(2022) How To Code Hiatal Hernia ICD 10 – List With Codes & Guidelines

Hiatal hernia ICD 10 is K44.9. In this article, you will learn the diagnosis coding of hiatal hernia and the updated guidelines for ICD 10 and 11.

What Is Hiatal Hernia?

Hiatal hernia is a condition in which the upper part of the stomach bulges through a diaphragm opening into the chest. The opening is called hiatus, and this hernia is called hiatal hernia.

A diaphragm is a thin muscle sheet that separates the abdomen by the chest; it is also known as a diaphragmatic hernia.

Common Causes Of Hiatal Hernia

The common causes of Hiatal Hernia include an increased intra-abdominal pressure due to pregnancy or obesity, age-related changes in diaphragm, and being born with a larger hiatal opening than usual.

Common symptoms include:

• Heartburn
• Regurgitation/ backward flow of gastric contents into the mouth
• Shortness of breath
• Difficulty in swallowing
• Chest or abdominal pain

Hiatal Hernia ICD 10

Hiatal Hernia ICD 10 code is K44.9, unspecified.

Approximate synonyms include:

• Diaphragmatic hernia
• GERD co-occurrent and due to diaphragmatic hernia
• GERD co-occurrent and due to para esophageal hernia
• GERD with diaphragmatic hernia
• GERD with hiatal hernia
• GERD with para esophageal hernia
• Hiatal hernia
• Para esophageal hernia

Type 1 Excludes:

Type 1 excludes conditions for diaphragmatic or Hiatal hernias are:

ICD 10 code for diaphragmatic hernia, congenital Q79.0

ICD 10 code for congenital hiatus hernia Q40.1

ICD 10 codes of hiatal hernia should not code with type 1 excludes conditions because both conditions cannot co-exist. Otherwise, it would be denied.

Hiatal Hernia ICD 11

Hiatal Hernia ICD 11 code is DD50.0. It is a specific, billable code used for reimbursement purposes.

Exclusions:

Type 1 exclusions are:

ICD 11 code for congenital diaphragmatic hernia (LB00.0)

ICD 11 code for congenital hiatus hernia (LB13.1)

Post Coordination:

We can also code any manifestation or complication caused by a hiatal hernia in the digestive system.

ICD 10 code for other manifestations of the digestive system is ME24. 

What Is Hiatal Hernia Unspecified?

Unspecified or Not otherwise specified terms in ICD 10 are used for those diagnoses that are not specified either by their location or type.

Hiatal hernia unspecified (NOS) or Diaphragmatic hernia NOS is a condition when a patient is diagnosed with hiatal hernia but not explicitly known to have any obstruction or gangrene along with hernia, as these could be the direct manifestation of hernia.

Hiatal Hernia Unspecified ICD 10

Hiatal Hernia Unspecified ICD 10 code NOS is K44.9. It is a billable code used for reimbursement purposes. 

As discussed above, whenever the patient is only diagnosed with hiatal hernia or when it is only documented in medical records or the superbill, we will code ICD 10 for hiatal hernia NOS, which is also applicable for diaphragmatic hernia NOS. In addition, it should also code for the condition hiatal hernia without obstruction or gangrene.

Hiatal Hernia Unspecified ICD 11

Hiatal Hernia Unspecified ICD 11 code is DD50.0.

Matching terms:

• Diaphragmatic hernia
• Hiatus hernia
• Hiatal hernia NOS
• Oesophageal hiatus hernia
• Sliding hiatus hernia

Inclusions:

Paraoesophageal hernia

What Is A Hiatal hernia With Obstruction?

There are two main types of Hiatal Hernias:

The first is a sliding hernia and the second is a paraesophageal hernia.

Paraesophageal hernia is more dangerous than any other type of hernia because, in this condition, your esophagus and stomach stay at their standard location. Still, the upper part of the stomach squeezes through the hiatus into the esophagus.

 As a result of the stomach squeezing, its blood supply can be obstructed, resulting in gangrene if it lasts for a prolonged period. That is why this is also called a strangulated hernia.

Hiatal Hernia With Obstruction ICD 10

Hiatal Hernia with Obstruction ICD 10 code is K44.0. It is a billable code used for reimbursement purposes.

It is also applicable for:

ICD 10 CM of Diaphragmatic hernia with obstruction

ICD 10 CM of Incarcerated diaphragmatic hernia

ICD 10 CM of Irreducible diaphragmatic hernia

ICD 10 CM of Strangulated diaphragmatic hernia

This code is coded when a hiatal hernia with obstruction, without gangrene, is documented in medical records.

Hiatal Hernia With Gangrene ICD 10

Hiatal hernia with gangrene ICD 10 code is K44.1.

Approximate Synonyms

• ICD 10 of gangrenous hiatal hernia
• ICD 10 of gangrenous paraesophageal hernia
• ICD 10 of hiatal hernia with gangrene
• ICD 10 of paraesophageal hernia with gangrene

Type 1 Excludes:

ICD 10 code I96, which is used for diagnosis of gangrene, not elsewhere classified is Type 1 exclude for ICD 10 code K44.1. So, according to the ICD 10 guidelines, both codes should not code together for the same patient.

Hiatal Hernia With Obstruction ICD 11

Hiatal hernia with obstruction ICD 11 code is DD50.0/ME24.2.

Use additional code:

• XT5R Acute
• XT8W Chronic

It is a cluster code, a combination of two codes:

DD50.0 Hiatal hernia

ME24.2 Digestive system obstruction

What Is A Hiatal Hernia With GERD And Esophagitis?

Hiatal hernia with GERD and esophagitis is a chronic condition in which the gastric or duodenal contents regurgitate into the lower end esophagus.

Symptoms of GERD are heartburn and indigestion. 

Hiatal hernia is also a cause of GERD because it may cause an obstruction that results in incomplete drainage of food into the intestine.

Recurrent GERD may cause ulcers to the esophageal mucosa and esophagitis. 

Hiatal Hernia With GERD And Esophagitis ICD 10

Hiatal hernia with GERD and esophagitis ICD 10 code is K44.9.

Approximate Synonyms:

Diaphragmatic hernia without obstruction or gangrene:

Gastroesophageal reflux disease with and due to diaphragmatic hernia

Gastroesophageal reflux disease is co-occurrent and due to paraesophageal hernia

Gastroesophageal reflux disease with diaphragmatic hernia

Gastroesophageal reflux disease with hiatal hernia

Gastroesophageal reflux disease with paraesophageal hernia

Hiatal Hernia With GERD And Esophagitis ICD 11

Hiatal hernia with GERD and esophagitis ICD 11 code is DD50.0/ME24 (with digestive manifestations).

ME24 ICD 11 codes clinical manifestations of the digestive system are:

ME24.0 Digestive system abscess ICD 11

ME24.1 Digestive system fistula ICD 11

ME24.2 Digestive system obstruction ICD 11

ME24.3 Digestive system perforation ICD 11

ME24.4 Digestive system stenosis ICD 11

ME24.5 Digestive system ulcer ICD 11

ME24.6 Digestive system dilatation ICD 11

ME24.7 Digestive system incarceration ICD 11

ME24.8 Digestive system strangulation or gangrene ICD 11

ME24.9 Gastrointestinal bleeding ICD 11

ME24.Other digestive system hemorrhages, not elsewhere classified ICD 11

ME24.Y Other specified clinical manifestations of the digestive system ICD 11

ICD 10 GERD With Hiatal Hernia

ICD 10 GERD with hiatal hernia (gastroesophageal reflux disease) is K44.9.

ICD 11 For GERD With Hiatal Hernia

ICD 11 for GERD with hiatal hernia is DA22.Z/DD50.0.

What Is A Hiatal Hernia With Cameron Ulcer?

Cameron ulcers are gastric ulcers on the mucosal walls at the diaphragmatic impression in patients with a hiatal hernia. 

Sliding Hiatal hernias develop when the gastroesophageal junction and some stomach parts protrude above the diaphragm. Hiatal hernia is an idiopathic disease because the cause of hiatal hernia is usually unknown.

Hiatal hernias usually do not show any symptoms (asymptomatic) but are commonly associated with gastroesophageal reflux disease (GERD) and esophagitis. Complications from hiatal hernia are following:

• Iron-deficiency anemia, acute or chronic bleeding, with or without ulcers/erosion. 

Hiatal Hernia With Cameron Ulcer ICD 10

Hiatal hernia with cameron ulcer ICD 10 is K44.9.

ICD 10 codes for gastric ulcers according to their types are following.

For acute ulcers:

ICD 10 code for Acute gastric ulcer with hemorrhage is K25.0.

ICD 10 code for Acute gastric ulcer with perforation is K25.1.

ICD 10 code for Acute gastric ulcer with both bleeding and perforation is K25.2.

ICD 10 code for Acute gastric ulcer without hemorrhage or perforation is K25.3.

For chronic ulcers:

ICD 10 code for chronic or unspecified gastric ulcer with hemorrhage is K25.4.

ICD 10 code for chronic or unspecified gastric ulcer with perforation is K25.5.

ICD 10 code for chronic or unspecified gastric ulcer with both hemorrhage and perforation is K25.6.

ICD 10 code for chronic gastric ulcer without hemorrhage or perforation is K25.7.

ICD 10 code for gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation, is K25.9.

Parent Code: K25

Excludes 1:

Acute gastritis (K29.0-)

Peptic ulcer NOS (K27.-)

Includes:

Erosion (acute) of the stomach

Pylorus ulcer (peptic)

Stomach ulcer (peptic)

Hiatal Hernia With Cameron Ulcer ICD 11

Hiatal Hernia with cameron ulcer ICD 11 code is DD50.0/ME24.5.

What Is A Hiatal Hernia With Reflux Esophagitis?

Hiatal hernia with reflux esophagitis is a chronic condition in which the gastric or duodenal contents regurgitate into the lower end esophagus. Symptoms of GERD are heartburn and indigestion. 

Hiatal hernia is also a cause of GERD because it may cause an obstruction that results in incomplete drainage of food into the intestine.

Recurrent GERD may cause ulcers to the esophageal mucosa and esophagitis. 

Hiatal Hernia With Reflux Esophagitis ICD 10

Hiatal Hernia with reflux esophagitis ICD 10 (diaphragmatic hernia) is K44.9.

It is also applicable for hernias with GERD. However, ICD 10 codes for reflex esophagitis are following:

ICD 10 for Reflux esophagitis without bleeding is K21.00.

ICD 10 for Reflux esophagitis with bleeding is K21.01.

Hiatal Hernia With Reflux Esophagitis ICD 11

Hiatal Hernia with reflux esophagitis ICD 11 code is DA22.1/DD50.0.

By Sana Akhtar
Expert Medical Coding & Billing