Chapter XI K35-K38 Disease of Appendix K40-K46 Disease of Appendix

นพ.บรรกษ เจรญศลป กลมงานศลยกรรม รพ.สวรรคประชารกษ นครสวรรค

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Appendicitis Appendicitis ICD-10 depend on ‘Abdominal Examination’ ICD-10 Version for 2010

กรณมการผาตดไสตง Summary Diagnosis ICD-10 Acute appendicitis with localized peritonitis Appendicitis K37 Acute appendicitis K35.8 : ตรวจพบ rebound tenderness/guarding ททองนอยขวา Acute appendicitis with localized peritonitis K35.3 : ไมวาจะเปน ruptured/accidental ruptured Acute inflammatory appendicitis K35.8 Acute appendicitis with generalized peritonitis Acute suppurative appendicitis K35.8 : ตรวจพบ rebound tenderness/guarding ทงสองฝง Acute gangrenous appendicitis K35.8 Ruptured appendicitis K35.8 : มกเปน ruptured รวมกบหนองกระจายทวทงชองทอง Appendiceal abscess K35.3 กรณไมมการผาตดไสตง Ruptured appendicitis with generalized peritonitis K35.2 สถานภาพจหนาย ตองไมใช improved-approval Peritonitis due to ruptured peritonitis K35.2 ยกเวน มหลกฐานยนยนการวนจฉย หรอ มขอหามตอการผาตด Chronic appendicitis K36

3 4 WHO’s ICD-10

----continued ----continued — see condition — see also Agenesis K31.8 Other specified diseases of stomach and duodenum (see also Achlorhydria Osteochondrosis) Gastroptosis Hourglass contraction of stomach K31.9 Disease of stomach and duodenum, unspecified Diseases of appendix (K35-K38) K35 Acute appendicitis K35.0 Acute appendicitis with generalized peritonitis Appendicitis (acute) with: · perforation · peritonitis (generalized)(localized) following rupture or perforation · rupture (see also K35.1 Acute appendicitis with peritoneal Infarctabscess, myocardium) Abscess of appendix (see also 4 6.8 7K35.2 O t h e r Acutei n s ert iappendicitiso n o f colo n iwithc s te generalizedn t(s) peritonitis Hemorrhage, intracerebral) Includes: Appendicitis that by: (acute) with generalized (diffuse) peritonitissee also Tabular List & Alphabetical Index fluoroscopic guidance only K31.8following Other rupture specified or perforation diseases of stomach and duodenum rectal guiding tube K35.3 Acute appendicitisAchlorhydria with localized peritonitis (see also Appendicitis Non- endoscopic insertion Hemorrhage, subarachnoid) Acute appendicitisGastroptosis with localized peritonitis with or without 2010 Code also any synchronous diagnostic procedure(s) ICD-10 Version for 2016 rupture orHo perforationurglass contraction of stomach Acute appendicitis with peritoneal abscess K31.9 Disease of stomach and duodenum, unspecified Summary Diagnosis ICD-10 4 6.9 O t heK35.8r o p e r aAcutetio n s appendicitis,on in testin otheres and unspecified 4 6.9 1 M y o t o DiseasesmAcutey o f sappendicitisi gm oofi d appendixcol owithoutn mention of localized or generalized Appendicitis K37 peritonitis 4 6.9 2 M y o t o(K35-K38)m y o f o th er p a rts o f colo n Acute appendicitis K35.8 4 6.9 3K35.9 Re v i s ioAcuten o f a nappendicitis,as t o m osis o unspecifiedf s m all i n te sti n e K35 Acute appendicitis Acute appendicitis with localized peritonitis K35.3 Acute appendicitis with peritonitis, localized or NOS 4 6.9 4 Re v isiK35.2o n o f a nAcuteas t om appendicitisosis o f l a r g ewith i n t egeneralizeds ti n e peritonitis Acute appendicitis without: 4 6.9 5 Local p e rf u si oAppendicitisn o f s m all i n(acute)tes ti n ewith generalized (diffuse) peritonitis Acute inflammatory appendicitis K35.8 · generalized peritonitis Code also substancefollowing perfused rupture (99.21- or perforation 99.29) Acute suppurative appendicitis K35.8 · perforation K35.3 Acute appendicitis with localized peritonitis 20164 6.9 6 Local p·e peritonealrf u sio n o fabscess l ar g e i ntes ti ne Acute gangrenous appendicitis K35.8 Code also · rupture substance Acute appendicitisperfused (99.21- (with 99.29)or without perforation or rupture) with Peritonitis : Ruptured appendicitis K35.3 4 6.9 7 T r a ns p l a n t o f i n tes ti n e · NOS Tabular List & Alphabetical Index K36 Other appendicitis Appendiceal abscess K35.3 Note: To report· localizeddonor source codes 00.91- 00.93 Appendicitis: 4 6.9 9 O t h e r Acute appendicitis with peritoneal abscess · chronic Ruptured appendicitis with generalized peritonitis K35.2 IleoentectropyK35.8 Acute appendicitis, other and unspecified · recurrent Peritonitis due to ruptured peritonitis K35.2 Acute appendicitis without mention of localized or generalized version for 2016peritonitis 1127 Version for 2010 467 Chronic appendicitis K36

K36 Other appendicitis Appendicitis: · chronic 5 6 · recurrent K37 Unspecified appendicitis

K38 Other diseases of appendix K38.0 Hyperplasia of appendix K38.1Appendectomy Appendicular concretions Appendectomy 4 7 O p e r a tion s o n a pFaecalithp e n d i x of appendix Includes: appendiceal‘Appendectomy Stercolithstump for} Appendicitis’ or ‘Not’ ’47.09’ for ‘All Technic of Appendectomy’ Code also anyK38.2 application Diverticulum or administration of appendix of an adhesion barrier substance (99.77) K38.3 Fistula of appendix Summary Procedure ICD-9-CM 4 7.0 A p p e n d ecto m y K38.8 Other specified diseases of appendix Appendectomy 47.09 Intussusception of appendix K38.9 Disease of appendix, unspecified Open appendectomy 47.09 Laparoscopic appendectomy 47.01 4 7.0 1 La p ar oversionsco p ic fora p p2016e n d e c to m y 467 4 7.0 9 O t h e r a p p e n d ec to m y Exploratory laparotomy to appendectomy 47.09

New code ® Revised code 4th digit required 131 Drainage of appendices abscess 47.2 Open drainage of abscess with appendectomy 47.09 4 7.1 Incid e n tal ap p e n d ecto m y Laparoscopic drainage of abscess with appendectomy 47.01 4 7.1 1 La p ar osco p ic i n ci d e n t al a p p e n d ect o m y 4 7.1 9 O t h e r i n ci d e n tal a p p e n d ect o m y Incidental open appendectomy 47.19 4 7.2 D rain a g e of a p p e n dice al a b scess Incidental laparoscopic appendectomy 47.11 4 7.9 O t h er o p eratio n s on ap p e n dix 4 7.9 1 A p p e n d icos t o m y 4 7.9 2 C los u r e o f a p p e n d ice al fis t u l a 4 7.9 97 O t h e r 8 Anastomosis of appendix

4 8 O p e r a tion s o n r ectu m, r ecto sig m oid a n d p e rirect al tissu e Code also any application or administration of an adhesion barrier substance (99.77) 4 8.0 Proctoto m y Decompression of imperforate anus Panas' operation [linear proctotomy] 4 8.1 Proctosto m y 4 8.2 D ia g nostic p roce d u res o n rect u m, rectosig m oid a n d p erirectal tissu e 4 8.2 1 T r a n s a b d o m i n al p r oc to si g m oi d osco p y Intraoperative proctosigmoidoscopy 4 8.2 2 Pr octosi g m oi d osco p y t h r o u g h a rtifici al s to m a 4 8.2 3 Ri g i d p r octosi g m oi d osco p y 4 8.2 4 C lo s e d [e n d osco p ic] b i o p s y o f r ect u m Brushing or washing for specimen collection Proctosigmoidoscopy with biopsy 4 8.2 5 O p e n b io p s y o f r ect u m 4 8.2 6 Bio p s y o f p erir ect al tis s u e 4 8.2 9 O t h e r d i a g n os tic p r oce d u r es o n r ect u m, r ectosi g m oi d a n d p erir ec tal tis s u e

132 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG ผาตด Exploratory laparotomy พบ ruptured appendicitis มหนองกระจายทว ผาตด Exploratory laparotomy พบ ruptured appendicitis มหนองกระจายทว ชองทอง ลไสบวม หลงตดไสตง ลางทองดวยนเกลออนกอนเยบปดชองทองดวย ชองทอง ลไสบวม หลงตดไสตง ลางทองดวยนเกลออนกอนเยบปดชองทองดวย retention suture แตไมเยบปดชนผวหนง หลงผาตดวนท 4 เยบปดแผลผาตด retention suture แตไมเยบปดชนผวหนง หลงผาตดวนท 4 เยบปดแผลผาตด ไมมภาวะแทรกซอน จหนายในวนท 10 ไมมภาวะแทรกซอน จหนายในวนท 10

Peritonitis K65.9 Exploratory laparotomy 54.11 Peritonitis due to ruptured appendicitis K35.2 Appendectomy 47.09 Ruptured appendicitis K35.8 Exploratory laparotomy to appendectomy 47.09 Ruptured appendicitis with generalized peritonitis K35.2 Peritoneal toilet 54.25 Op Op Intraabominal abscess K65.0 Retention suture - Ruptured appendicitis with intraabdominal abscess K35.3 Delayed primary closure 86.59 Appendiceal abscess K35.3 Resuture of abdominal wall 54.61 Appencitis K37 Suture of skin of abdomen 86.59

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K37 Unspecified appendicitis K37 Unspecified appendicitis

K38 Other diseases of appendix K38 Other diseases of appendix K38.0 Hyperplasia of appendix K38.0 Hyperplasia of appendix K38.0 Hyperplasia of appendix K38.1 Appendicular concretions K38.1 Appendicular concretions K38.1 Appendicular concretions Faecalith Faecalith Faecalith of appendix of appendix Stercolith } of appendix Stercolith } Stercolith } K38.2 Diverticulum of appendix K38.2 Diverticulum of appendix K38.2 Diverticulum of appendix K38.3 Fistula of appendix K38.3 Fistula of appendix K38.3 Fistula of appendix K38.8 Other specified diseases of appendix K38.8 Other specified diseases of appendix K38.8 OtherIntussusception specified of diseases appendix of appendix Hernia Intussusception of appendix Intussusception of appendix K38.9 Disease of appendix, unspecified K38.9 Disease of appendix, unspecified K38.9 Disease of appendix, unspecified Hernia Hernia Hernia (K40-K46) (K40-K46) (K40-K46) Note: Hernia with both gangrene and obstruction is classifiedNote: to Hernia with both gangrene and obstruction is classified to Note: herniaHernia withwith gangrene.both gangrene and obstruction is classified to hernia with gangrene. hernia with gangrene. Includes: hernia: Includes: hernia: Includes: ·hernia: acquired · acquired · congenitalacquired [except diaphragmatic or hiatus] · congenital [except diaphragmatic or hiatus] · congenitalrecurrent [except diaphragmatic or hiatus] · recurrent · recurrent K40 Inguinal hernia K40 Inguinal hernia Includes: K40 IInguinalncludes: herniabubonocele bubonocele Includes: inguinalbubonocele hernia: 11 inguinal hernia: 12 ·inguinal NOS hernia: · NOS · directNOS · direct · directdouble · double · indirectdouble · indirect · obliqueindirect · oblique scrotal· oblique hernia scrotal hernia K40.0 Bilateral inguinalscrotal hernia, hernia with obstruction, withoutK40.0 gangrene Bilateral inguinal hernia, with obstruction, without gangrene K40.0 Bilateral inguinal hernia, with obstruction, without gangrene K40.1 Bilateral inguinal hernia, with gangrene K40.1 Bilateral inguinal hernia, with gangrene K40.1 Bilateral inguinal hernia, with gangrene K40.2 Bilateral inguinal hernia, without obstruction K40.2or gangrene Bilateral inguinal hernia, without obstruction or gangrene K40.2 Bilateral inguinal inguinal hernia hernia, NOS with out obstruction or gangrene Bilateral inguinal hernia NOS Bilateral inguinal hernia NOS

468 468 WHO’s ICD-10 WHO’s ICD-10 468 WHO’s ICD-10 Special Hernia Groin Hernia Definitions ‘Clinical diagnosis’ difference from ‘ICD-10’

Littre’s hernia Hernia involving a Meckel’s diverticulum Indirect inguinal hernia (IIH) Direct inguinal hernia (DIH) Petersen’s hernia Seen after bariatric gastric bypass Femoral hernia (FH) ภาวะแทรกซอน Petit’s hernia Hernia through Petit’s triangle (inferior lumbar triangle) : Incarcerated hernia เปนไสเลอนทไมสามารถดนสวนทไหลออก

K37Hernia Unspecified through appendicitis Grynfeltt-Lesshaft triangle (superior lumbar Grynfeltt’s hernia กลบเขาไปในชองทองไดเอง triangle) K38 Other diseases of appendix : Strangulated hernia เปนไสเลอนททใหมการขาดเลอดไปเลยง K38.0Incarcerated Hyperplasia of orappendix strangulated hernia involving only one Richter’s hernia K38.1sidewall Appendicular of there concretions bowel ของสวนทไหลออกมาและเกดเนา (gangrene) ตามมาได Faecalith } of appendix Stercolith : เปนไสเลอนททใหมการอดตนของลไส Amyand’s herniaK38.2Hernia Diverticulum sac containing of appendix a ruptured appendix K38.3 Fistula of appendix

K38.8 Other specified diseases of appendix Intussusception of appendix K40.3 Unilateral or unspecified inguinal hernia, with obstruction, K38.9 Disease of appendix, unspecified 13 without gangrene 14 Inguinal hernia (unilateral): Hernia · causing obstruction · incarcerated (K40-K46) without gangrene Note: Hernia with both gangrene and obstruction is classified to · irreducible hernia with gangrene. · strangulated K40.4 Unilateral or unspecified inguinal hernia, with gangrene Includes: hernia: Inguinal hernia NOS with gangrene · acquired · congenital [except diaphragmatic or hiatus] K40.9 Unilateral or unspecified inguinal hernia, without obstruction Groin· recurrent Hernia or gangreneGroin Hernia Inguinal hernia (unilateral) NOS K40 Inguinal hernia Includes: K41 Femoral hernia bubonocele K41.0 Bilateral femoral hernia, with obstruction, without gangrene inguinal hernia: · NOS K41.1 Bilateral femoral hernia, with gangrene · direct K41.2 Bilateral femoral hernia, without obstruction or gangrene · double Bilateral femoral hernia NOS · indirect K41.3 Unilateral or unspecified femoral hernia, with obstruction, · oblique without gangrene scrotal hernia Femoral hernia (unilateral): K40.0 Bilateral inguinal hernia, with obstruction, without gangrene · causing obstruction K40.1 Bilateral inguinal hernia, with gangrene · incarcerated without gangrene · irreducible K40.2 Bilateral inguinal hernia, without obstruction or gangrene · strangulated Bilateral inguinal hernia NOS K40.3 Unilateral or unspecified inguinal hernia, with obstruction, K41.4 Unilateral or unspecified femoral hernia, with gangrene without gangrene K41.9 Unilateral or unspecified femoral hernia, without 468 Inguinal hernia (unilateral): WHO’s ICD-10 obstruction or gangrene · causing obstruction Femoral hernia (unilateral) NOS · incarcerated without gangrene · irreducible K42 Umbilical hernia · strangulated Includes: paraumbilical hernia K40.4 Unilateral or unspecified inguinal hernia, with gangrene Inguinal hernia NOS with gangrene Excludes: ( Q79.2 ) K42.0 Umbilical hernia with obstruction, without gangrene K40.9 Unilateral or unspecified inguinal hernia, without obstruction or gangrene Umbilical hernia: Inguinal hernia (unilateral) NOS · causing obstruction

· incarcerated K41 Femoral hernia without gangrene K41.0 Bilateral femoral hernia, with obstruction, without gangrene · irreducible K41.1 Bilateral femoral hernia, with gangrene · strangulated K41.2 Bilateral femoral hernia, 15without obstruction or gangrene 16 Bilateral femoral hernia NOS Version for 2010 469 K41.3 Unilateral or unspecified femoral hernia, with obstruction, without gangrene Femoral hernia (unilateral): · causing obstruction · incarcerated · irreducible without gangrene · strangulated 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 Includes: paraumbilical hernia Excludes: omphalocele ( Q79.2 ) K42.0 Umbilical hernia with obstruction, without gangrene Umbilical hernia: · causing obstruction · incarcerated · irreducible without gangrene · strangulated

Version for 2010 469 Groin Hernia Groin Hernia ‘Unilateral hernia’ or ‘Bilateral hernia’ Clinical Diagnosis ICD-10 Diagnosis Hernia Hernia ICD-10 Summary Diagnosis Reducible hernia Unilateral Bilateral Sliding hernia Inguinal hernia K40.9 K40.2 Pantaloon hernia [IIH & DIH] Indirect inguinal hernia K40.9 K40.2 Recurrent hernia Direct inguinal henia K40.9 K40.2 Incarcerated hernia Hernia with obstruction Femoral hernia K41.9 K41.2 Irreducible hernia Hernia K46.9 K46.9 Obstructed hernia Hernia with obstruction Incarcerated inguinal hernia K40.3 K40.0 Strangulated hernia Hernia with obstruction Obstructed inguinal henia K40.3 K40.0 Hernia with gangrene Hernia with gangrene Incarcerated femoral hernia K41.3 K41.0 Hernia with obstruction with gangrene Obstructed femoral hernia K41.3 K41.0 Obstructed hernia K46.0 K46.0

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Groin Hernia Groin Hernia ‘Strangulated’ in Clinical Diagnosis may difference from ICD-10 ‘Strangulated’ in Clinical Diagnosis may Gangrenous bowel or Viable bowel

ICD-10 ICD-10 Summary Diagnosis Summary Diagnosis Unilateral Bilateral Unilateral Bilateral Incarcerated indirect inguinal hernia K40.3 K40.0 Strangulated indirect inguinal hernia K40.3 K40.0 Incarcerated direct inguinal hernia K40.3 K40.0 Strangulated direct inguinal hernia K40.3 K40.0 Obstructed indirect inguinal henia K40.3 K40.0 Strangulated femoral hernia K41.3 K41.0 Obstructed direct inguinal hernia K40.3 K40.0 Indirect inguinal hernia with gangrene K40.4 K40.1 Incarcerated femoral hernia K41.3 K41.0 Direct inguinal hernia with gangrene K40.4 K40.1 Obstructed femoral hernia K41.3 K41.0 Femoral hernia with gangrene K41.4 K41.1

19 20 Repair of Hernia Repair of Hernia ‘Herniotomy’ ‘Herniorrhaphy’ ‘Hernioplasty’ ‘Herniorrhaphy’ Non-mesh repair vs Mesh repair Open and Non-mesh repair Open repair vs Laparoscopic repair : Herniotomy : Bassini herniorrhaphy : McVay herniorrhaphy : Shouldice herniorrhaphy : Halsted herniorrhaphy : Furguson herniorrphaphy

Other: Ball, Cattle, Dennis-Varco, Gross, Mayo, Moschowitz,….

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Repair of Hernia Repair of Hernia ‘Hernioplasty’ ‘Laparoscopic Herniorrhaphy’ ‘Laparoscopic Hernioplasty’ Open and Mesh repair Laparoscopic repair [all mesh repair] : Lichtenstein hernioplasty : Total extraperitoneal technique (TEP) : Plug and patch hernioplasty : Transabdominal preperitoneal approach (TAPP)

TEP TAPP

TAPP

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5 3 Re p air o f h e rn ia Includes: hernioplasty herniorrhaphy Code also any application or administration of an adhesion barrier substance (99.77) 5 3.0 O t h er u nilateral re p air o f in g uin al h er nia ® 5 3.0 0 U n il at er al r e p air o f i n g u i n al h er n i a, n o t o th e r w is e s p ecifie d Inguinal herniorrhaphy NOS 5 3.0 1 O t h e r a n d o p e n r e p air o f d ir ect i n g u i n al h er 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 air o f i n d ir ect i n g u i n al h er n i a ® 5 3 Re p air o f h e rn ia 5 3.0 3 O t h e r a n d o p e n r e p air o f d ir ect i n g u i n al h er n i a w i t h g r af t o r 5 3 Includes:Re p air ohernioplastyf h e rn ia p r os t h esis ® Includes: herniorrhaphy hernioplasty 5 3.0 4 O t h e r a n d o p e n r e p air o f i n d ir ect i n g u i n al h er n i a w it h g r af t o r Code alsoherniorrhaphy any application or administration of an adhesion barrier substance p r os t h esis ® Repair(99.77) of Groin Hernia Repair of Groin Hernia Code also any application or administration of an adhesion barrier substance 5 3.0 5 Re p air o f i n g u i n al h e r n i a w it h g r af t o r p r os t h esis, n o t o t h e r w is e (99.77) s p ecifie d 5 3.0 Ot h er u nilateral re p air o f in g u in al h er n ia ® 5 3.1 O t h er b ilateral re p air of in g u in al h ern ia ® 5 3.0 O t h er un ilateral re p air o f in g u in al h er nia ® 5 3.0 0 U nil at er al r e p air o f i n g u i n al h er n i a, n o t o th e r w is e sp ecifie d 5 3.1 0 Bil ater al r e p air o f i n g u i n al h e r n i a, n o t o t h er w is e s p ecifie d Inguinal herniorrhaphy NOS 5 3.0 0 U n il at er al r e p air o f i n g u i n al h er n i a, n o t o th e r w is e s p ecifie d 5 3.1 1 O t h e r a n d o p e n b il a ter al r e p air o f d ir ect i n g u i n al h er n i a ® 5 3.0 1 O tInguinalh e r a n d herniorrhaphyo p e n r e p air o fNOS d ir e ct i n g u i n al h er n i a ® Direct and indirect inguinal hernia 5 3.1 2 O t h e r a n d o p e n b il a ter al r e p air o f i n d ir ect i n g u i n al h er n i a ® 5 3.0 1 O t h e r a n d o p e n r e p air o f d ir ect i n g u i n al h er n i a ® 5 3.1 3 O t h e r a n d o p e n b il a ter al r e p air o f i n g u i n al h er n i a, o n e d ir e ct a n d 5 3.0 2 O tDirecth e r a nandd o pindirecte n r e p a inguinalir o f i n d iherniar ect i n g u i n al h er n i a ® o n e i n d ir ect ® 5 3..0032 OOtthheerr aanndd ooppeenn r reeppaairi ro of fd iinr edcitr ei nctg ui ni ngauli nhaelr nhiear nwiiat h ® g r af t o r p r os t h esis ® 5 3.1 4 O t h e r a n d o p e n b il a ter al r e p air o f d ir ect i n g u i n al h er n i a w i t h g r af t 5 3.0 3 O t h e r a n d o p e n r e p air o f d ir ect i n g u i n al h er n i a w i t h g r af t o r o r p r os t h esis ® 5 3.0 4 Optrhoesrt haensdi so ®p e n r e p air o f i n d ir ect i n g u i n al h er n i a w it h g r af t o r p r os t h esis ® 5 3.1 5 O t h e r a n d o p e n b il a ter al r e p air o f i n d ir ect i n g u i n al h er n i a w it h 5 3.0 4 O t h e r a n d o p e n r e p air o f i n d ir ect i n g u i n al h er n i a w it h g r af t o r g r af t o r p r os t h esis ® 5 3.0 5 Re p air o f i n g u i n al h e r n i a w it h g r af t o r p r os t h esis, n o t o t h e r w is e p r os t h esis ® s p ecifie d 5 3.1 6 O t h e r a n d o p e n b il a ter al r e p air o f i n g u i n al h er n i a, o n e d ir e ct a n d 5 3.0 5 Re p air o f i n g u i n al h e r n i a w it h g r af t o r p r os t h esis, n o t o t h e r w is e o n e i n d ir ect, w i t h g r af t o r p r os t h esis ® 5 3.1 O t h er sbpielcaitfeieradl re p air of in g u in al h ern ia ® 5 3.1 7 Bil ater al i n g u i n al h er n i a r e p air w it h g r af t o r p r os t h esis, n o t 5 3.1 O t h er b ilateral re p air of in g u in al h ern ia ® o th er w is e s p ecifie d 5 3.1 0 Bil ater al r e p air o f i n g u i n al h e r n i a, n o t o t h er w is e s p ecifie d 5 3.2 Un ilateral re p air o f fe m oral h er n ia 5 3.1 1 O t h e r a n d o p e n b il a ter al r e p air o f d ir ect i n g u i n al h er n i a ® 5 3.1 0 Bil ater al r e p air o f i n g u i n al h e r n i a, n o t o t h er w is e s p ecifie d 5 3.2 1 U n il at er al r e p air o f f e m o ral h er n i a w it h g r af t o r p r os t h esis 5 3.1 2 O t h e r a n d o p e n b il a ter al r e p air o f i n d ir ect i n g u i n al h er n i a ® 5 3.1 1 O t h e r a n d o p e n b il a ter al r e p air o f d ir ect i n g u i n al h er n i a ® 5 3.2 9 O t h e r u n il at er al f e m o r al h er n io r r h a p h y 5 3.1 3 O t h e r a n d o p e n b il a ter al r e p air o f i n g u i n al h er n i a, o n e d ir e ct a n d 5 3.1 2 O t h e r a n d o p e n b il a ter al r e p air o f i n d ir ect i n g u i n al h er n i a ® 5 3.3 Bilateral re p air o f f e m oral h er n ia o n e i n d ir ect ® 5 3.3 1 Bil ater al r e p air o f f e m o r al h er n i a w i t h g r af t o r p r os t h esis 5 3..1143 OOtthheerr aanndd ooppeenn b bilial ateter ar la lr er25pe paiari ro fo fd iirnegcut iinnaglu hi nearln ihae, ronni ae wdiitrhe cgtr a nf td 26 oorn per ionsdt hireescits ® ® 5 3.3 9 O t h e r b il at er al f e m o r al h e r n io rr h a p h y 5 3.1 4 O t h e r a n d o p e n b il a ter al r e p air o f d ir ect i n g u i n al h er n i a w i t h g r af t 5 3.1 5 O t h e r a n d o p e n b il a ter al r e p air o f i n d ir ect i n g u i n al h er n i a w it h 146 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG gorra pf tr osr tphreossitsh ®es is ® 5 3..1165 OOtthheerr aanndd ooppeenn b bilial ateter ar la lr er pe paiari ro fo fi n ignudiinr ealc th ienr gn iuai,n oanl eh edrirneicat waintdh ognrea fitn odrir pecr to, swt hi tehs igsr a®f t o r p r os t h esis ® 5 3..1176 BOiltahteerr aaln idn goupi ne nal bhiel ar ntei ar arle rpeapira iwr iot hf ignrgauf ti noarl phreorsntihae, soins,e n doitr e ct a n d Repairootnhee riwn disier e scpt,e wc iiftofihe d g r a f tGroin o r p r os t h esis ® Hernia 3 A O TRepairH ER MISC ELLA NE O U Sof DI A G NGroinOSTIC A N D T H E R AHerniaPE U TIC PR O C E D URES 5 3.2 5U3n.1il7a tBeirlalt erreapl ai nirg uoifn afel mh eorrnai al hr eepraniira w it h g r af t o r p r o s t h esis, n o t o th er w is e s p ecifie d 5 3.2 1 U n il at er al r e p air o f f e m o ral h er n i a w it h g r af t o r p r os t h esis 1 7 O th e r m isce ll a n e ou s p r oce d u r es 5 3.2 5 U3.n2i9l atOetrhaelr ruenpil aitre roalf ffeemmoor arla hl ehr en ironrirah a p h y 1 7.1 La p arosco pic u n ilateral re p air o f in g u in al h er n ia 5 3.2 1 U n il at er al r e p air o f f e m o ral h er n i a w it h g r af t o r p r os t h esis 5 3.3 Bilateral re p air o f f e m oral h er n ia 5 3.2 9 O t h e r u n il at er al f e m o r al h er n io r r h a p h y 1 7.1 1 La p ar osco p ic r e p air o f d ir ect i n g u i n al h er n i a w i t h g r af t o r 5 3.3 1 Bil ater al r e p air o f f e m o r al h er n i a w i t h g r af t o r p r o s t h esis p r os t h esis 5 3.3 5 B3i.3la9t eOr tahl erre bpilaaitre roafl fe m oorraal lh ehrenrino rirah a p h y Laparoscopic repair of direct and indirect inguinal hernia with graft or 5 3.3 1 Bil ater al r e p air o f f e m o r al h er n i a w i t h g r af t o r p r os t h esis prosthesis 146 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG 5 3.3 9 O t h e r b il at er al f e m o r al h e r n io rr h a p h y 1 7.1 2 La p ar osco p ic r e p air o f i n d ir ec t i n g u i n al h er n i a w it h g r af t o r p r os t h esis 146 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG 1 7.1 3 L a p ar osco p ic r e p air o f i n g u i n al h er n i a w it h g r af t o r p r os t h esis, n o t o th er w is e s p ecifie d 1 7.2 La p arosco pic bilateral re p air of in g u in al h er n ia 1 7.2 1 L a p a r osco p ic b il a ter al r e p air o f d ir ect i n g u i n al h er n i a w it h g r af t o r p r os t h esis 1 7.2 2 La p ar osco p ic b il a ter al r e p air o f i n d ir ec t i n g u i n al h er n i a w it h g r af t o r p r os t h esis 1 7.2 3 La p ar osco p ic b il a ter al r e p air o f i n g u i n al h er n i a, o n e d ir ect a n d o n e i n d ir ect, w i t h g r af t o r p r os t h esis 1 7.2 4 La p ar osco p ic b il a ter al r e p air o f i n g u i n al h er n i a w i t h g r af t o r p r os t h esis, n o t o th er w is e s p ecifie d 1 7.3 La p arosco pic p artial e xcisio n of lar g e in testin e 27 1 7.3 1 La p ar osco p ic m u lti p l e s e g m28e n t al r es ectio n o f l a r g e i n tes ti n e 1 7.3 2 La p ar osco p ic cecec to m y 1 7.3 3 La p ar osco p ic ri g h t h e m icolect o m y 1 7.3 4 La p ar osco p ic r es ectio n o f tr a n s v e rs e colo n 1 7.3 5 La p ar osco p ic lef t h e m icolec to m y 1 7.3 6 La p ar osco p ic si g m oi d ec to m y 1 7.3 9 O t h er l a p ar osco p ic p a rti al e x cisio n o f l ar g e i n t es ti n e 1 7.4 Ro b otic assiste d p roce d u res Computer assisted robotic surgery Computer- enhanced robotic surgery Robotic procedure with computer assistance Surgeon- controlled robotic surgery Code first primary procedure Note:This category includes use of a computer console with (3- D) imaging, software, camera(s), visualization and instrumentation combined with the use of robotic arms, device(s), or system(s) at the time of the procedure.

51 1 .1 OR procedure 0 .2 Non OR procedure but affects ThaiDRG Summary for Groin Hernia Groin Hernia

การบนทกและใหรหสการวนจฉยไสเลอนขาหนบ ICD-9-CM Summary Procedure 1. ระบชนดของไสเลอน Indirect – Direct – Femoral Unilateral Bilateral 2. ระบขางของไสเลอน Right / Left – Bilateral Herniotomy 53.02 53.12 3. ระบภาวะแทรกซอนของไสเลอน Herniorrhaphy 53.00 53.10 Obstructed / Incarcerated / Strangulated – Gangrenous Indirect herniorrhaphy 53.02 53.12 Direct herniorrhaphy 53.01 53.11 การบนทกและใหรหสหตถการซอมไสเลอนขาหนบ Femoral hernorrhaphy 53.29 53.39 1. ระบชนดของไสเลอน Indirect – Direct – Femoral Bassini herniorrhaphy ? ? 2. ระบขางททหตถการ Right / Left – Bilateral McVay herniorrhaphy ? ? 3. ระบวาใชแผนวสดเทยมรวมดวยหรอไม Prosthesis / Graft Shouldice herniorrhaphy ? ? Furguson herniorrhaphy ? ? 4. ระบเทคนคของการทหตถการ Laparoscopic

29 30

Groin Hernia Groin Hernia

ICD-9-CM ICD-9-CM Summary Procedure Summary Procedure Unilateral Bilateral Unilateral Bilateral Hernioplasty 53.05 53.17 Laparoscopic hernioplasty 17.13 17.24 Indirect hernioplasty 53.04 53.15 Laparoscopic indirect hernioplasty 17.12 17.22 Direct hernioplasty 53.03 53.14 Laparoscopic direct hernioplasty 17.11 17.21 Femoral hernioplasty 53.21 53.31 Indirect herniorrhaphy with mesh graft 53.04 53.15 Direct herniorrhaphy with mesh graft 53.03 53.14 Femoral herniorrhaphy with mesh graft 53.21 53.31 Lichtenstein hernioplasty ? ? Plug and patch hernioplasty ? ?

31 32 K42.1 Umbilical hernia with gangrene Gangrenous umbilical hernia K42.9 Umbilical hernia without obstruction or gangrene Umbilical hernia NOS

Abdominal Wall Hernia K43 Ventral hernia Includes: hernia: K41.2 Bilateral femoral hernia, without obstruction or gangrene Abdominal Wall· epigastric Hernia K42: Umbilical hernia K42.1 Umbilical hernia with gangrene · incisional Epigastric herniaBilateral femoral hernia NOS Gangrenous umbilical hernia K43: Ventral hernia K42.9 Umbilical hernia without obstruction or gangreneK43.0 Ventral hernia with obstruction, without gangrene K41.3 Unilateral or unspecified femoral hernia, with obstruction, Umbilical hernia NOS Ventral hernia: K45: Posterior/Internal hernia · causing obstruction K43 Ventral hernia without gangrene · incarcerated Includes: hernia: Femoral hernia (unilateral): · epigastric K45 Other· irreducible abdominal herniawithout gangrene · incisional Includes: hernia: Lumbar hernia · strangulated · causing obstruction Superior K43.0 Ventral hernia with obstruction, withoutRevision gangrene in· abdominal,2016 specified site NEC Lumbar hernia Ventral hernia: K43.1 Ventral hernia· lumbar with gangrene · incarcerated Inferior · causing obstruction · incarcerated Gangrenous· ventralobturator hernia without gangrene without gangrene · irreducible · irreducible K43.9 Ventral hernia· pudendal without obstruction or gangrene · strangulated Ventral hernia· retroperitoneal NOS · strangulated K43.1 Ventral hernia with gangrene · sciatic Gangrenous ventral hernia K41.4 Unilateral or unspecified femoral hernia, with gangrene K43.9 Ventral hernia without obstruction or gangreneK45.0 K44 OtherDiaphragmatic specified abdominal hernia hernia with obstruction, without Ventral hernia NOS gangrene hiatus hernia (oesophageal)(sliding) Includes: K41.9 Unilateral or unspecified femoral hernia, without K44 Any conditionparaoesophageal listed under K45: hernia K45 Other abdominal hernia Includes: hiatus hernia (oesophageal)(sliding) ·E causingxcludes: obstruction congenital hernia: obstruction or gangrene Includes: hernia:paraoesophageal hernia · abdominal, specified site NEC · incarcerated Excludes: congenital hernia: · diaphragmaticwithout ( Q79.0 gangrene ) Femoral hernia (unilateral) NOS · lumbar · irreducible · diaphragmatic ( Q79.0 ) · obturator · hiatus ( Q40.1 ) · hiatus ( Q40.1 ) · strangulated · pudendal K44.0 Diaphragmatic hernia with obstruction, without gangrene K42 Umbilical hernia K44.0 Diaphragmatic· retroperitoneal hernia with obstruction, withoutK45.1 gangrene Other specified abdominal hernia with gangrene Diaphragmatic· sciatic hernia: Diaphragmatic hernia: K42.1 Umbilical hernia with gangrene K42.1 Umbilical hernia Anywith condition gangrene listed under K45 specified as gangrenous K45.0 Other· causing specified obstruction abdominal hernia with obstruction, without · causing obstruction Includes: Gangrenous paraumbilical umbilical hernia hernia · incarcerated GangrenousK45.8 umbilical Other hernia specified abdominal hernia without obstruction or gangrene without gangrene · incarcerated K42.9 Umbilical hernia without obstruction or gangrene Any· irreducible condition listed underK42.9 K45: Umbilical hernia gwithoutangrene obstruction or gangrenewithout gangrene omphalocele ( Q79.2 ) ·· causingstrangulated obstruction · irreducible Excludes: Umbilical hernia NOS K44.1 ·Diaphragmatic incarcerated hernia with gangrene Umbilical K46hernia NOSUnspecified abdominal hernia without gangrene · strangulated K42.0 Umbilical hernia with obstruction, without gangrene ·Gangrenous irreducible diaphragmatic hernia Includes: enterocele K44.9 ·Diaphragmatic strangulated hernia without obstruction or K44.1gangrene Diaphragmatic hernia with gangrene K42.1 K43 UmbilicalVentral hernia with gangrene K42.1 K43 UmbilicalVentral hernia with gangreneepiplocele Umbilical hernia: K45.1 OtherDiaphragmatic specified hernia abdomina NOS l hernia with gangrene Gangrenous diaphragmatic hernia GangrenousIncludes: hernia: umbilical 33hernia Any condition listed under K45 specifiedGangrenousIncludes: as gangrenous hernia: umbilical 34hernia hernia: K44.9 Diaphragmatic hernia without obstruction or gangrene · K42.9causing Umbilical obstruction hernia· epigastric without obstruction or gangrene K45.8 Other specified abdominalK42.9 hern iaUmbilical without obstruction hernia· epigastric or without obstruction· NOS or gangrene gangrene Diaphragmatic hernia NOS Umbilical hernia· incisional NOS Umbilical hernia· incisional NOS · interstitial · incarcerated 470 WHO’s ICD-10 K43.0 Ventral hernia with obstruction, without gangrene K46 Unspecified abdominal K43.0 hernia Ventral hernia with obstruction,· intestinal without gangrene without gangrene Includes: enterocele · intra-abdominal · irreducible K43 Ventral hernia: hernia epiplocele K43 Ventral hernia: hernia · strangulated I· ncludes:causing obstructionhernia: hernia: I· ncludes:causing obstructionhernia: E xcludes: vaginal enterocele ( N81.5 ) · NOS K46.0 Unspecified abdominal hernia with obstruction, without Incisional· incarcerated / Parastomal· epigastric Hernia Incisional· interstitial · incarcerated / 470Parastomal· epigastric Hernia WHO’s ICD-10 K42.1 Umbilical· irreducible hernia· incisional with gangrene without gangrene · intestinal · irreducible· incisional gangrene without gangrene · intra-abdominal Any condition listed under K46: K43.0 Ventral· strangulated hernia with obstruction, without gangrene K43.0 Ventral· strangulated hernia with obstruction, without gangrene Gangrenous umbilical hernia Excludes: vaginal enterocele ( N81.5 ) · causing obstruction K43.1 Ventral hernia: hernia with gangrene K46.0 Unspecified abdominal K43.1 hernia withVentral obstruction, hernia: hernia without with · incarcerated gangrene · causing obstruction gangrene · causing obstruction without gangrene K42.9 Umbilical Gangrenous hernia ventral without hernia obstruction or gangrene Any condition listed under K46: Gangrenous ventral· irreduciblehernia · incarcerated · incarcerated UmbilicalK43.9 Ventral hernia hernia NOS without obstruction or gangrene · causing obstruction K43.9 Ventral hernia without· strangulated obstruction or gangrene · irreducible without gangrene · incarcerated · irreducible without gangrene Ventral hernia NOS without Ventral gangrene hernia K46.1 NOS Unspecified abdominal hernia with gangrene · strangulated · irreducible · strangulated · strangulated Any condition listed under K46 specified as gangrenous K43.1 K44 VentralDiaphragmatic hernia with hernia gangrene K46.1 Unspecified abdominalK43.1 K44 hernia withVentralDiaphragmatic gangrene hernia with hernia gangrene K43 Ventral hernia Any condition listed under K46 specified as gangrenousK46.9 Unspecified abdominal hernia without obstruction or gangrene GangrenousIncludes: ICD-10 ventralhiatus revisionhernia (oesophageal)(sliding) 2016 GangrenousIncludes: ICD-10 ventralhiatus revisionhernia (oesophageal)(sliding) 2016 K46.9 Unspecified abdominal hernia without obstruction or gangrene Abdominal hernia NOS K43.0 IncisionalK43.9 Ventral hernia herniaparaoesophageal with without obstruction, obstruction hernia or gangrene without gangrene AbdominalK43.3 hernia NOSParastomalK43.9 Ventral hernia herniaparaoesophageal withoutwith obstruction, obstruction hernia or gangrene without gangrene Incisional VentralExcludes: hernia: hernia congenital NOS hernia: Parastomal VentralExcludes: hernia: hernia Versioncongenital NOS for 2010 hernia: 471 · diaphragmatic ( Q79.0 ) Version for 2010 · diaphragmatic 471 ( Q79.0 ) · causingK44 Diaphragmatic obstruction· hiatus hernia ( Q40.1 ) · causing K44 Diaphragmatic obstruction· hiatus hernia ( Q40.1 )

· incarceratedK44.0 IDiaphragmaticncludes: hiatus hernia hernia with (oesophageal)(sliding) obstruction, without gangrene · incarcerated K44.0 IDiaphragmaticncludes: hiatus hernia hernia with (oesophageal)(sliding) obstruction, without gangrene paraoesophageal hernia paraoesophageal hernia · irreducible Diaphragmatic hernia: without gangrene · irreducible Diaphragmatic hernia: without gangrene E· causingxcludes: obstruction congenital hernia: E· causingxcludes: obstruction congenital hernia: · strangulated· incarcerated · diaphragmatic ( Q79.0 ) · strangulated· incarcerated · diaphragmatic ( Q79.0 ) without gangrene without gangrene · irreducible · hiatus ( Q40.1 ) · irreducible · hiatus ( Q40.1 ) K43.1 IncisionalK44.0 Diaphragmatic· strangulated hernia with hernia gangrene with obstruction, without gangrene K43.4 ParastomalK44.0 Diaphragmatic· strangulated hernia herniawith withgangrene obstruction, without gangrene Gangrenous K44.1 Diaphragmatic incisonal hernia: hernia hernia with gangrene Gangrenous K44.1 Diaphragmatic parastomal hernia: hernia hernia with gangrene ·Gangrenous causing obstruction diaphragmatic hernia ·Gangrenous causing obstruction diaphragmatic hernia K43.2 Incisional· incarcerated hernia without obstruction or gangrene K43.5 Parastomal· incarcerated hernia without obstruction or gangrene K44.9 Diaphragmatic hernia withouwithoutt obstruction gangrene or gangrene K44.9 Diaphragmatic hernia withouwithoutt obstruction gangrene or gangrene Incisional ·Diaphragmatic irreducible hernia NOS hernia NOS Parastomal ·Diaphragmatic irreducible hernia NOS hernia NOS · strangulated K43.6 Other and· strangulated unspecified ventral hernia with obstruction, version forK44.1 2016 Diaphragmatic hernia with gangrene 469 K44.1 Diaphragmatic hernia with gangrene Gangrenous diaphragmatic hernia without Gangrenousgangrene diaphragmatic hernia K44.9 Diaphragmatic hernia without obstruction or gangrene Hernia:K44.9 Diaphragmatic hernia without obstruction or gangrene 470 WHO’s ICD-10 470 WHO’s ICD-10 Diaphragmatic hernia 35NOS · epigastric Diaphragmatic hernia 36NOS

· hypogastric · midline 470 WHO’s ICD-10 · spigelian470 WHO’s ICD-10 · subxiphoid Any condition listed under K43.6 · causing obstruction · incarcerated · irreducible without gangrene · strangulated K43.7 Other and unspecified ventral hernia with gangrene Any condition listed under K43.6 specified as gangrenous K43.9 Other and unspecified ventral hernia without obstruction or gangrene Ventral hernia NOS

K44 Diaphragmatic hernia Includes: hiatus hernia (oesophageal)(sliding) paraoesophageal hernia Excludes: congenital hernia: · diaphragmatic ( Q79.0 ) · hiatus ( Q40.1 ) K44.0 Diaphragmatic hernia with obstruction, without gangrene Diaphragmatic hernia:

470 -10 K43.3 ParastomalK42.1 Umbilical hernia hernia with with obstruction, gangrene without gangrene K43.3 Parastomal Gangrenous hernia: hernia umbilical with obstruction, hernia without gangrene ·Parastomal causingK42.9 obstructionUmbilical hernia: hernia without obstruction or gangrene Umbilical hernia NOS · incarceratedcausing obstruction · irreducibleincarceratedK42.1 K43 UmbilicalVentral hernia with gangrenewithout gangrene · strangulatedirreducible GangrenousIncludes: hernia: umbilical herniawithout gangrene K42.9 Umbilical hernia· epigastric without obstruction or gangrene · strangulated K43.4K43.3 ParastomalParastomal Umbilical herniahernia hernia· incisional withwith NOS gangrene obstruction, without gangrene

K43.4 GangrenousParastomalK43.0 Ventral parastomalhernia hernia with with hernia obstrugangrenection, without gangrene Parastomal K43 Ventral hernia: hernia: hernia K43.5 ParastomalGangrenous· causing I·obstruction ncludes:causing parastomalhernia obstructionhernia: without hernia obstruction or gangrene Incisional· incarcerated / Parastomal· epigastric Hernia K43.5 Parastomal· incarcerated hernia hernia NOS without obstructionwithout gangrene or gangrene · irreducible· incisional without gangrene K43.6 OtherParastomal· irreducibleK43.0 and Ventral· strangulated unspecifiedhernia hernia NOS with ventral obstruction, hernia without with gangrene obstruction, Abdominal Wall Hernia K43.6 withoutOther· strangulated K43.1 and gangreneVentral unspecified hernia: hernia with ventral gangrene hernia with obstruction, Hernia:without gangrene·Gangrenous causing obstruction ventral hernia Ventral hernia = Anterior abdominal wall hernias except ‘Groin hernias’ K43.4 Parastomal· incarcerated hernia with gangrene K43.9 Ventral hernia without obstruction or gangrene ·Hernia: epigastric · irreducible without gangrene Gangrenous Ventral parastomal hernia NOS hernia Summary Diagnosis [revision 2016] ICD-10 · hypogastricepigastric· strangulated K43.5 Parastomal hernia without obstruction or gangrene · midlinehypogastricK43.1 K44 VentralDiaphragmatic hernia with hernia gangrene Ventral hernia K43.9 Parastomal hernia NOS · spigelianmidline GangrenousI ncludes: ICD-10 ventralhiatus revisionhernia (oesophageal)(sliding) 2016 paraoesophageal hernia Incisional hernia K43.2 K43.6 ·Other subxiphoidspigelianK43.9 and Ventral unspecified hernia without ventral obstruction hernia or gangrene with obstruction, without gangreneVentralExcludes: hernia congenital NOS hernia: Parastomal hernia K43.5 ·Any subxiphoid condition listed· diaphragmatic under K43.6 ( Q79.0 ) Hernia: K44 Diaphragmatic· hiatus hernia ( Q40.1 ) · Any causing condition obstruction listed under K43.6 Strangulated ventral hernia K43.6 · epigastric K44.0 IDiaphragmaticncludes: hiatus hernia hernia with (oesophageal)(sliding) obstruction, without gangrene Obstructed ventral hernia K43.6 · incarceratedcausing Diaphragmaticobstruction paraoesophageal hernia: hernia · hypogastric without gangrene ·· irreducibleincarceratedmidline E· causingxcludes: obstruction congenital hernia: Strangulated incisional hernia K43.0 · strangulatedirreducible· incarcerated · diaphragmaticwithout ( Q79.0 gangrene ) · spigelian · hiatus ( Q40.1 without ) gangrene Obstructed incisional hernia K43.0 · strangulated· irreducible K43.7 Other· subxiphoidK44.0 and Diaphragmatic· strangulated unspecified hernia ventral with obstruction, hernia with without gangrene gangrene Strangulated parastomal hernia K43.3 K43.7 AnyOther Any K44.1 condition condition and Diaphragmatic unspecified listed listed hernia:under herniaunder ventral K43.6with K43.6 gangrene hernia specified with as gangrene gangrenous ·Gangrenous causing obstruction diaphragmatic hernia Obstructed parastomal hernia K43.3 K43.9 OtherAny· causing condition and · obstructionincarcerated unspecified listed under ventral K43.6 hernia specified without as gangrenous obstruction or K44.9 Diaphragmatic hernia withouwithoutt obstruction gangrene or gangrene K43.9 gangreneOther· incarcerated and ·Diaphragmatic irreducible unspecified hernia v entralNOS hernia without obstruction or · strangulated Ventralgangrene· irreducible hernia NOS without gangrene K44.1 Diaphragmatic hernia with gangrene Ventral· strangulated herniaGangrenous NOS diaphragmatic hernia K44 DiaphragmaticK44.9 Diaphragmatic hernia hernia withou t obstruction or gangrene K43.7 Other470 and unspecified ventral hernia with gangrene WHO’s ICD-10 K44 Includes:Diaphragmatic Diaphragmatic hiatus hernia hernia 37NOS (oesophageal)(sl iding) 38 Any condition listed under K43.6 specified as gangrenous Includes: paraoesophagealhiatus hernia (oesophageal)(sl hernia iding)

K43.9 Other and unspecifiedparaoesophageal ventral hernia hernia without obstruction or Excludes:gangrene congenital hernia: Excludes:Ventral470 hernia ·congenital diaphragmatic NOS hernia: ( Q79.0 ) WHO’s ICD-10 · hiatusdiaphragmatic ( Q40.1 )( Q79.0 ) K44.0 K44 AbdominalDiaphragmaticDiaphragmatic· hiatus hernia hernia ( Q40.1 with Wall obstruction,) Hernia without gangrene Abdominal Wall Hernia K44.0 DiaphragmaticIncludes: hiatus hernia: hernia hernia with (oesophageal)(sl obstruction, withoutiding) gangrene Ventral herniaDiaphragmatic = Anteriorparaoesophageal hernia: abdominal wall hernia hernias except ‘Groin hernias’ ‘Anterior Abdominal Hernia’ Excludes: congenital hernia: Summary Diagnosis· diaphragmatic [revision ( 2016]Q79.0 ) ICD-10 Summary Diagnosis ICD-10 · hiatus ( Q40.1 ) Epigastric470 hernia K43.9 -10 Ventral hernia with gangrene K43.7 Hypogastric470K44.0 Diaphragmatic hernia hernia with obstruction, without gangreneK43.9 -10 Incisional hernia with gangrene K43.1 Spigelian herniaDiaphragmatic hernia: K43.9 Parastomal hernia with gangrene K43.4 Umbilical hernia K42.9 Epigastric hernia with gangrene K43.7 Strangulated / Obstructed epigastric hernia K43.6 Hypogastric hernia with gangrene K43.7 Spigelian hernia with gangrene K43.7 Strangulated470 / Obstructed hypogastric hernia K43.6 -10 Strangulated / Obstructed spigelian hernia K43.6 Umbilical hernia with gangrene K42.1 Strangulated / Obstructed umbilical hernia K42.0 ตองมหตถการของการตดตอลไสรวมดวยเสมอ

39 40 Abdominal Wall Hernia Internal Hernia ‘Posterior Abdominal Hernia’ ‘Intra-abdominal hernia’

Summary Diagnosis ICD-10 Summary Diagnosis ICD-10 Lumbar hernia K45.8 Internal hernia K46.9 Obturator hernia K45.8 Intra-abdominal hernia K46.9 Strangulated lumbar hernia K45.1 Strangulated internal hernia K46.0 Obstructed lumbar hernia K45.1 Obstructed internal hernia K46.0 Strangulated obturator hernia K45.1 Strangulated intra-abdominal hernia K46.0 Obstructed obturator hernia K45.1 Obstructed intra-abdominal hernia K46.0 Gangrenous lumbar hernia K45.0 Gangrenous internal hernia K46.0 Lumbar hernia with gangrene K45.0 Internal hernia with gangrene K46.0 Gangrenous obturator hernia K45.0 Gangrenous intra-abdominal hernia K46.0 Obturator hernia with gangrene K45.0 Intra-abdominal hernia with gangrene K46.0

ICD-9-CM TABULAR LIST OF PROCEDURES (FY15) ICD-9-CM TABULAR LIST OF PROCEDURES (FY15) ICDICD-9-CM TABULAR LIST OF PROCEDURES (FY(FY1515)) Excludes: repair of (54.71) 41 Excludes: repair of gastroschisis (54.71)42 53.41 Other and open repair of umbilical hernia with graft or prosthesis Excludes:53.41Excludes: Other repair and of opengastroschisis repair of (54.71) umbilical hernia with graft or prosthesis 53.42 Laparoscopic repair of umbilical hernia with graft or prosthesis 53.4153.4253.41 Other Laparoscopic and open repair repair of of umbilical umbilical hernia herniahernia with withwith graft graftgraft or ororprosthesis prostheprosthesissis 53.43 Other laparoscopic umbilical herniorrhaphy 53.4253.4353.42 LaparoscopicOther laparoscopic repair umbilical of umbilical herniorrhaphy herniahernia withwith graftgraft oror prosthesisprosthesis 53.49 Other open umbilical herniorrhaphy 53.4353.4953.43 OtherOther openlaparoscopic umbilical umbilical herniorrhaphy herniorrhaphy Excludes: other laparoscopic umbilical herniorrhaphy (53.43) 53.4953.49 Excludes:Other open other umbilical laparoscopic herniorrhaphy umbilical herniorrhaphy (53.43) repair of umbilical hernia with graft or prosthesis repair of umbilical hernia with graft or prosthesis Excludes: other laparoscopic umbilical herniorrhaphyherniorrhaphy( 53.41, ((53.4353.43 )53.42) ) Repair of Umbilical Hernia Repairrepair of(53.41, of umbilicalAbdominal 53.42) hernia withwith graftgraft oror prosthesisprosthesis Hernia 53.5 Repair of other hernia(53.41, of 53.42anterior53.5)) Repair abdominal of other wall hernia (without of anteriorgraft or abdominal wall (without graft or prosthesis) 53.553.5 Repairprosthesis) of other hernia of anterior abdominal wallwall (without(without graftgraft or or 5 3.4 Re p air o f u m bilical h er n ia prosthesis)53.51 Incisional hernia repair 53.51 Incisional hernia repair 53.59 Repair of other hernia of anterior abdominal wall 53.5153.5153.59 IncisionalIncisionalRepair of otherhernia hernia repair of anterior abdominal wall Repair of hernia: Repair of hernia: 5 3.4 1 O t h e r a n d o p e n r e p air o f u m b ilical h er n i a w it h g r af t o r p r o s t h esis ® 53.5953.59 Repair of other hernia of anterior abdominalabdominal wallwall epigastric epigastric Repair of hernia: 5 3.4 2 L a p ar osco p ic r e p air o f u m b ilical h er n i a w it h g r af t o r p r os t h esis hypogastric hypogastric epigastric spigelian spigelian 5 3.4 3 O t h e r l a p ar osco p ic u m b ilical h er n io r r h a p h y hypogastric ventral spigelianventral spigelian That by laparoscopic approach 5 3.4 9 O t h e r o p e n u m b ilical h er n io rr h a p h y ® That by laparoscopic approach ICD-9-CM 2015 ventral 53.6 Repair ofThat other by laparoscopic hernia of approachan 53.6 Repair of other hernia of an 53.6terior53.6 Repair abdominal of other wall hernia with graftof an or terior prosthesis abdominal wall with graft or prosthesis 53.61 Other open incisional hernia repair with graft or prosthesis 5 3.5 Re p air o f ot h er h er nia o f a n terior ab d o m in al w all (w ith o u t g ra f t or teriorterior53.61 abdominalabdominal Other open wall iwithncisional graft hernia or prosthesis repair with graft or prosthesis 53.62 Laparoscopic incisional hernia repair with graft or prosthesis p rost h esis) 53.6153.6153.62 Other Laparoscopic open incisional incisional hernia hernia repair repair withwith with graftgraft graft oror or prosthesisprosthesis prosthesis 53.63 Other laparoscopic repair of other hernia of anterior abdominal 5 3.5 1 In cisio n al h er n i a r e p air 53.6253.6253.63 LaparoscopicOther laparoscopic incisional repair hernia of other repair hernia withwith of graftgraft anterior oror prosthesisprosthesis abdominal wall with graft or prosthesis wall with graft or prosthesis 5 3.5 9 Re p air o f o th e r h er n i a o f a n terio r a b d o m i n al w all 53.6353.63 Other laparoscopic repair of other hernia ofof anterioranterior abdominalabdominal 53.69 Other and open repair of other53.69 hernia Other of anterior and open abdominal repair of wal otherl hernia of anterior abdominal wall Repair of hernia: wall with graft or prosthesis epigastric with graft or prosthesis with graft or prosthesis 53.69 Other and open repair of other hernia of anterior abdominal wall hypogastric 53.69 Other and open repair of other hernia of anterior abdominal wall Excludes:with graft other or prosthesis laparoscopic repair of otherExcludes: hernia other of anteriorlaparoscopic repair of other hernia of anterior spigelian with graft orabdominal prosthesis wall with graft or prosthesisabdominal (53.63) wall with graft or prosthesis (53.63) ventral Excludes: other laparoscopic repair ofof otherother herniahernia ofof anterioranterior 53.7 Repair of diaphragmaticabdominal hernia, wall53.7 with abdominalRepair graft oror of prosthesisprosthesis diaphragmatic approach ((53.6353.63 )) hernia, abdominal approach 5 3.6 Re p air o f ot h er h er n ia o f a n terior a b d o m in al w all w it h g raf t or 53.71 Laparoscopic repair of diaphragmatic53.71 Laparoscopic hernia, abdominal repair approachof diaphragmatic hernia, abdominal approach p rost h esis 53.753.7 Repair of diaphragmatic hernia, abdominal approachapproach 53.72 Other and open repair of diaphragmatic53.72 Other hernia, and openabdominal repair of diaphragmatic hernia, abdominal 5 3.6 1 O t h e r o p e n i n cisio n al h er n i a r e p air w it h g r af t o r p r os t h esis ® 53.71 Laparoscopic repair of diaphragmatic hernia, abdominal approach 43 53.71 approachLaparoscopic repair of diaphragmatic44 approach hernia, abdominal approach 5 3.6 2 La p ar osco p ic i n cisio n al h er n i a r e p air w i t h g r af t o r p r os t h esis 53.7253.72 Other and open repair of diaphragmatic hernia,hernia, abdominalabdominal 53.75 approachRepair of diaphragmatic hernia,53.75 abdominal Repair approach,of diaphragmatic not hernia, abdominal approach, not 5 3.6 3 O t h e r l a p ar osco p ic r e p air o f o t h er h er n i a o f a n t erio r a b d o m i n al approachotherwise specified otherwise specified 53.75 Repair of diaphragmatic hernia, abdominal approach, not w all w it h g r af t o r p r os t h esis 53.75 Repair of diaphragmatic hernia, abdominal approach, not otherwiseExcludes: laparoscopic specified repair of diaphragmaticExcludes: hernia laparoscopic (53.71 )repai r of diaphragmatic hernia (53.71) 5 3.6 9 O t h e r a n d o p e n r e p air o f o th e r h er n i a o f a n terio r a b d o m i n al w all otherwise other specified and open repair of diaphragmatic other hernia and (53.72 open )repair of diaphragmatic hernia (53.72) Excludes: laparoscopic repair of diaphragmatic hernia (53.71) w it h g r af t o r p r os t h esis® Excludes: laparoscopic repair of diaphragmatic hernia (53.71) 53.8 Repair of diaphragmatic other and open hernia, repair53.8 thoracicofRepair diaphragmatic of approach diaphragmatic hernia (53.72 hernia,) thoracic approach other and open repair of diaphragmatic hernia (53.72) 53.8 53.80Repair Repair of diaphragmatic of diaphragmatic hernia, hernia 53.80thoracic with thoracicRepair approach of approach, diaphragmatic not hernia with thoracic approach, not 53.8 Repairotherwise of diaphragmatic specified hernia, thoracicotherwise approach specified 53.80 Repair of diaphragmatic hernia with thoracic approach, not 5 3.7 Re p air o f dia p h ra g m atic h er n ia, a b d o m in al a p pro ach 53.80 RepairThoracoabdominal of diaphragmatic repair hernia of diaphragmatic with thoracicThoracoabdominal hernia approach, notrepair of diaphragmatic hernia otherwise specified 53.81 otherwisePlication of specified the diaphragm 53.81 Plication of the diaphragm 5 3.7 1 L a p ar osco p ic r e p air o f d i a p h r a g m atic h e r n i a, a b d o m i n al a p p r o ac h Thoracoabdominal repair of diaphragmatic hernia 53.82 RepairThoracoabdominal of parasternal repair hernia of diaphragmatic hernia 5 3.7 2 O t h e r a n d o p e n r e p air o f d i a p h r a g m a tic h er n i a, a b d o m i n al 53.81 Plication of the diaphragm 53.82 Repair of parasternal hernia 53.811 .1PlicationOR procedure of the diaphragm 012 Non OR procedure but affects ThaiDRG a p p r o ac h 152 53.82 Repair of parasternal hernia152 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG 53.82 Repair of parasternal hernia 5 3.7 5 Re p air o f d i a p h r a g m atic h er n i a, a b d o m i n al a p p r o ac h, n o t 152 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG o th er w is e s p ecifie d 152 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG 5 3.8 Re p air o f dia p h ra g m atic h er n ia, t h oracic a p p roach 5 3.8 0 Re p air o f d i a p h r a g m a tic h er n i a w it h t h o r acic a p p r o ac h, n o t o th er w is e s p ecifie d Thoracoabdominal repair of diaphragmatic hernia 5 3.8 1 Plicatio n o f t h e d i a p h r a g m

New code ® Revised code 4th digit required 147 Repair of Abdominal Hernia Repair of Abdominal Hernia ‘Incisional hernia’ ‘Umbilical hernia’ ‘Ventral hernia’ ‘Epigastric hernia’ ’Spigelian hernia’

Summary Procedure ICD-9-CM Summary Procedure ICD-9-CM [Open] Repair incisional hernia 53.51 [Open/Laparoscopic] Repair ventral hernia 53.59 [Open] Repair incisional hernia with graft 53.61 [Open] Repair ventral hernia with graft 53.69 Laparoscopic repair incisional hernia 53.62 [Open/Laparoscopic] Repair epigastric hernia 53.59 Laparoscopic repair incisional hernia with graft 53.62 [Open] Repair epigastric hernia with graft 53.69 [Open/Laparoscopic] Repair spigelian hernia 53.59 [Open] Umbilical herniorrhaphy 53.49 [Open] Repair spigelian hernia with graft 53.69 [Open] Umbilical herniorrhaphy with graft 53.41 Laparoscopic umbilical herniorrhaphy 53.43 Laparoscopic repair ventral hernia with graft 53.63 Laparoscopic repair epigastric hernia with graft 53.63 Laparoscopic umbilical herniorrhaphy with graft 53.42 Laparoscopic repair spigelian hernia with graft 53.63

K45 Other abdominal hernia ‘Incisional hernia procedure’ NOT ‘Ventral Includes: hernia hernia: procedure’ · abdominal, specified site NEC Laparoscopic สหรบไสเลอนเหลานมกจะใช Graft · lumbar · obturator · pudendal · retroperitoneal 45 · sciatic 46 K45.0 Other specified abdominal hernia with obstruction, without gangrene 5 3.8 2 Re p air o f p ar as t er n al h e r n i a Any condition listed under K45: · causing obstruction

5 3.8 3 La p ar osco p ic r e p air o f d i a p h r a g m·a incarceratedtic h er n i a , w i t h t h o r acic a p p r o ac h · irreducible without gangrene 5 3.8 4 O t h e r a n d o p e n r e p air o f d i a p h r a g· mstrangulateda tic h er n i a, w i t h t h o racic a p p r o ac h K45.1 Other specified abdominal hernia with gangrene Any condition listed under K45 specified as gangrenous Repair of Abdominal Hernia Repair of Abdominal Hernia K45.8 Other specified abdominal hernia without obstruction or gangrene ‘lumbar hernia’ ‘Obturator hernia’ ’Omental hernia’ 5 3.9 O t h er h ernia re p air K46 Unspecified abdominal hernia Repair of hernia: Includes: enterocele ischiatic epiplocele Summary Procedure ICD-9-CM ischiorectal hernia: lumbar · NOS [Open] Repair lumbar hernia 53.9 obturator · interstitial [Open] Repair obturator hernia 53.9 omental · intestinal retroperitoneal · intra-abdominal [Open] Repair omental hernia 53.9 sciatic Excludes: vaginal enterocele ( N81.5 ) [Open] Repair hernia 53.9 K46.0 Unspecified abdominal hernia with obstruction, without gangrene Any condition listed under K46: Laparoscopic repair lumbar hernia 53.9 + 54.21 · causing obstruction · incarcerated Laparoscopic repair obturator hernia 53.9 + 54.21 · irreducible without gangrene 5 4 O t h e r o p e r a tion s on a b d o mi n al r·e strangulatedg ion ® Laparoscopic repair omental hernia 53.9 + 54.21 K46.1 Unspecified abdominal hernia with gangrene Includes: operations on: Any condition listed under K46 specified as gangrenous epigastric region flank K46.9 Unspecified abdominal hernia without obstruction or gangrene groin region Abdominal hernia NOS Laparoscopic สหรบไสเลอนเหลานจะไมใช Graft hypochondrium inguinal region Version for 2010 471 loin region pelvic cavity mesentery omentum peritoneum 47 48 retroperitoneal tissue space Code also any application or administration of an adhesion barrier substance (99.77) 5 4.0 Incisio n of ab d o m in al w all Drainage of: abdominal wall extraperitoneal abscess retroperitoneal abscess 5 4.1 La p aroto m y 148 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG Diaphragmatic Hernia ‘Congenital hernia’ or ‘Acquired hernia’ Diaphragmatic Hernia ‘Congenital hernia’ or Not Congenital diaphragmatic hernia Summary Diagnosis ICD-10 : Morgagni hernia (retrosternal/parasternal) [Acquired] Diaphragmatic hernia K44.9 5 3.4 Reeppaaiirr ooff uummbbiliilcicaal lh herenrinai a : Bochdalek hernia (posterolateral) [Acquired] Hiatus hernia K44.9 5 3.4 1 O t h e r a n d o p e n r e p air o f u m b ilical h er n i a w it h g r af t o r p r o s t h esis ® [Acquired] Paraesophageal hernia K44.9 5 3.4 1 O t h e r a n d o p e n r e p air o f u m b ilical h er n i a w it h g r af t o r p r o s t h esis ® Acquired5 3.4 2 diaphragmatic L a p ar osco p ic r e p air o f u m b herniailical h er n i a w it h g r af t o r p r os t h esis 5 3.4 2 L a p ar osco p ic r e p air o f u m b ilical h er n i a w it h g r af t o r p r os t h esis Strangulated / Obstructed diaphragmatic hernia K44.0 5 3.4 3 O t h e r l a p ar osco p ic u m b ilical h er n io r r h a p h y 5 3.4 3 O t h e r l a p ar osco p ic u m b ilical h er n io r r h a p h y Strangulated / Obstructed hiatus hernia K44.0 : Hiatal hernia5 3.4 9 O t h e r o p e n u m b ilical h er n io rr h a p h y ® 5 3.4 9 O t h e r o p e n u m b ilical h er n io rr h a p h y ® Strangulated / Obstructed paraesophageal hernia K44.0 Sliding hernia Diaphragmatic hernia with gangrene K44.0 Paraesophageal hernia 5 3.5 Re p air o f ot h er h er nia o f a n terior ab d o m in al w all (w ith o u t g ra f t or Hiatus hernia with gangrene K44.0 5 3.5 pRreopsat hire osifs o) t h er h er nia o f a n terior ab d o m in al w all (w ith o u t g ra f t or : Traumatic5p3r.o5s1 t diaphragmatichInecsisisio) n al h er n i a r e p heair rnia Paraesophageal hernia with gangrene K44.0 5533..5591 RIne pciasiiro onfa ol thheerrn hi ae rrneipa aoirf a n terio r a b d o m i n al w all Congenital diaphragmatic hernia Q79.0 5 3.5 9 RRepaire p air ofo f hernia:o th e r h er n i a o f a n terio r a b d o m i n al w all Repairepigastric of hernia: Congenital hiatus hernia Q40.1 hypogastricepigastric spigelianhypogastric ventralspigelian 5 3.6 Re p air o f ventralot h er h er n ia o f a n teri49or a b d o m in al w all w it h g raf t or 50 5 3.6 pRreopsat hire osifs o t h er h er n ia o f a n terior a b d o m in al w all w it h g raf t or 5p3r.o6s1t hOet hseisr o p e n i n cisio n al h er n i a r e p air w it h g r af t o r p r os t h esis ® 5533..6621 LOatphaerro ospcoepni ci n icnicsiisoionnaal lh heerrnni iaa rreeppaaiirr w iitth gr afftt oorr pprroosstthheessisis ® 5533..6632 OLtahpearr loaspcaorpoiscc oi npcicis rieopnaailr hoef rontihae rre hpearinr iwa iotfh agnrtaefrti oorr apbrdoosmt hi neasli s w all w it h g r af t o r p r os t h esis 5 3.6 3 O t h e r l a p ar osco p ic r e p air o f o t h er h er n i a o f a n t erio r a b d o m i n al 5 3.6 9 Owtahlel rw aint hd ogpr aefnt roerp pairro osft hoetshiesr h e r n i a o f a n terio r a b d o m i n al w all w it h g r af t o r p r os t h esis® Repair5 3.6 9 O t hofe r a n d Diaphragmatico p e n r e p air o f o th e r h er n i a o f a n terio r a b d oHerniam i n al w all Repair of Diaphragmatic Hernia w it h g r af t o r p r os t h esis® Abdominal route or Thoracic route ‘Abdominal route or Thoracic route’ and ‘Open or MIS’ 5 3.7 Re p air o f dia p h rag m atic h er n ia, a b d o m in al a p pro ach 5 3.7 1 L a p ar osco p ic r e p air o f d i a p h r a g m atic h e r n i a, a b d o m i n al a p p r o ac h 5 3.7 Re p air o f dia p h ra g m atic h er nia, a b d o m in al a p pro ach Summary Procedure ICD-9-CM 5 3.7 2 O t h e r a n d o p e n r e p air o f d i a p h r a g m a tic h er n i a, a b d o m i n al 5 3.7 1 a Lpappr oaar oc hs co p ic r e p air o f d i a p h r a g m atic h e r n i a, a b d o m i n al a p p r o ac h Exploratory laparotomy to repair diaphragmatic hernia 53.72 5 33..7752 ROetphaeir oafn d i aoppherna gr empaatiirc ohfe rdniiaap, harbadgommai ntiacl haeprpnrioaa, cahb, dnoomt i n al Thoracotomy to repair diaphragmatic hernia 53.84 oatphper owaisceh sp e cifie d 5 3.7 5 Re p air o f d i a p h r a g m atic h er n i a, a b d o m i n al a p p r oac h, no t Thoracoabdominal repair diaphragmatic hernia 53.80 o th er w ise s p ecifie d 5 3.8 Re p air o f dia p h ra g m atic h er n ia, t h oracic a p p roach Laparoscopic repair diaphragmatic hernia 53.71 5 3.8 0 Re p air o f d i a p h r a g m a tic h er n i a w it h t h o r acic a p p r o ac h, n o t Thoracoscopic repair diaphragmatic hernia 53.83 5 3.8 Re p aiort hoefr wdiisaep shpreacgifmie da tic h er nia, t h oracic a p p roach Thoracoabdominal repair of diaphragmatic hernia 5 3.8 0 Re p air o f d i a p h r a g m a tic h er n i a w it h t h o r acic a pp r o ac h, n o t Repair diaphragmatic hernia 53.75 5 3.8 1 Politchaetriowni soef stph e cdiifaiepdh r a g m 5 3.8 2 RThoracoabdominale p air o f p ar as t er n a repairl h e r n iofa diaphragmatic hernia Repair parasternal hernia 53.82 5 33..8831 P LNewlaicpaatr icodeoosnc oo pf itc®h re e Revisedpdai airp ohfr acodedgi amp h r ag m 4atht idigitc h e rrequiredn i a, w i t h t h o r a c i c 147 a p p r o ac h 5 3.8 4 O Newt h e r codea n d o pe®n rRevisede p air o fcode d i a p h ra g m 4atht idigitc h e rrequiredn i a, w i t h t h o r a c i c 147 Parasternal hernia = Morgagni hernia a p p r o ac h Thoracoscopic or Laparoscopic approach are also used. 5 3.9 O t h er h ernia re p air Repair of hernia: ischiatic 51 52 ischiorectal lumbar obturator omental retroperitoneal sciatic

5 4 O t h e r o p e r a tion s on a b d o mi n al re g ion ® Includes: operations on: epigastric region flank groin region hypochondrium inguinal region loin region pelvic cavity mesentery omentum peritoneum retroperitoneal tissue space Code also any application or administration of an adhesion barrier substance (99.77) 5 4.0 Incisio n of ab d o m in al w all Drainage of: abdominal wall extraperitoneal abscess retroperitoneal abscess 5 4.1 La p aroto m y 148 1 .1 OR procedure 012 Non OR procedure but affects ThaiDRG