Rectus sheath hematoma

[donnajrichmond]

Has anybody found a better diagnosis for rectus sheath hematoma than 729.92?

[Grintwig]

How about 569.3 Hemorrhage of rectum and anus?

[donnajrichmond]

Rectus sheath hematoma is not the same thing as rectal bleeding. It's not in the rectum at all.

[ohn0disaster]

Rectus sheath is not your rectum/anus. It is formed by the aponeuroses of the Obliqui and Transversus. It contains the Rectus abdominis and Pyramidalis muscles.



A rectus sheath hematoma is an accumulation of blood in the sheath of the rectus abdominis muscle. It causes abdominal pain with or without a mass.

How about 922.2? I did not open my book to the tabular list but in the index, hematoma indicates "see also Contusion". Contusion of the abdominal wall = 922.2. However, if this code does not fit the documented discription, I would also go with the nonspecific code for hematoma of a muscle.

[donnajrichmond]

thanks Vanessa. If it said "rectus sheath hematoma caused by blunt trauma to abdomen" then I'd use 922.2. But when it doesn't give me that cause indicating trauma, and because it can be caused by violent coughing or vomiting I'm uncomfortable with 922.2. I was just hoping for something better!

[donnajrichmond]

thanks Vanessa. If it said "rectus sheath hematoma caused by blunt trauma to abdomen" then I'd use 922.2. But when it doesn't give me that cause indicating trauma, and because it can be caused by violent coughing or vomiting I'm uncomfortable with 922.2. I was just hoping for something better!

[ohn0disaster]

So it doesn't mention trauma in this case? Or it does? Does it mention nothing at all? If you have a chance to have the doctor clarify, I would do so. If nothing is written explaining the hematoma, the doc can add an addendum to further specify.

[preserene]

Non traumatic hematoma of soft tissues , nontraumatic hematoma of MUSCLE- 729.92