Hiatus Hernia J016

Current RMA Instruments
Reasonable Hypothesis SOP
60 of 2022
Balance of Probabilities SOP
61 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: K44.0, K44.1, K44.9

Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Diaphragmatic hernia*
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a disease or injury

* another SOP applies

# non-SOP condition

 

Clinical onset

Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/h-l/hiatus-hernia-j016-k44

Last amended

Rulebase for hiatus hernia

<h5>Current RMA Instruments</h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><address><a href="http://www.rma.gov.au/assets/SOP/2022/9cce0ac86c/060.pdf&quot; target="_blank"><u><font color="#0066cc">Reasonable Hypothesis SOP</font></u></a></address></address></td><td>60 of 2022</td></tr><tr><td><address><address><a href="http://www.rma.gov.au/assets/SOP/2017/9db685d378/061.pdf&quot; target="_blank"><u><font color="#0066cc">Balance of Probabilities SOP</font></u></a></address></address></td><td>61 of 2022</td></tr></tbody></table><h5>Changes from previous Instruments</h5><p><drupal-media data-entity-type="media" data-entity-uuid="b0e3410a-c863-4549-b13d-b8b8b219af02" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding</h5><p>ICD-10-AM Codes: K44.0, K44.1, K44.9</p><h5>Brief description</h5><p>This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.</p><h5>Confirming the diagnosis</h5><p>This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.</p><p>The appropriate medical specialist is general surgeon or a gastroenterologist.</p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Sliding hiatus hernia</li><li>Paraoesophageal hiatus hernia</li></ul><h5><strong>Conditions excluded from SOP </strong></h5><ul><li>Congenital hiatus hernia<span><sup>#</sup></span></li><li>Diaphragmatic hernia*</li><li>Eventration of the diaphragm<span><sup>#</sup></span></li><li>Gastro-oesphageal reflux disease*</li><li>Physiological herniation during swallowing - not a disease or injury</li></ul><p>* another SOP applies</p><p><sup><span># </span></sup>non-SOP condition</p><p> </p><h5>Clinical onset</h5><p>Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.</p><h5>Clinical worsening</h5><p>Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.</p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/hiatus-hernia-j016-k44/rulebase-hiatus-hernia

Acute traumatic injury to the diaphragm

Current RMA Instruments
Reasonable Hypothesis SOP
60 of 2022
Balance of Probabilities SOP
61 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: K44.0, K44.1, K44.9

Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Diaphragmatic hernia*
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a disease or injury

* another SOP applies

# non-SOP condition

 

Clinical onset

Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/hiatus-hernia-j016-k44/rulebase-hiatus-hernia/acute-traumatic-injury-diaphragm

Being obese

Current RMA Instruments
Reasonable Hypothesis SOP
60 of 2022
Balance of Probabilities SOP
61 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: K44.0, K44.1, K44.9

Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Diaphragmatic hernia*
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a disease or injury

* another SOP applies

# non-SOP condition

 

Clinical onset

Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/hiatus-hernia-j016-k44/rulebase-hiatus-hernia/being-obese

Gastro-oesophageal reflux disease

Current RMA Instruments
Reasonable Hypothesis SOP
60 of 2022
Balance of Probabilities SOP
61 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: K44.0, K44.1, K44.9

Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Diaphragmatic hernia*
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a disease or injury

* another SOP applies

# non-SOP condition

 

Clinical onset

Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/hiatus-hernia-j016-k44/rulebase-hiatus-hernia/gastro-oesophageal-reflux-disease

Inability to obtain appropriate clinical management for hiatus hernia

Current RMA Instruments
Reasonable Hypothesis SOP
60 of 2022
Balance of Probabilities SOP
61 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: K44.0, K44.1, K44.9

Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Diaphragmatic hernia*
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a disease or injury

* another SOP applies

# non-SOP condition

 

Clinical onset

Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/hiatus-hernia-j016-k44/rulebase-hiatus-hernia/inability-obtain-appropriate-clinical-management-hiatus-hernia

Surgical procedure

Current RMA Instruments
Reasonable Hypothesis SOP
60 of 2022
Balance of Probabilities SOP
61 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: K44.0, K44.1, K44.9

Brief description

This is a herniation of abdominal contents into the chest cavity through the diaphragmatic opening (hiatus).  It typically involves the gastro-oesophageal junction and a small section of stomach moving to above the diaphragm.

Confirming the diagnosis

This diagnosis is based on radiological imaging of the oesophagus and stomach (barium swallow), upper gastrointestinal endoscopy, or high resolution manometry.  Symptoms or signs of the condition are not required.

The appropriate medical specialist is general surgeon or a gastroenterologist.

Additional diagnoses covered by SOP
  • Sliding hiatus hernia
  • Paraoesophageal hiatus hernia
Conditions excluded from SOP
  • Congenital hiatus hernia#
  • Diaphragmatic hernia*
  • Eventration of the diaphragm#
  • Gastro-oesphageal reflux disease*
  • Physiological herniation during swallowing - not a disease or injury

* another SOP applies

# non-SOP condition

 

Clinical onset

Most hiatus hernias are asymptomatic and the condition is usually an incidental finding.  Gastro-oesophageal reflux symptoms are common but cannot be used to date clinical onset of hiatus hernia.  Clinical onset will be at the time of diagnosis in most cases.

Clinical worsening

Worsening may be evidenced by a documented increase in the size/extent of herniation.  Worsening of reflux symptoms does not represent a worsening of hiatus hernia.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/hiatus-hernia-j016-k44/rulebase-hiatus-hernia/surgical-procedure