AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 2; Ask the Editor

Abdominal Hernia with Obstruction and Torsion of Bowel

A patient presents to the Emergency Department with a bowel obstruction. Imaging demonstrates a closed loop obstruction of the small bowel with ischemic changes. The patient undergoes exploratory laparotomy with small bowel resection and primary anastomosis. The final diagnosis is intestinal torsion, closed loop obstruction with internal hernia into the omentum of the mid jejunum with small bowel necrosis, and ischemia. In ICD-10-CM, torsion of the bowel indexes to K56.2, Volvulus. Would the torsion be included in the code for abdominal hernia with obstruction or coded separately? There are no excludes notes for either condition. Similarly, is the small bowel necrosis and ischemia captured with the code for the abdominal hernia with gangrene? ...

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