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.