Incisional hernia J033

Current RMA Instruments

SOP bulletin information on new SOPs

ICD Coding

• ICD-9-CM Codes:551.21, 552.21, 553.21
• ICD-10-AM Codes: K43.0-2

Brief description

An incisional hernia is a hernia that develops at a site where an incision was made for a prior abdominal surgical procedure.   It is due to a failure of fascial tissues to adequately heal following an incision.

Confirming the diagnosis

The diagnosis is based on the history and the clinical findings on examination.

The relevant medical specialist is a general surgeon.

Additional diagnoses covered by SOP

• Nil

Related conditions that may be covered by SOP (further information required)

• Ventral hernia (see comments)

Conditions not covered by SOP

• Femoral hernia^#
• Hiatus hernia*
• Inguinal hernia*
• Obturator hernia^#
• Umbilical and paraumbilical hernia^# (under investigation by the RMA as at Sep 2016)

* another SOP applies 

^# non-SOP condition

Clinical onset

The condition may be asymptomatic and may be found incidentally at examination.  More usually, a bulge at the site of a previous incision is noticed.  There may be discomfort with coughing, exercise, or bowel movements.  Hernias are rarely painful. Once diagnosis has been confirmed clinical onset can be backdated to when the bulge first became noticable (post surgery).

Clinical worsening

The normal course for a hernia is to remain fairly stable or slowly progress.  Serious complications can develop in a small proportion of cases.  Treatment may be conservative or surgery may be required.  Worsening could be evidenced by sudden progression or the development of complications.

Further comments on diagnosis

A ventral hernia is a bulge of tissues through an opening or defect within the abdominal wall muscles.  Many but not all ventral hernias are incisional hernias. Ventral hernias may also be congenital or due to trauma.  These latter types are not covered by the incisional hernia SOP.