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ICD-10 Guide
ICD-10 CodesK41.21

K41.21

Billable

Bilateral femoral hernia, without obstruction or gangrene, recurrent

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

Code Description

ICD-10 K41.21 is a billable code used to indicate a diagnosis of bilateral femoral hernia, without obstruction or gangrene, recurrent.

Key Diagnostic Point:

K41.21 refers to a bilateral femoral hernia that is recurrent and not accompanied by obstruction or 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. In bilateral cases, both sides of the groin are affected. Clinically, patients may present with a bulge in the groin area, discomfort, or pain, especially during activities that increase abdominal pressure, such as lifting or straining. Over time, recurrent hernias can develop due to factors like increased intra-abdominal pressure, obesity, or connective tissue disorders. Diagnosis typically involves a physical examination and may be confirmed through imaging studies such as ultrasound or CT scans. It is crucial to differentiate K41.21 from other hernia codes, particularly those indicating obstruction or gangrene, as these conditions require different management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm recurrence and rule out complications.
  • Treatment complexity: Surgical intervention is often needed, with considerations for anesthesia and potential complications.
  • Documentation requirements: Detailed documentation of recurrence, symptoms, and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other hernia types and complications.

Audit Risk Factors

  • Common coding errors: Misclassification of the hernia type or failure to document recurrence.
  • Documentation gaps: Incomplete records regarding the patient's history of hernia and treatment outcomes.
  • Billing challenges: Potential denials if the documentation does not clearly support the recurrent nature of the hernia.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K41.21 lies in its potential to cause discomfort and complications if left untreated. Population health impacts include the prevalence of hernias in certain demographics, particularly among older adults and those with risk factors such as obesity. Quality measures may focus on surgical outcomes and recurrence rates, while healthcare utilization patterns may reflect the need for surgical interventions and follow-up care. Epidemiologically, understanding the recurrence of femoral hernias can aid in developing preventive strategies and improving patient education.

ICD-9 vs ICD-10

The clinical significance of K41.21 lies in its potential to cause discomfort and complications if left untreated. Population health impacts include the prevalence of hernias in certain demographics, particularly among older adults and those with risk factors such as obesity. Quality measures may focus on surgical outcomes and recurrence rates, while healthcare utilization patterns may reflect the need for surgical interventions and follow-up care. Epidemiologically, understanding the recurrence of femoral hernias can aid in developing preventive strategies and improving patient education.

Reimbursement & Billing Impact

Reimbursement considerations include the surgical procedure performed, the patient's insurance coverage, and adherence to payer-specific guidelines. Common denials may arise from insufficient documentation or incorrect coding. Best practices include thorough documentation of the patient's history, clear notes on the recurrence, and ensuring that the procedure codes align with the diagnosis.

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 K41.21?

K41.21 specifically covers recurrent bilateral femoral hernias that are not obstructed or gangrenous. It is important to document the recurrence and the absence of complications to justify the use of this code.

When should K41.21 be used instead of related codes?

K41.21 should be used when a patient has a documented history of bilateral femoral hernias that have recurred without obstruction or gangrene. If the hernia is unilateral or has complications, other codes should be considered.

What documentation supports K41.21?

Documentation should include a detailed history of the patient's hernia, evidence of recurrence, physical examination findings, imaging results, and treatment plans. Clear notes on the absence of obstruction or gangrene are also necessary.