mesh
11008Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Incisional hernia with obstruction
K43.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abdominal Wall Hernia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K43.2.
Impact
Clinical: Inaccurate representation of surgical procedure, Regulatory: Non-compliance with coding guidelines, Financial: Potential loss of reimbursement for mesh use
Mitigation Strategy
Include mesh details in operative notes, Use templates to ensure completeness
Impact
Reimbursement: Potential underpayment for more complex cases, Compliance: Risk of audit failure, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Verify clinical documentation for signs of obstruction.
Impact
Failure to document precise defect size can lead to coding errors.
Mitigation Strategy
Use standardized templates to ensure all necessary details are captured.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abdominal Wall Hernia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abdominal Wall Hernia
Use these documentation templates to ensure complete and accurate documentation for Abdominal Wall Hernia. These templates include all required elements for proper coding and billing.
Initial repair of ventral hernia
Specialty: General SurgeryRequired Elements
- Defect size
- Location
- Reducibility
- Mesh use
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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