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K44.9
ICD-10-CM
Large Hiatal Hernia

Find comprehensive information on large hiatal hernia diagnosis, including clinical documentation requirements, ICD-10-CM codes (K44.9), CPT codes for surgical repair, and best practices for healthcare professionals. Learn about symptoms, diagnostic testing like EGD and barium swallow, treatment options, and post-operative care. This resource covers key aspects of large hiatal hernia management for accurate medical coding and improved patient outcomes.

Also known as

Giant Hiatal Hernia
Massive Hiatal Hernia

Diagnosis Snapshot

Key Facts
  • Definition : Stomach protrudes through diaphragm into chest.
  • Clinical Signs : Heartburn, regurgitation, chest pain, difficulty swallowing.
  • Common Settings : Primary care, gastroenterology, surgery.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC K44.9 Coding
K44.9

Diaphragmatic hernia without obstruction or gangrene

This code specifies a diaphragmatic hernia, including hiatal hernias, without obstruction or gangrene.

K44.0

Sliding hiatal hernia

This code designates a sliding hiatal hernia, the most common type.

K44.1

Paraesophageal hiatal hernia

This code identifies a paraesophageal hiatal hernia, a less common but potentially more serious type.

K44

Diaphragmatic hernia

This code encompasses all types of diaphragmatic hernias, including hiatal hernias.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the hiatal hernia sliding (axial)?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Large hiatal hernia
Paraesophageal hernia
Sliding hiatal hernia

Documentation Best Practices

Documentation Checklist
  • Hiatal hernia size documented (e.g., >5cm)
  • Symptoms impacting quality of life specified
  • Objective evidence from imaging study (e.g., barium swallow, endoscopy)
  • Anatomical location within thorax described
  • Surgical vs. nonsurgical management plan

Coding and Audit Risks

Common Risks
  • Unspecified Type

    Coding a large hiatal hernia without specifying sliding or paraesophageal type (K44.9 vs. K44.0/K44.1) leads to inaccurate severity and reimbursement.

  • Comorbidity Overlap

    GERD is often present with hiatal hernias. Incorrectly coding both separately (K44.9 and K21.0) can lead to overcoding and denials.

  • Missing Complication Codes

    Failing to code complications like obstruction, strangulation, or hemorrhage (e.g., K44.011) with the hernia diagnosis understates acuity and resource use.

Mitigation Tips

Best Practices
  • Thorough HPI vital for accurate HH ICD-10 coding (K44.9)
  • Document HH size, type for CDI, optimize reimbursement
  • EGD report key for HH diagnosis confirmation, compliance
  • Image findings (CXR, barium swallow) crucial for compliant coding
  • Surgical vs. conservative management notes improve CDI accuracy

Clinical Decision Support

Checklist
  • Confirm upper GI symptoms (heartburn, regurgitation)
  • Verify imaging (barium swallow, endoscopy) showing hernia>5cm
  • Document hernia type (sliding, paraesophageal)
  • Assess complications (reflux, obstruction, strangulation)
  • Consider surgical consult for giant paraesophageal hernia

Reimbursement and Quality Metrics

Impact Summary
  • Large Hiatal Hernia reimbursement: CPT 43235, ICD-10 K44.9 impacts DRG and APC assignment.
  • Coding accuracy crucial for hiatal hernia repair claims. Avoid denials with proper modifier use.
  • Quality metrics: Surgical site infection (SSI) rates, length of stay (LOS), readmission reduction.
  • Hospital reporting: Hiatal hernia repair complications, resource utilization, cost analysis.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code K44.9 for unspecified hiatal hernia
  • Document hernia size exceeding 3-5cm
  • Specify if paraesophageal K44.2
  • Confirm sliding type with imaging
  • Look for GERD symptoms, code K21.9

Documentation Templates

Patient presents with symptoms suggestive of a large hiatal hernia, including heartburn, regurgitation, chest pain, dysphagia, and shortness of breath.  The patient reports experiencing postprandial fullness and nocturnal reflux.  Physical examination reveals mild epigastric tenderness without rebound or guarding.  Differential diagnosis includes gastroesophageal reflux disease (GERD), esophageal spasm, angina, and peptic ulcer disease.  Upper gastrointestinal endoscopy reveals a large hiatal hernia with evidence of esophagitis.  The gastroesophageal junction is significantly displaced above the diaphragm.  Biopsy results confirm the presence of esophagitis.  Barium swallow study confirms the diagnosis of a large hiatal hernia, demonstrating significant herniation of the stomach into the thoracic cavity.  Impression: Large type III or IV hiatal hernia.  Plan: Conservative management with lifestyle modifications, including dietary changes, weight loss if indicated, and elevation of the head of the bed.  Patient education regarding hiatal hernia symptoms, complications, and management strategies.  Pharmacological management with proton pump inhibitors (PPIs) for symptom control and esophagitis treatment.  Surgical consultation is considered due to the size of the hernia and the presence of persistent symptoms.  Surgical options, including laparoscopic Nissen fundoplication, will be discussed with the patient.  Follow-up scheduled in four weeks to assess symptom response to therapy and discuss further management.  ICD-10 code K44.9 for diaphragmatic hernia without obstruction or gangrene will be used for billing and coding purposes.  CPT codes for the procedures performed, such as the endoscopy and barium swallow, will also be included in the billing documentation.