K40-K46
Medium Complexity
Hernia
Primary Specialty: General Surgery
Last Updated: 2025-09-10
ICD-10 Codes (45)
33 billable6 category headers
K41K41.0K41.00Billable
K41.01Billable
K41.1K41.10Billable
K41.11Billable
K41.2K41.20Billable
K41.21Billable
K41.3K41.30Billable
K41.31Billable
K41.4K41.40Billable
K41.41Billable
K41.9K41.90Billable
K41.91Billable
K42K42.0Billable
K42.1Billable
K42.9Billable
K43K43.0Billable
K43.1Billable
K43.2Billable
K43.3Billable
K43.4Billable
K43.5Billable
K43.6Billable
K43.7Billable
K43.9Billable
K44K44.0Billable
K44.1Billable
K44.9Billable
K45K45.0Billable
K45.1Billable
K45.8Billable
K46K46.0Billable
K46.1Billable
K46.9Billable
Updates & Changes
FY 2026 Updates
Current Year
New Codes (1)
K50.919
Crohn's disease, unspecified, with perianal disease complications
Revised Codes (2)
K51.90
Ulcerative colitis, unspecified, without complications - updated endoscopic severity scoring
K50.90
Crohn's disease, unspecified, without complications - enhanced phenotyping
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for K40-K46 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
high priority
The ICD-10 code range K40-K46 is specifically designed to classify various types of hernias. This includes inguinal hernias, femoral hernias, umbilical hernias, ventral hernias, and other abdominal hernias. These codes are further divided based on whether the hernia is unilateral or bilateral, obstructed or gangrenous, and recurrent or not. The range also includes codes for hernias without mention of obstruction or gangrene.
Key Usage Points:
- •Always specify the type of hernia in the documentation.
- •Identify if the hernia is unilateral or bilateral.
- •Specify if the hernia is obstructed or gangrenous.
- •Include if the hernia is recurrent.
- •Use additional codes to identify any associated conditions.
Coding Guidelines
When to Use:
- ✓When a patient presents with an inguinal hernia.
- ✓When a patient has a femoral hernia.
- ✓When a patient is diagnosed with an umbilical hernia.
- ✓When a patient has a ventral hernia.
- ✓When a patient is diagnosed with another abdominal hernia.
When NOT to Use:
- ✗When a patient has a hernia in a location other than the abdomen.
- ✗When a patient has a diaphragmatic hernia.
- ✗When a patient has a hiatal hernia.
- ✗When a patient has a hernia of the spinal disc.
- ✗When a patient has a hernia of the anterior abdominal wall.
Code Exclusions
Always verify exclusions before assigning a code from the K40-K46 range.
Documentation Requirements
Documentation for hernias should be comprehensive and include the type of hernia, its location, whether it is unilateral or bilateral, and if it is obstructed or gangrenous. Recurrence of the hernia should also be noted.
Clinical Information:
- •Type of hernia
- •Location of hernia
- •Unilateral or bilateral
- •Obstructed or gangrenous
- •Recurrence
Supporting Evidence:
- •Clinical notes
- •Imaging reports
- •Surgical reports
- •Pathology reports
Good Documentation Example:
Patient presents with a recurrent, bilateral inguinal hernia with obstruction.
Poor Documentation Example:
Patient has a hernia.
Common Documentation Errors:
- âš Not specifying the type of hernia
- âš Not indicating if the hernia is unilateral or bilateral
- âš Not documenting if the hernia is obstructed or gangrenous
- âš Not noting if the hernia is recurrent
Range Statistics
7
Total Codes
33
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:11
Coding Complexity
Medium
Complexity Rating
The coding complexity for the K40-K46 range is medium due to the need to accurately identify the type of hernia, its location, whether it is unilateral or bilateral, and if it is obstructed or gangrenous. The recurrence of the hernia also needs to be noted, and additional codes may be necessary to identify any associated conditions.
Key Factors:
- â–¸Determining the type of hernia
- â–¸Identifying if the hernia is unilateral or bilateral
- â–¸Determining if the hernia is obstructed or gangrenous
- â–¸Identifying if the hernia is recurrent
- â–¸Using additional codes for associated conditions
Specialty Focus
The K40-K46 code range is most commonly used by general surgeons, gastroenterologists, and emergency medicine physicians.
Primary Specialties:
General Surgery
60%
Gastroenterology
25%
Emergency Medicine
15%
Clinical Scenarios:
- • A patient presents to the emergency department with severe abdominal pain and is diagnosed with a gangrenous umbilical hernia.
- • A patient is seen in the general surgery clinic for a recurrent, bilateral inguinal hernia.
- • A patient is diagnosed with a femoral hernia during a colonoscopy performed by a gastroenterologist.
- • A patient presents to the emergency department with a ventral hernia with obstruction.
- • A patient is seen in the general surgery clinic for a recurrent, unilateral inguinal hernia without obstruction.
Resources & References
The ICD-10-CM Official Guidelines for Coding and Reporting, the American Hernia Society, and various medical coding textbooks are valuable resources for coding hernias.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Hernia Society
- Medical Coding Textbooks
Clinical References:
- Clinical Notes
- Imaging Reports
- Surgical Reports
Educational Materials:
- ICD-10-CM Coding Handbook
- Online Medical Coding Courses
- Medical Coding Webinars
Frequently Asked Questions
Can I use a K40-K46 code for a diaphragmatic hernia?
No, diaphragmatic hernias have their own specific code, K44.