ICD-10 Coding for History of Hernia Repair(K40.90, Z98.890)
Complete ICD-10-CM coding and documentation guide for History of Hernia Repair. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Hernia Repair
K40-K46Primary Range
Hernia codes covering inguinal, femoral, umbilical, and other abdominal hernias
These codes are used for active hernia conditions, including recurrent hernias.
Other specified postprocedural states
Used for documenting the history of hernia repair when no active hernia is present.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K40.90 | Unilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent | Use for initial presentation of unilateral inguinal hernia without prior repair. |
|
| Z98.890 | Other specified postprocedural states | Use for follow-up visits post-hernia repair when no active hernia is present. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for history of hernia repair
Essential facts and insights about History of Hernia Repair
Primary ICD-10-CM Codes for history of hernia repair
Decision Criteria
clinical Criteria
- Presence of inguinal bulge without prior surgery
Applicable To
- Inguinal hernia without obstruction
Excludes
- Bilateral inguinal hernia (K40.20)
Clinical Validation Requirements
- Physical examination showing inguinal bulge
- Patient history indicating no prior hernia repair
Code-Specific Risks
- Misclassification if prior repair is not documented
Coding Notes
- Ensure documentation specifies laterality and recurrence status.
Z98.890 - Other specified postprocedural states
Use for follow-up visits post-hernia repair when no active hernia is present.
Applicable To
- History of hernia repair
Excludes
- Active hernia conditions (K40-K46)
Clinical Validation Requirements
- Patient history confirming prior hernia surgery
- No current symptoms of hernia
Coding Notes
Ensure no active hernia is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified postprocedural states
Z98.890Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Hernia Repair to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K40.90.
Impact
Clinical: Inaccurate patient history, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Review surgical history, Include repair details in notes
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify current symptoms and use active hernia codes if applicable.
Impact
Using Z98.890 when active hernia is present
Mitigation Strategy
Verify current symptoms and imaging before coding.
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 History of Hernia Repair, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Hernia Repair
Use these documentation templates to ensure complete and accurate documentation for History of Hernia Repair. These templates include all required elements for proper coding and billing.
Follow-up after hernia repair
Specialty: General SurgeryRequired Elements
- Patient history
- Physical examination
- Imaging results (if applicable)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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