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General surgery coding: Umbilical hernia versus ventral hernia

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Do you know the difference between umbilical hernia and ventral hernia? If not, here's what you should look for in the op report to decipher the proper code.

Difference: The difference is where the hernia is located and how it formed.

Umbilical hernia: As the name suggests, an umbilical hernia occurs at the umbilicus (belly-button); but then that is not the only criteria. An umbilical hernia involves residual structures from when the chord fed the fetus directly into the intestine. An umbilical hernia is rare, except of course in infants.

Ventral Hernia: This is a fairly general term that may describe a hernia taking place at various abdominal sites such as the site of a previous surgery (incisional hernia), above the umbilicus (epigastric hernia), or on the side of the abdomen (spigelian hernia). An incisional hernia might also take place at the umbilicus; however that doesn't make it an umbilical hernia.

Abdominal hernia: Abdominal hernia occurs when the peritoneal lining of the abdominal cavity protrudes through a defect in the fascia that normally contains it. Simply stated, the fascia develops a tear, and the peritoneal lining "spills out," in pretty much the same way that an inflated inner tube will bulge out from a cut in the sidewall of a tire. In some instances, only an empty sac protrudes through the fascia. However if the fascial defect is large enough, the sac can contain abdominal contents (normally intestines).

Epigastric: These take place because of weakness in the muscles of the upper-middle abdomen, above the navel (the epigastric region).

This is not all: In order to choose the proper CPT code for hernia repair, location is only the first piece of information you will be requiring to glean from the op report.

For further information on this and for other specialty-specific articles to assist your general surgery coding, sign up for a good resource like Coding Institute.

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erin masercola
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