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ICD-10 Guide
ICD-10 CodesK41.11

K41.11

Billable

Bilateral femoral hernia, with gangrene, recurrent

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

Code Description

ICD-10 K41.11 is a billable code used to indicate a diagnosis of bilateral femoral hernia, with gangrene, recurrent.

Key Diagnostic Point:

K41.11 refers to a bilateral femoral hernia that is recurrent and has progressed to gangrene. A femoral hernia occurs when tissue, often part of the intestine, protrudes through a weak spot in the femoral canal, which is located just below the inguinal ligament. This condition is more common in women and can lead to serious complications if not treated promptly. Clinical presentation typically includes a bulge in the groin area, pain, and signs of bowel obstruction. In cases where gangrene develops, there is a risk of tissue death due to compromised blood supply, necessitating urgent surgical intervention. Disease progression can lead to severe complications, including sepsis, if the hernia is not addressed. Diagnostic considerations involve physical examination, imaging studies such as ultrasound or CT scans, and assessment of the patient's history of hernia repair, as recurrent hernias are often more complex to manage. Prompt diagnosis and treatment are critical to prevent serious outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors include misidentifying the hernia type or failing to document recurrence.
  • Documentation gaps may arise from insufficient clinical details regarding the gangrene or previous hernia repairs.
  • Billing challenges often stem from the need for detailed operative reports and justification for surgical interventions.

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 ICD-10 Codes

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

The clinical significance of K41.11 lies in its potential for severe complications, including bowel necrosis and sepsis, which can lead to increased morbidity and mortality. The population health impact is notable, as femoral hernias can affect a significant number of individuals, particularly women. Quality measures related to timely surgical intervention and postoperative outcomes are critical in managing this condition. Healthcare utilization patterns may reflect higher rates of emergency surgeries and hospital admissions due to complications arising from untreated or recurrent hernias.

ICD-9 vs ICD-10

The clinical significance of K41.11 lies in its potential for severe complications, including bowel necrosis and sepsis, which can lead to increased morbidity and mortality. The population health impact is notable, as femoral hernias can affect a significant number of individuals, particularly women. Quality measures related to timely surgical intervention and postoperative outcomes are critical in managing this condition. Healthcare utilization patterns may reflect higher rates of emergency surgeries and hospital admissions due to complications arising from untreated or recurrent hernias.

Reimbursement & Billing Impact

Reimbursement may be affected by the complexity of the case, and payers may require additional documentation to justify surgical interventions. Common denials can occur if the documentation does not clearly establish the recurrent nature of the hernia or the presence of gangrene. Coding best practices include using the most specific code available and ensuring that all relevant clinical details are captured in the medical record.

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 K41.11?

K41.11 specifically covers bilateral femoral hernias that are recurrent and have developed gangrene. This includes cases where the hernia has previously been repaired but has recurred, leading to complications such as strangulation and necrosis of the bowel.

When should K41.11 be used instead of related codes?

K41.11 should be used when there is a documented bilateral femoral hernia that is recurrent and has progressed to gangrene. If the hernia is unilateral or not recurrent, other codes such as K41.0 or K41.9 should be considered.

What documentation supports K41.11?

Documentation must include a detailed history of the patient's hernia, evidence of recurrence, clinical findings of gangrene, and any imaging studies that support the diagnosis. Operative reports detailing the surgical intervention and findings are also essential.