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ICD-10 Guide
ICD-10 CodesK45.8

K45.8

Billable

Other specified abdominal hernia without obstruction or gangrene

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K45.8 is a billable code used to indicate a diagnosis of other specified abdominal hernia without obstruction or gangrene.

Key Diagnostic Point:

K45.8 refers to 'Other specified abdominal hernia without obstruction or gangrene,' which encompasses various types of hernias that do not fall under the more common classifications such as inguinal or umbilical hernias. Abdominal hernias occur when an organ or tissue protrudes through a weak spot in the abdominal wall. Clinically, patients may present with a noticeable bulge in the abdomen, discomfort, or pain, especially during activities that increase intra-abdominal pressure, such as lifting or straining. The anatomy involved typically includes the abdominal wall, which may be weakened due to congenital factors, surgical scars, or increased pressure from obesity or pregnancy. Disease progression can lead to complications if left untreated, although K45.8 specifies cases without obstruction or gangrene, indicating a lower risk of acute complications. Diagnostic considerations include physical examination, imaging studies such as ultrasound or CT scans, and patient history to differentiate from other abdominal conditions. Accurate diagnosis is essential to determine the appropriate management and potential surgical intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of hernia types.
  • Documentation gaps may arise if the specific type of hernia is not clearly stated.
  • Billing challenges can occur if the relationship between the hernia and any symptoms is not well-documented.

Specialty Focus

Medical Specialties

General Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K45.8 lies in its potential to lead to complications if not addressed, impacting patient quality of life and healthcare utilization. Abdominal hernias are prevalent in the population, with varying degrees of severity. Understanding and accurately coding these conditions can improve population health outcomes and inform quality measures aimed at reducing surgical complications and hospital readmissions.

ICD-9 vs ICD-10

The clinical significance of K45.8 lies in its potential to lead to complications if not addressed, impacting patient quality of life and healthcare utilization. Abdominal hernias are prevalent in the population, with varying degrees of severity. Understanding and accurately coding these conditions can improve population health outcomes and inform quality measures aimed at reducing surgical complications and hospital readmissions.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the hernia repair and the patient's overall health status. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include ensuring that all clinical notes clearly outline the diagnosis and treatment plan, and that coding aligns with the documentation provided.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K45.8?

K45.8 covers various types of abdominal hernias that do not fit into the standard categories, such as spigelian hernias or other rare forms. It is important to document the specific type of hernia for accurate coding.

When should K45.8 be used instead of related codes?

K45.8 should be used when the hernia is specified as 'other' and does not involve obstruction or gangrene. If the hernia is classified under a more common type, such as inguinal or umbilical, the corresponding codes should be used instead.

What documentation supports K45.8?

Documentation should include a clear description of the hernia type, clinical findings, imaging results, and any relevant patient history. A detailed note on the absence of obstruction or gangrene is also necessary.