K42.1 Umbilical hernia with gangrene
0WUF4JZ Supplement abdominal wall with synthetic substitute, percutaneous endoscopic approach
To Locate Diagnosis Code:
- K42.1: Index > Hernia > umbilicus, umbilical > with > gangrene (and obstruction) > verify in Tabular
Feedback for Diagnosis Code:
- K42.1: Umbilical hernias have gained little attention from surgeons in comparison with other types of abdominal wall hernias. However, the primary suture for umbilical hernia is associated with a recurrence rate of 19-54%. Most of the ICD-10-CM hernia diagnoses codes make accommodations for recurrence, but NOT for umbilical hernias.
To Locate Procedure Code:
- 0WUF4JZ: Px Index > Herniorrhaphy > with synthetic substitute > see Supplement, Anatomical Regions, General > 0WU > locate table 0WU and go across the row to finish building the code. NOTE: The instructions to see Anatomical Regions, applies to the table, not the Index. At any rate, the table is:
For body systems, 2nd character, ICD-10-PCS includes Anatomical Regions, General, which describe general locations of the body. We know from the instructions given in the PCS Index that the body system we need to locate is Anatomical Regions, General, and the root operation, which we also need to locate, is Supplement. For a more detailed explanation on body systems, either read the last paragraph of this tidbit or just skip it altogether.
Supplement is defined as “Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a body part.” This applies to mesh insertion, synthetic. Because the approach was via laparoscope, the approach value is 4, percutaneous endoscopic. This approach is defined as entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach the site of the procedure. When you see the approach described as laparoscopic in any Med/Surg procedure, the value in the this section will always be 4. And finally, because mesh was inserted, we have to account for the device.
You can also build the code by going directly to the appropriate table. Identify the section (Med/Surg), the body system (Anatomical Regions, General), and the root operation (Supplement). NOTE that the root operations are listed alphabetically. This gives you the values for the 1st 3 characters, 0WU, and puts you in the correct table. To assign the 4 remaining values for characters 4-7, you must identify the body part, the approach, devices and qualifiers, if any:
- Body part – Abdominal wall, with a value of F
- Approach – Percutaneous endoscopic, with a value of 4
- Device – Synthetic substitute, with a value of J
- Qualifier – No qualifier, with a value of Z = 0WUF4JZ
Supplementary Reading: These general locations are for use in coding when procedures are performed on multiple body part and through various types of structures such as skin, muscles, arteries, nerves, and bone, all within one area of the body. This facilitates coding of procedures that involve all of these structures and reduce the number of codes required to correctly describe complex procedures performed in these areas. For example, amputation of the right arm at midshaft, below the elbow, is coded with one code – 0X6D0Z2- rather than multiple codes from several body systems, such as the skin, musculoskeletal system, nervous system, and circulatory system.