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ICD-10 Guide
ICD-10 CodesK41.20

K41.20

Billable

Bilateral femoral hernia, without obstruction or gangrene, not specified as recurrent

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

Code Description

ICD-10 K41.20 is a billable code used to indicate a diagnosis of bilateral femoral hernia, without obstruction or gangrene, not specified as recurrent.

Key Diagnostic Point:

A bilateral 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 characterized by the presence of herniated tissue on both sides of the groin. Patients may present with a bulge in the groin area, which may or may not be painful. Symptoms can include discomfort, especially during activities that increase intra-abdominal pressure, such as lifting or straining. The anatomy involved includes the femoral canal, femoral vein, and surrounding connective tissues. Disease progression can lead to complications such as incarceration or strangulation, although K41.20 specifies that there is no obstruction or gangrene present. Diagnostic considerations include physical examination and imaging studies, such as ultrasound or CT scans, to confirm the presence of the hernia and rule out other conditions. It is crucial for healthcare providers to differentiate between a femoral hernia and other types of hernias, such as inguinal hernias, to ensure accurate diagnosis and treatment.

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 the type of hernia or failing to specify bilateral involvement.
  • Documentation gaps may arise if the clinical notes do not clearly indicate the absence of obstruction or gangrene.
  • Billing challenges can occur if the hernia is incorrectly coded as recurrent without proper documentation.

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

Bilateral femoral hernias can significantly impact patient quality of life, leading to discomfort and potential complications if left untreated. Understanding the epidemiology of hernias, including risk factors such as obesity and physical activity, can aid in population health strategies. Effective management and coding of this condition contribute to improved healthcare utilization patterns and quality measures in surgical care.

ICD-9 vs ICD-10

Bilateral femoral hernias can significantly impact patient quality of life, leading to discomfort and potential complications if left untreated. Understanding the epidemiology of hernias, including risk factors such as obesity and physical activity, can aid in population health strategies. Effective management and coding of this condition contribute to improved healthcare utilization patterns and quality measures in surgical care.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, the patient's clinical status, and the payer's specific guidelines. Common denials may arise from insufficient documentation or incorrect coding of the hernia type. Best practices include ensuring that all clinical notes are thorough and that the coding accurately reflects the diagnosis to avoid billing issues.

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 K41.20?

K41.20 covers bilateral femoral hernias that are not obstructed or gangrenous and are not specified as recurrent. It is important to document the absence of complications to ensure accurate coding.

When should K41.20 be used instead of related codes?

K41.20 should be used when the hernia is bilateral, without obstruction or gangrene, and not recurrent. If there are complications such as obstruction or gangrene, the appropriate codes K41.21 or K41.22 should be selected.

What documentation supports K41.20?

Documentation should include a clear diagnosis of bilateral femoral hernia, details of the clinical examination, imaging results, and confirmation that there are no complications such as obstruction or gangrene.