Hernias ICD-10-CM codes

Inguinal hernia (K40) is coded by bilateral versus unilateral, by complication, and by recurrence. Unilateral without obstruction or gangrene is K40.90 (or K40.91 if recurrent), bilateral is K40.20 or K40.21, unilateral with obstruction is K40.30, bilateral with obstruction is K40.00, and gangrene is K40.4- (unilateral) or K40.1- (bilateral). ICD-10-CM does not record right or left for hernias, only unilateral or bilateral. Femoral hernia (K41) follows the identical structure.

The terms incarcerated, irreducible, and strangulated all map to the with-obstruction codes, and a strangulated hernia with gangrene maps to the gangrene codes. Because the hernia code includes the obstruction, do not add a K56 intestinal obstruction code; K56 excludes obstruction due to hernia.

Umbilical hernia is K42 (K42.9 uncomplicated, K42.0 with obstruction, K42.1 with gangrene). Ventral hernias are K43: incisional K43.0 to K43.2, parastomal K43.3 to K43.5, and other ventral hernias such as epigastric or spigelian K43.6, K43.7, and K43.9. K45 is for other specified abdominal hernias and K46 for an unspecified abdominal hernia.

Hiatal and paraesophageal hernias are classified to K44 as diaphragmatic hernia: K44.9 uncomplicated, K44.0 with obstruction, and K44.1 with gangrene. Congenital diaphragmatic hernia is Q79.0. When GERD is documented with a hiatal hernia, report both K44.9 and K21.9.