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ICD-10 Guide
ICD-10 CodesK41.30

K41.30

Billable

Unilateral femoral hernia, with obstruction, without gangrene, not specified as recurrent

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

Code Description

ICD-10 K41.30 is a billable code used to indicate a diagnosis of unilateral femoral hernia, with obstruction, without gangrene, not specified as recurrent.

Key Diagnostic Point:

A unilateral femoral hernia occurs when tissue protrudes through a weak spot in the femoral canal, which is located below the inguinal ligament. This condition is characterized by the presence of a bulge in the groin area, which may become painful and tender, especially when straining or lifting. The obstruction associated with K41.30 indicates that the herniated tissue is trapped, leading to potential complications such as bowel ischemia or necrosis, although gangrene is not present in this case. Diagnosis typically involves a physical examination and imaging studies, such as ultrasound or CT scans, to confirm the presence of the hernia and assess for obstruction. The progression of a femoral hernia can lead to increased pain, nausea, vomiting, and signs of bowel obstruction if left untreated. Surgical intervention is often required to relieve the obstruction and repair the hernia, making timely diagnosis and treatment crucial to prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Unilateral femoral hernias can significantly impact patient quality of life and may lead to serious complications if not addressed promptly. The prevalence of hernias contributes to healthcare utilization patterns, including emergency visits and surgical interventions. Understanding the epidemiology of femoral hernias aids in developing preventive strategies and improving patient outcomes through timely diagnosis and treatment.

ICD-9 vs ICD-10

Unilateral femoral hernias can significantly impact patient quality of life and may lead to serious complications if not addressed promptly. The prevalence of hernias contributes to healthcare utilization patterns, including emergency visits and surgical interventions. Understanding the epidemiology of femoral hernias aids in developing preventive strategies and improving patient outcomes through timely diagnosis and treatment.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, and common denials can occur if documentation does not clearly support the diagnosis or if there are discrepancies in the coding. Best practices include thorough documentation of the patient's symptoms, the rationale for surgical intervention, and adherence to coding guidelines 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 K41.30?

K41.30 specifically covers unilateral femoral hernias that are obstructed but do not present with gangrene. It is important to differentiate this from other types of hernias and conditions that may present similarly.

When should K41.30 be used instead of related codes?

K41.30 should be used when a unilateral femoral hernia is confirmed to be obstructed without gangrene. If the hernia is recurrent or presents with gangrene, other codes such as K41.31 or K41.32 should be utilized.

What documentation supports K41.30?

Documentation must include clinical findings from physical examinations, imaging results confirming the presence of the hernia and obstruction, and any relevant surgical notes if intervention is performed.