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ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK41

K41

Non-billable

Femoral hernia

Chapter 11:Diseases of the digestive system

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K41 is a used to indicate a diagnosis of femoral hernia.

Key Diagnostic Point:

A femoral hernia occurs when tissue, often part of the intestine, protrudes through a weak spot in the femoral canal, located just below the inguinal ligament. This condition is more common in women and can present with symptoms such as a bulge in the groin area, pain or discomfort, especially when lifting or straining, and potential complications like incarceration or strangulation of the herniated tissue. The anatomical structures involved include the femoral canal, which contains lymphatics and the femoral vein, and the surrounding muscles and fascia. Disease progression may lead to increased pain and complications if not addressed promptly. Diagnosis typically involves a physical examination, where a bulge may be palpated, and imaging studies like ultrasound or CT scans may be utilized to confirm the diagnosis and assess for complications. Early diagnosis and intervention are crucial to prevent serious outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassifying femoral hernias as inguinal hernias.
  • Documentation gaps may arise if the clinical notes do not clearly indicate the type of hernia or any complications.
  • Billing challenges can occur if the procedure performed is not adequately documented or if the diagnosis is not supported by clinical evidence.

Specialty Focus

Medical Specialties

General Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Femoral hernias can significantly impact patient quality of life due to pain and discomfort, and they may lead to serious complications if not treated promptly. The prevalence of femoral hernias is lower than inguinal hernias, but they are critical to recognize due to their potential for incarceration and strangulation. Understanding the epidemiology of femoral hernias can help healthcare providers identify at-risk populations and improve surgical outcomes, ultimately enhancing healthcare utilization patterns.

ICD-9 vs ICD-10

Femoral hernias can significantly impact patient quality of life due to pain and discomfort, and they may lead to serious complications if not treated promptly. The prevalence of femoral hernias is lower than inguinal hernias, but they are critical to recognize due to their potential for incarceration and strangulation. Understanding the epidemiology of femoral hernias can help healthcare providers identify at-risk populations and improve surgical outcomes, ultimately enhancing healthcare utilization patterns.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the hernia repair procedure performed. Common denials may occur if the documentation does not support the diagnosis or if the procedure performed is not clearly linked to the diagnosis. Best practices include thorough documentation of the clinical rationale for surgery and ensuring that all coding guidelines are followed to minimize audit risks.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K41?

K41 specifically covers femoral hernias, which can be classified as either reducible or incarcerated. Incarcerated hernias may lead to strangulation, requiring urgent surgical intervention.

When should K41 be used instead of related codes?

K41 should be used when the hernia is specifically located in the femoral canal. It should not be used for inguinal hernias (K40) or umbilical hernias (K42), which have different anatomical locations and implications.

What documentation supports K41?

Documentation should include a detailed physical examination noting the presence of a bulge in the groin, any associated symptoms, imaging results if performed, and the clinical decision-making process leading to the diagnosis.