Chapter XI K00-K93 Digestive System Disease of Stomach · Chapter XI K00-K93 Digestive System...
Transcript of Chapter XI K00-K93 Digestive System Disease of Stomach · Chapter XI K00-K93 Digestive System...
Chapter XI K00-K93 Digestive System
นพ.บก เจญล
กมงานลยกรรม รพ.สวรรประชาก นครสวรร
1
Disease of Stomach
2
Dyspepsia
Chronic or recurrent pain or discomfort centered in the upper
abdomen when eating
One or more the following symptoms (ROME III)
Postprandial fullness
Early satiety
Epigastric pain
Epigastric burning
Functional dyspepsia [Non-ulcer dyspepsia]
Peptic ulcer disease
Gastroesophageal reflux disease
dys “bad” or “difficult” & pepsis “digestion” = indigestion
3
Dyspepsia
Summary Diagnosis ICD-10
Dyspepsia
Heartburn
Indigestion
Regurgitation
Functional dyspepsia
K30
R12
R11
R11
F45.3
Subjective Diagnosis
4
Gastritis
Diagnosis view
: Endoscopic diagnosis
: Pathologic diagnosis
: with underlying condition
CAG
CSG
AEGAHG
Objective Diagnosis
5
Gastritis
Acute gastritis
- Acute infectious gastritis: including H.pylori
- Acute erosive gastritis: NSAID, alcohol, chemical ingestion
- Acute hemorrhagic gastritis: ischemia
Chronic gastritis
- Helicobactor pylori type
- Chronic atrophic gastritis: type A, type B
- Chemical: bile reflux, NSAID
- Granulomatous gastritis: Crohn’s disease, sarcoidosis, vasculitides
- Allergic gastritis: Eosinophilic gastritis
- Specific infection: HIV, TB, syphilis, cytomegalovirus, histoplasmosis
Objective Diagnosis
6
Gastritis
Summary Diagnosis ICD-10
Acute erosive gastritis
Acute hemorrhagic gastritis
K29.0
K29.0
Alcoholic gastritis
Allergic gastritis
Giant hypertrophic gastritis [Menetrier’s disease]
Granulomatous gastritis
K29.2
K29.6
K29.6
K29.6
Eosinophilc gastritis
Lymphocytic gastritis
K52.8
K29.6
Gastritis K29.7
Objective Diagnosis
7
Gastritis
Summary Diagnosis ICD-10
Chronic gastritis
Chronic atrophic gastritis
Chronic superficial gastritis
Intestinal metaplasia
K29.5
K29.4
K29.3
K29.5
Curling ulcer
Cushing ulcer
K25.0
K25.0
Viral gastritis
Tuberculous gastritis
Helicobacter pylori gastritis
A08.4
A18.8 + K93.8
K29.- + B96.8
Objective Diagnosis
8
Peptic Ulcer
An ulcer is defined as disruption of the mucosal integrity in a
region that touches gastric acid and pepsin, so ‘peptic ulcer’
refers to an ulcer in the lower esophagus, stomach or
duodenum, in jejunum after surgical anastomosis to stomach or
rarely in there ileum adjacent to Meckel’s diverticulum leading to
local defect or excavation due to active inflammation.
Acute: associated with superficial erosion and minimal
inflammation
Chronic: one of long duration eroding through the muscular
wall with the formation of fibrous tissue
9
Peptic Ulcer
acute chronic
10
Peptic Ulcer
Gastric ulcer
Duodenal ulcer
Gastrojejunal ulcer / Marginal ulcer / Stomal ulcer
Jejunal ulcer
Dyspepsia
!
: Gastrointestinal ulcer องจยจากการตรวจเศษเาน
: Peptic ulcer ไใในการจยโรคในจน
: Dyspepsia ใจยจากอาการ [แทน peptic ulcer]
11
Peptic Ulcer
Gastric ulcer
Duodenal ulcer
Gastrojejunal ulcer / Marginal ulcer / Stomal ulcer
Jejunal ulcer
Dyspepsia
12
Gastric Ulcer
Summary Diagnosis ICD-10
Gastric ulcer K25.9
Acute gastric ulcer
Acute gastric ulcer with bleeding
Acute gastric ulcer with perforation
Acute gastric ulcer with bleeding and perforation
K25.3
K25.0
K25.1
K25.2
Chronic gastric ulcer
Chronic gastric ulcer with bleeding
Chronic gastric ulcer with perforation
Chronic gastric ulcer with bleeding and perforation
K25.7
K25.4*
K25.5*
K25.6*
* included Unspecified Gastric Ulcer
13
Duodenal Ulcer
Summary Diagnosis ICD-10
Duodenal ulcer K26.9
Acute duodenal ulcer
Acute duodenal ulcer with bleeding
Acute duodenal ulcer with perforation
Acute duodenal ulcer with bleeding and perforation
K26.3
K26.0
K26.1
K26.2
Chronic duodenal ulcer
Chronic duodenal ulcer with bleeding
Chronic duodenal ulcer with perforation
Chronic duodenal ulcer with bleeding and perforation
K26.7
K26.4*
K26.5*
K26.6*
* included Unspecified Duodenal Ulcer
14
Barry J Marshall & J Robin Warren at Perth, first discover
in the stomachs of gastritis and gastric ulcer at 1982
Diagnosis of H.pylori infection
Non-endoscopic tests
: Blood antibody
: Urea breath test
: Stool antigen
Endoscopic tests
: Biopsy urease test “CLO-test”
: Histology
: Culture
Helicobacter pyloriB98.0 H.pylori infection
15
Helicobacter pylori diseases classified to other chapters
B98.0 Helicobacter pylori [H.pylori] as the cause of diseases classified
to other chapters-B98.1 Vibrio vulnificus as the cause of diseases classified to other
-
16
Gastrointestinal Bleeding
Hematemesis
อาเยนเนเอดแดงสด หอเอดำเาๆ [coffee-ground]
Hematochezia
ายเนเอดแดงสด
Melena
จจาระำเนน เหยว และกนเหน [เอดออก 60 ลตร]
Stool occult blood
Rectal bleeding
17
Gastrointestinal Bleeding
Summary Diagnosis ICD-10 Neonate
Hematemesis
Hematochezia
Melena
Stool occult blood
Upper gastrointestinal bleeding
Coffee ground [NG lavage]
Coffee ground emesis
Lower gastrointestinal bleeding
Gastrointestinal bleeding
Rectal bleeding
K92.0
K92.1
K92.1
R19.5
K92.2
K92.2
K92.0
K92.2
K92.2
K62.5
P54.0
P54.1
P54.1
-
P54.3
P54.3
P54.0
P54.3
P54.3
P54.2
18
Gastrointestinal Bleeding
กรตรวจพบรอยโรค เน erosion, ulcer, varix
สามารถจยาเนสาเหของเอดออกไ โดยไำเนอง
พบาเอดออกในขณะน (acute bleeding)
แพทควรระา lesion with bleeding หอ hemorrhage
ใรสองตรวจสอบรสการจยา ำเนองเมรส
ของ gastrointestinal bleeding เมเมหอไ [บางรสการจยไครอบคมวย เน K72.6 Mallory-Weiss tear]
19
FORREST classification
Clinical Diagnosis Endoscopic Finding
Acute bleeding
Forrest Ia
Forrest Ia
!
Arterial spurting bleeding
Oozing bleeding
Recent bleeding
Forrest IIa
Forrest IIb
Forrest IIc
!
Ulcer with non-bleeding visible vessel
Ulcer with adherent clot on surface
Ulcer with hematin-covered lesion
Lesions without active bleeding
Forrest III
!
Ulcer with clean base
20
Endoscopic Findings
21
Peptic Ulcer Coding
The following fourth-character subdivisions are for use with categories
K25-K28:
.0 Acute with haemorrhage
.1 Acute with perforation
.2 Acute with both haemorrhage and perforation
.3 Acute without haemorrhage or perforation
.4 Chronic or unspecified with haemorrhage
.5 Chronic or unspecified with perforation
.6 Chronic or unspecified with both haemorrhage and perforation
.7 Chronic without haemorrhage or perforation
.9 Unspecified as acute or chronic, without haemorrhage or
perforation
K25 Gastric ulcer
22
- Endoscopic injection therapy: saline, adrenaline
- Endoscopic clipping
- Endoscopic coagulation: heater probe, gold probe, APC
44.43 Endoscopic control gastric and duodenal bleeding
Endoscopic Stop Bleeding
23
Peptic Ulcer Perforation
24
44.41 Simple closure of gastric ulcer perforation
44.42 Simple closure of duodenal ulcer perforation
!
ไองใรสตถการ Omental graft, Peritoneal toilet
!
!
!
Peptic Ulcer Perforation
25
Peptic Ulcer Obstruction
จยจากอาการ [pyloric obstruction]
: Splashing sound
จยจากการตรวจเมเม [pyloric or duodenal obstruction]
: สามารถระสาเหของภาวะ
ในกสาเหเนการจยหก
: ไสามารถระสาเหของภาวะ
ในกำแหงดนเนการจยหก
‘Gastric Outlet Obstruction’
26
Gastric Outlet Obstruction
27
Gastric Outlet Obstruction
Summary Diagnosis ICD-10
Pyloric obstruction
Duodenal obstruction
K31.1
K31.5 Acute distension of stomach
K31.1 Adult hypertrophic pyloric stenosis
Pyloric stenosis NOS
Excludes: congenital or infantile pyloric stenosis ( Q40.0 )
K31.2 Hourglass stricture and stenosis of stomach
Excludes: congenital hourglass stomach ( Q40.2 )
hourglass contraction of stomach ( K31.8 )
K31.3 Pylorospasm, not elsewhere classified
xcludes: pylorospasm:
xcludes: congenital diverticulum of stomach ( Q40.2 )
K31.5 Obstruction of duodenum
Constriction
Stenosis
Stricture } of duodenum
Duodenal ileus (chronic)
Excludes: congenital stenosis of duodenum ( Q41.0 )
K31.6 Fistula of stomach and duodenum
clinical diagnosis ‘unknown etiology'
28
Esophageal Varices
29
Bleeding Esophageal Varices
เกณการจย สปสช.2559
: ประอาเยนเนเอดหอายำ
: การนกจยของแพท Bleeding esophageal varices
- พบ active bleeding
- ไพบ recent/active bleeding หอ
- เอดออกภายใน 10 นหงำหาย
- องการกษาโรค [SB-tube, Somatostatin, Vasopressin]
กรทราบสาเห องนกเนโรคหก
ใรส I98.2* หอ I98.3*
30
Esophageal Varices
Summary Diagnosis ICD-10
Bleeding esophageal varices
Bleeding esophageal varices due to cirrhosis
Bleeding esophageal varices due to alcoholic cirrhosis
Bleeding esophageal varices due to hepatitis cirrhosis
I85.0
K74.6 + I98.3
K70.3 + I98.3
B15-B19 + I98.3
Esophageal varices I85.9· lesions of pinta [carate] ( A67.2† )
I98.2* Oesophageal varices without bleeding in diseases classified
elsewhere
Oesophageal varices in:
· liver disorders ( K70-K71† , K74.-† )
· schistosomiasis ( B65.-† )
I98.3* Oesophageal varices with bleeding in diseases classified
elsewhere-
Oesophageal varices in:
· liver disorders ( K70-K71† , K74.-† )
· schistosomiasis ( B65.-† )
I98.8* Other specified disorders of circulatory system in diseases
classified elsewhere
31
Disease of Appendix
32
Appendicitis
Abscess of appendix
K35.2 Acute appendicitis with generalized peritonitis-
Appendicitis (acute) with generalized (diffuse) peritonitis
following rupture or perforation
K35.3 Acute appendicitis with localized peritonitis-
Acute appendicitis with localized peritonitis with or without
rupture or perforation
Acute appendicitis with peritoneal abscess
K35.8 Acute appendicitis, other and unspecified-
Acute appendicitis without mention of localized or generalized
peritonitis
K35.9 Acute appendicitis, unspecified
Acute appendicitis with peritonitis, localized or NOS
33
Appendicitis
กรการาดไง
Acute appendicitis with localized peritonitis
: ตรวจพบ rebound tenderness/guarding องอยขวา
: ไาจะเน ruptured/accidental ruptured
Acute appendicitis with generalized peritonitis
: ตรวจพบ rebound tenderness/guarding งสองง
: กเน ruptured วมบหนองกระจายวงององ
กรไการาดไง
สถานภาพำหาย องไใ improved-approval
ยกเน หกฐานนนการจย หอ อามอการาด
34
Appendicitis
กรการาดไง
Acute appendicitis with localized peritonitis
: ตรวจพบ rebound tenderness/guarding องอยขวา
: ไาจะเน ruptured/accidental ruptured
Acute appendicitis with generalized peritonitis
: ตรวจพบ rebound tenderness/guarding งสองง
: กเน ruptured วมบหนองกระจายวงององ
กรไการาดไง
สถานภาพำหาย องไใ improved-approval
ยกเน หกฐานนนการจย หอ อามอการาด
35
Appendicitis
Summary Diagnosis ICD-10
Appendicitis
Acute appendicitis
Acute appendicitis with localized peritonitis
Acute inflammatory appendicitis
Appendiceal abscess
K37
K35.8
K35.3
!
!
!
!
K35.3
Ruptured appendicitis with generalized peritonitis
Peritonitis due to ruptured peritonitis
K35.2
K35.2
Chronic appendicitis K36
Acute suppurative appendicitis
Acute gangrenous appendicitis
Ruptured appendicitis
36
Appendectomy
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(99.77)
4 7 .0 A p p e n d ecto m y
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4 7 .1 9 O t h e r i n c i d e n t a l a p p e n d ec t o m y
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37
Appendectomy
Summary Procedure ICD-9-CM
Appendectomy
Open appendectomy
Laparoscopic appendectomy
Exploratory laparotomy to appendectomy
47.09
47.09
47.01
47.09
Drainage of appendices abscess
Open drainage of abscess with appendectomy
Laparoscopic drainage of abscess with appendectomy
47.2
47.09
47.01
Incidental open appendectomy
Incidental laparoscopic appendectomy
47.19
47.11
38
าด Exploratory laparotomy พบ ruptured appendicitis หนองกระจายวององ ำไบวม หงดไง างองวยำเกอนอนเบดององวย
retention suture แไเบดนวหง หงาดน 4 เบดแผลาด ไภาวะแทรกอน ำหายในน 10
Op
Peritonitis K65.9
Peritonitis due to ruptured appendicitis K35.2
Ruptured appendicitis K35.8
Ruptured appendicitis with generalized peritonitis K35.2
Intraabominal abscess K65.0
Ruptured appendicitis with intraabdominal abscess K35.3
Appendiceal abscess K35.3
Appencitis K37
39
าด Exploratory laparotomy พบ ruptured appendicitis หนองกระจายวององ ำไบวม หงดไง างองวยำเกอนอนเบดององวย
retention suture แไเบดนวหง หงาดน 4 เบดแผลาด ไภาวะแทรกอน ำหายในน 10
Op
Exploratory laparotomy 54.11
Appendectomy 47.09
Exploratory laparotomy to appendectomy 47.09
Peritoneal toilet 54.25
Retention suture -
Delayed primary closure 86.59
Resuture of abdominal wall 54.61
Suture of skin of abdomen 86.59
40
Hernia
41
Groin Hernia
Indirect inguinal hernia (IIH)
Direct inguinal hernia (DIH)
Femoral hernia (FH)
ภาวะแทรกอน
: Incarcerated hernia เนไเอนไสามารถนวนไหลออก
มากบเาไปในององ
: Strangulated hernia เนไเอนำใการขาดเอดไปเยง
ของวนไหลออกมาและเดเา (gangrene) ตามมาไ
: Bowel obstruction เนไเอนำใการดนของำไ
Strangulation…..IS…..Gangrene…..in Practice
42
K40 Inguinal hernia Includes: bubonocele
inguinal hernia:
· NOS
· direct
· double
· indirect
· oblique
scrotal 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
Bilateral inguinal hernia NOS K40.3 Unilateral or unspecified inguinal hernia, with obstruction,
without gangrene
Inguinal hernia (unilateral):
· causing obstruction
· incarcerated
· irreducible
· strangulated
without gangrene
K40.4 Unilateral or unspecified inguinal hernia, with gangrene
Inguinal hernia NOS with gangrene
K40.9 Unilateral or unspecified inguinal hernia, without obstruction
or gangrene
Inguinal hernia (unilateral) NOS
K41 Femoral hernia
Groin Hernia
43
Groin Hernia
Inguinal hernia (unilateral) NOS
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
Bilateral femoral hernia NOS
K41.3 Unilateral or unspecified femoral hernia, with obstruction,
without gangrene
Femoral hernia (unilateral):
· causing obstruction
· incarcerated
· irreducible
· strangulated
without gangrene
K41.4 Unilateral or unspecified femoral hernia, with gangrene
K41.9 Unilateral or unspecified femoral hernia, without
obstruction or gangrene
Femoral hernia (unilateral) NOS
K42 Umbilical hernia
Strangulation…..IS…..Gangrene…..in Practice
Strangulation…..NOT…..Gangrene…..in ICD-10
44
Groin Hernia
Clinical Diagnosis ICD-10 Diagnosis
Hernia
Reducible hernia
Sliding hernia
Pantaloon hernia
Recurrent hernia
Hernia
Incarcerated hernia
Irreducible hernia
Hernia with obstruction
Obstructed hernia Hernia with obstruction
Strangulated hernia Hernia with obstruction
Hernia with gangrene Hernia with gangrene
Hernia with obstruction with gangrene
45
Groin Hernia
Summary DiagnosisICD-10
Unilateral Bilateral
Inguinal hernia
Indirect inguinal hernia
Direct inguinal henia
Femoral hernia
Hernia
K40.9
K40.9
K40.9
K41.9
K46.9
K40.2
K40.2
K40.2
K41.2
K46.9
Incarcerated inguinal hernia
Obstructed inguinal henia
Incarcerated femoral hernia
Obstructed femoral hernia
K40.3
K40.3
K41.3
K41.3
K40.0
K40.0
K41.0
K41.0
46
Groin Hernia
Summary DiagnosisICD-10
Unilateral Bilateral
Incarcerated indirect inguinal hernia
Incarcerated direct inguinal hernia
Obstructed indirect inguinal henia
Obstructed direct inguinal hernia
Incarcerated femoral hernia
Obstructed femoral hernia
K40.3
K40.3
K40.3
K40.3
K41.3
K41.3
K40.0
K40.0
K40.0
K40.0
K41.0
K41.0
47
Groin Hernia
Summary DiagnosisICD-10
Unilateral Bilateral
Strangulated indirect inguinal hernia
Strangulated direct inguinal hernia
Strangulated femoral hernia
K40.3
K40.3
K41.3
K40.0
K40.0
K41.0
Indirect inguinal hernia with gangrene
Direct inguinal hernia with gangrene
Femoral hernia with gangrene
K40.4
K40.4
K41.4
K40.1
K40.1
K41.1
Strangulation…..NOT…..Gangrene…..in ICD-10
48
Repair of Hernia
Herniotomy and Herniorrhaphy or Hernioplasty
Non-mesh repair vs Mesh repair
Open repair vs Laparoscopic repair
49
Repair of Hernia
Open and Non-mesh repair
: Herniotomy
: Bassini herniorrhaphy
: McVay herniorrhaphy
: Shouldice herniorrhaphy
: Halsted herniorrhaphy
: Furguson herniorrphaphy
50
Repair of Hernia
Open and Mesh repair
: Lichtenstein hernioplasty
: Plug and patch hernioplasty
51
Repair of Hernia
Laparoscopic repair [all mesh repair]
- Total extraperitoneal technique (TEP)
- Transabdominal preperitoneal approach (TAPP)
TEP
TAPP
TAPP
52
Repair of Groin Hernia
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5 3 .0 1 O t h e r a n d o p e n r e p a i r o f d i r ec t i n g u i n a l h e r n i a ®
Direct and indirect inguinal hernia
5 3 .0 2 O t h e r a n d o p e n r e p a i r o f i n d i r ec t i n g u i n a l h e r n i a ®
5 3 .0 3 O t h e r a n d o p e n r e p a i r o f d i r ec t i n g u i n a l h e r n i a w i t h g r a f t o r
p r o s t h es i s ®
5 3 .0 4 O t h e r a n d o p e n r e p a i r o f i n d i r ec t i n g u i n a l h e r n i a w i t h g r a f t o r
p r o s t h es i s ®
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Gzenwfgu<"ncrctqueqrke"wpkncvgtcn"tgrckt"qh"kpiwkpcn"jgtpkc"*39033/39035+"
5 3 .1 O t h e r b i l a t e r a l r e p a i r o f in g u in a l h e rn ia ®
Gzenwfgu<"ncrctqueqrke"dkncvgtcn"tgrckt"qh"kpiwkpcn"jgtpkc"*39043" 39046+"
5 3 .1 0 Bi l a t e r a l r e p a i r o f i n g u i n a l h e r n i a , n o t o t h e r w is e s p ec i f i e d
5 3 .1 1 O t h e r a n d o p e n b i l a t e r a l r e p a i r o f d i r ec t i n g u i n a l h e r n i a ®
5 3 .1 2 O t h e r a n d o p e n b i l a t e r a l r e p a i r o f i n d i r ec t i n g u i n a l h e r n i a ®
5 3 .1 3 O t h e r a n d o p e n b i l a t e r a l r e p a i r o f i n g u i n a l h e r n i a , o n e d i r e c t a n d
o n e i n d i r ec t ®
5 3 .1 4 O t h e r a n d o p e n b i l a t e r a l r e p a i r o f d i r ec t i n g u i n a l h e r n i a w i t h g r a f t
o r p r o s t h es i s ®
5 3 .1 5 O t h e r a n d o p e n b i l a t e r a l r e p a i r o f i n d i r ec t i n g u i n a l h e r n i a w i t h
g r a f t o r p r o s t h es i s ®
5 3 .1 6 O t h e r a n d o p e n b i l a t e r a l r e p a i r o f i n g u i n a l h e r n i a , o n e d i r e c t a n d
o n e i n d i r ec t , w i t h g r a f t o r p r o s t h es i s ®
5 3 .1 7 Bi l a t e r a l i n g u i n a l h e r n i a r e p a i r w i t h g r a f t o r p r o s t h es i s , n o t o t h e r w is e s p ec i f i e d
53
Repair of Groin HerniaQVJGT"OKUEGNNCPGQWU"FKCIPQUVKE"CPF"VJGTCRGWVKE"RTQEGFWTGU"*39+
1 7 .1 La p a rosco p ic u n i l a t e r a l r e p a i r o f i n g u in a l h e r n ia
Gzenwfgu<"qvjgt"cpf"qrgp"wpkncvgtcn"tgrckt"qh"jgtpkc"*75022" 75027+"
1 7 .1 1 La p a r o sc o p ic r e p a i r o f d i r ec t i n g u i n a l h e r n i a w i t h g r a f t o r
p r o s t h es i s- Laparoscopic repair of direct and indirect inguinal hernia with graft or
prosthesis
1 7 .1 2 La p a r o sc o p ic r e p a i r o f i n d i r ec t i n g u i n a l h e r n i a w i t h g r a f t o r
p r o s t h es i s-
1 7 .1 3 L a p a r o sc o p ic r e p a i r o f i n g u i n a l h e r n i a w i t h g r a f t o r p r o s t h es i s , n o t
o t h e r w is e s p ec i f i e d-
1 7 .2 La p a rosco p ic b i l a t e r a l r e p a i r o f i n g u in a l h e r n ia
Gzenwfgu<"qvjgt"cpf"qrgp"dkncvgtcn"tgrckt"qh"jgtpkc"*75032" "75039+"
1 7 .2 1 L a p a r o sc o p ic b i l a t e r a l r e p a i r o f d i r ec t i n g u i n a l h e r n i a w i t h g r a f t
o r p r o s t h es i s-
1 7 .2 2 La p a r o sc o p ic b i l a t e r a l r e p a i r o f i n d i r ec t i n g u i n a l h e r n i a w i t h
g r a f t o r p r o s t h es i s-
1 7 .2 3 La p a r o sc o p ic b i l a t e r a l r e p a i r o f i n g u i n a l h e r n i a , o n e d i r ec t a n d
o n e i n d i r ec t , w i t h g r a f t o r p r o s t h es i s-
1 7 .2 4 La p a r o sc o p ic b i l a t e r a l r e p a i r o f i n g u i n a l h e r n i a w i t h g r a f t o r
p r o s t h es i s , n o t o t h e r w is e s p ec i f i e d-
Gzenwfgu<"qvjgt"cpf"qrgp"rctvkcn"gzekukqp"qh"nctig"kpvguvkpg"*67093/"6709;+"
--
--
--
-
Gzenwfgu<"eqorwvgt"cuukuvgf"uwtigt{"*22053/22057."2205;+"
54
Repair of Groin Hernia
KEF/;/EO"VCDWNCT"NKUV"QH"RTQEGFWTGU"*H[32+"
146 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG
Gzenwfgu<"ocpwcn"tgfwevkqp"qh"jgtpkc"*;8049+"
Gzenwfgu<"ncrctqueqrke"wpkncvgtcn"tgrckt"qh"kpiwkpcn"jgtpkc"*39033/39035+"
Gzenwfgu<"ncrctqueqrke"dkncvgtcn"tgrckt"qh"kpiwkpcn"jgtpkc"*39043" 39046+"
5 3 .2 Un i l a t e r a l r e p a i r o f f e m ora l h e r n ia
5 3 .2 1 U n i l a t e r a l r e p a i r o f f e m o r a l h e r n i a w i t h g r a f t o r p r o s t h es i s
5 3 .2 9 O t h e r u n i l a t e r a l f e m o r a l h e r n i o r r h a p h y
5 3 .3 Bi l a t e r a l r e p a i r o f f e m or a l h e r n ia
5 3 .3 1 Bi l a t e r a l r e p a i r o f f e m o r a l h e r n i a w i t h g r a f t o r p r o s t h es i s
5 3 .3 9 O t h e r b i l a t e r a l f e m o r a l h e r n i o r r h a p h y
การนกการจยไเอนขาหบ
1. ระชดของไเอน
2. ระางของไเอน
3. ระภาวะแทรกอนของไเอน
การนกและใรสตถการอมไเอนขาหบ
1. ระางำตถการ
2. ระาใแนสเยมวมวยหอไ
3. ระเทคคของการำตถการ
55
Groin Hernia
Summary ProcedureICD-9-CM
Unilateral Bilateral
Herniotomy 53.02 53.12
Herniorrhaphy 53.00 53.10
Indirect herniorrhaphy
Direct herniorrhaphy
Femoral hernorrhaphy
53.02
53.01
53.29
53.12
53.11
53.39
Bassini herniorrhaphy
McVay herniorrhaphy
Shouldice herniorrhaphy
Furguson herniorrhaphy
?
?
?
?
?
?
?
?
56
Groin Hernia
Summary ProcedureICD-9-CM
Unilateral Bilateral
Hernioplasty 53.05 53.17
Indirect hernioplasty
Direct hernioplasty
Femoral hernoplasty
53.04
53.03
53.21
53.15
53.14
53.31
Indirect herniorrhaphy with mesh graft
Direct herniorrhaphy with mesh graft
Femoral herniorrhaphy with mesh graft
53.04
53.03
53.21
53.15
53.14
53.31
Lichtenstein hernioplasty
Plug and patch hernioplasty
?
?
?
?
57
Groin Hernia
Summary ProcedureICD-9-CM
Unilateral Bilateral
Laparoscopic hernioplasty 17.13 17.24
Laparoscopic indirect hernioplasty
Laparoscopic direct hernioplasty
17.12
17.11
17.22
17.21
58