Diaphragmatic hernia with gangrene

This code signifies a diaphragmatic hernia that has progressed to tissue necrosis (gangrene). This is a severe complication where a portion of an organ (typically intestine or stomach) herniated through the diaphragm has lost its blood supply, leading to irreversible tissue damage.

Apply this code when documentation clearly indicates a diaphragmatic hernia complicated by gangrene, often presenting with signs of sepsis, peritonitis, or bowel obstruction. This typically occurs in incarcerated or strangulated hernias where vascular compromise has occurred.

• Ensure physician documentation explicitly states "gangrene" or describes necrotic tissue in the context of a diaphragmatic hernia.
• Do not use this code for uncomplicated diaphragmatic hernias or those with only incarceration or obstruction without documented gangrene.
• Sequence this code as the principal diagnosis when it is the primary reason for the admission, followed by codes for any associated complications like peritonitis or sepsis.