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ICD-10 Guide
ICD-10 CodesK41.3

K41.3

Non-billable

Unilateral femoral hernia, with obstruction, without gangrene

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

Code Description

ICD-10 K41.3 is a used to indicate a diagnosis of unilateral femoral hernia, with obstruction, without gangrene.

Key Diagnostic Point:

K41.3 refers to a unilateral femoral hernia that is obstructed but does not present with 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. Clinically, patients may present with a bulge in the groin area, pain, nausea, and vomiting, particularly if the hernia is obstructed. The anatomy involved includes the femoral canal, femoral vein, and surrounding structures. Disease progression can lead to incarceration, where the hernia becomes trapped, and obstruction, which can cause bowel ischemia if not addressed promptly. Diagnosis typically involves a physical examination and imaging studies such as ultrasound or CT scan to confirm the presence of the hernia and assess for complications. Prompt surgical intervention is often required to prevent further complications, including strangulation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to differentiate from other types of hernias.
  • Treatment complexity: Surgical intervention is often necessary, which can vary in complexity based on the patient's condition.
  • Documentation requirements: Detailed documentation of symptoms, imaging results, and surgical notes is essential.
  • Coding specificity: Requires precise coding to indicate the type of hernia and its complications.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of hernia or failure to document obstruction.
  • Documentation gaps: Incomplete records regarding the patient's symptoms or imaging findings.
  • Billing challenges: Potential denials if the documentation does not clearly support the diagnosis and treatment provided.

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 K41.3 lies in its potential to lead to serious complications if not treated promptly. Unilateral femoral hernias are more common in certain populations, including women and older adults, and can significantly impact quality of life. Understanding the epidemiology of hernias and their treatment can inform healthcare utilization patterns and improve population health outcomes. Quality measures related to timely surgical intervention can help reduce the risk of complications and improve patient satisfaction.

ICD-9 vs ICD-10

The clinical significance of K41.3 lies in its potential to lead to serious complications if not treated promptly. Unilateral femoral hernias are more common in certain populations, including women and older adults, and can significantly impact quality of life. Understanding the epidemiology of hernias and their treatment can inform healthcare utilization patterns and improve population health outcomes. Quality measures related to timely surgical intervention can help reduce the risk of complications and improve patient satisfaction.

Reimbursement & Billing Impact

reimbursement considerations include the necessity of surgical intervention and the presence of complications. Be aware of potential denials related to insufficient documentation or misclassification of the hernia type. Adhering to coding best practices and ensuring that all relevant information is included in the medical record can help mitigate these challenges.

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 K41.3?

K41.3 specifically covers unilateral femoral hernias that are obstructed but do not exhibit gangrene. This includes cases where the hernia is incarcerated and leads to bowel obstruction without ischemic changes.

When should K41.3 be used instead of related codes?

K41.3 should be used when there is a confirmed diagnosis of a unilateral femoral hernia with obstruction. It is important to differentiate from K41.0, which is for hernias without obstruction, and K41.9, which is unspecified.

What documentation supports K41.3?

Documentation should include clinical findings from the physical examination, imaging results confirming the presence of the hernia and obstruction, and details of any surgical interventions performed.