Regarded as a common medical condition in the United States, hernia causes a localized bulge in the abdomen or groin. The condition arises when there is a hole or weakness in the peritoneum – the muscular wall that generally keeps abdominal organs in place. The weakness in the peritoneum allows organs and tissues to get herniated (or push through) – causing a small bulge. In most cases, this condition develops between the chest and hips. Hernias can be congenital, which are present at birth, or develop secondary to tissue weakness in the abdominal wall or groin. With an objective to generate widespread awareness about hernia, the month of June is observed as “National Hernia Awareness Month” in the United States. The month-long campaign offers a novel platform to raise public knowledge about the warning signs and the latest treatment options available for hernia. According to reports from the National Center for Health Statistics, approximately 5 million Americans have some type of hernia, but only 750,000 people seek treatment each year. Most types of hernias aren’t immediately life-threatening, but they don’t improve on their own and can lead to severe, life-threatening complications. Medications and self-care measures can help reduce the immediate symptoms to some extent. Physicians, in most cases, will recommend surgery to fix a hernia that is painful or enlarging. General surgeons or other specialists who provide treatment for different types of hernia need to correctly document the same in the patient medical records. Medical billing services from an established medical billing and coding company can help simplify the documentation process.

The 2020 observance in June aims to equip everyone with adequate tools and resources to create more awareness about this condition through a series of events and activities. Typically, hernias are of different types – inguinal hernia, hiatal hernia, umbilical hernia, femoral hernia, incisional/ventral hernia, epigastric hernia and diaphragmatic hernia. There is no specific cause or reason for a hernia to occur (except the case of incisional hernia that occurs due to a complication of abdominal surgery). In most cases, they are caused by a combination of muscle weakness and strain. It is more common in men than women and the risks increase with age. Other factors that increase the risk of developing a hernia include – family history of the condition, pregnancy, chronic constipation, overweight or obesity, old age and other conditions like enlarged prostate, abdominal fluid, cystic fibrosis, peritoneal dialysis and un-descended testicles.

A small bulge or painless lump in the affected area is one of the common symptoms associated with the condition. Other related symptoms include – sudden, severe pain or discomfort in the affected area (especially when bending over, coughing, or lifting), constipation, a burning sensation, nausea, vomiting, a feeling of pressure/heaviness in the abdomen, aching sensation at the site of the bulge, chest pain, acid reflex and difficulty swallowing.

Initial diagnosis of this condition begins with a physical examination wherein the physician may look for a bulge in the abdomen or groin (that gets larger when the patient stands, coughs or strains). In addition, imaging tests like X – rays, ultrasound and endoscopy may be performed to diagnose the symptoms and determine the exact type of hernia. Treatment modalities for the condition may depend on the type of hernia and the severity of the symptoms. For enlarged or painful hernias, surgery may be required to reduce the level of discomfort and other related complications. Surgery for hernia can either be open surgery or laparoscopic operation (keyhole surgery). For open surgery, an incision is made to push the protruding tissue back into the abdomen. For laparoscopic (keyhole) surgery, small incisions are made in the abdomen and the surgeon uses special instruments to repair the hernia. The diagnosis tests and treatment procedures must be carefully documented using the correct medical codes. Medical billing and coding companies can assist physicians with their medical coding and claims submission. In ICD-10-CM, codes for hernia come under the category – K40 – K46. Under each specific hernia type, there are several sub-category codes.

  • K40 – Inguinal hernia
    • K40.0 – Bilateral inguinal hernia, with obstruction, without gangrene
    • K40.1 – Bilateral inguinal hernia, with gangrene
    • K40.2 – Bilateral inguinal hernia, without obstruction or gangrene
    • K40.3 – Unilateral inguinal hernia, with obstruction, without gangrene
    • K40.4 – Unilateral inguinal hernia, with gangrene
    • K40.9 – Unilateral inguinal hernia, without obstruction or gangrene
  • K41 – Femoral hernia
    • K41.0 – Bilateral femoral hernia, with obstruction, without gangrene
    • K41.1 – Bilateral femoral hernia, with gangrene
    • K41.2 – Bilateral femoral hernia, without obstruction or gangrene
    • K41.3- Unilateral femoral hernia, with obstruction, without gangrene
    • K41.4 – Unilateral femoral hernia, with gangrene
    • K41.9 – Unilateral femoral hernia, without obstruction or gangrene
  • K42 – Umbilical hernia
    • K42.0 – Umbilical hernia with obstruction, without gangrene
    • K42.1 – Umbilical hernia with gangrene
    • K42.9 – Umbilical hernia without obstruction or gangrene
  • K43 – Ventral hernia
    • K43.0 – Incisional hernia with obstruction, without gangrene
    • K43.1 – Incisional hernia with gangrene
    • K43.2 – Incisional hernia without obstruction or gangrene
    • K43.3 – Parastomal hernia with obstruction, without gangrene
    • K43.4 – Parastomal hernia with gangrene
    • K43.5 – Parastomal hernia without obstruction or gangrene
    • K43.6 – Other and unspecified ventral hernia with obstruction, without gangrene
    • K43.7 – Other and unspecified ventral hernia with gangrene
    • K43.9 – Ventral hernia without obstruction or gangrene
  • K44 – Diaphragmatic hernia
    • K44.0 – Diaphragmatic hernia with obstruction, without gangrene
    • K44.1 – Diaphragmatic hernia with gangrene
    • K44.9 – Diaphragmatic hernia without obstruction or gangrene
  • K45 – Other abdominal hernia
    • K45.0 – Other specified abdominal hernia with obstruction, without gangrene
    • K45.1 – Other specified abdominal hernia with gangrene
    • K45.8 -Other specified abdominal hernia without obstruction or gangrene
  • K46 – Unspecified abdominal hernia
    • K46.0 – Unspecified abdominal hernia with obstruction, without gangrene
    • K46.1 – Unspecified abdominal hernia with gangrene
    • K46.9 – Unspecified abdominal hernia without obstruction or gangrene

Incorporating positive lifestyle changes such as maintaining a healthy body weight, making changes in diet, avoiding heavy meals, quitting smoking and doing certain exercises that help strengthen the muscles around the hernia site is important.

The goal of this month-long initiative is to generate awareness about different types of hernia, symptoms, treatment options and how to prevent its occurrence in the long run. As part of the observance, a wide range of events will be hosted in communities across the United States to spread awareness about this health condition. Throughout the campaign, healthcare organizations, local groups, medical professionals and online communities would offer education and counseling for managing hernia-affected people.