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v1.0.0
ICD-10 Guide
ICD-10 CodesK41.90

K41.90

Billable

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

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

Code Description

ICD-10 K41.90 is a billable code used to indicate a diagnosis of unilateral femoral hernia, without obstruction or gangrene, not specified as recurrent.

Key Diagnostic Point:

A unilateral femoral hernia occurs when tissue protrudes through a weak spot in the femoral canal, located just below the inguinal ligament. This condition is more common in females due to the anatomical differences in the pelvis. Clinically, patients may present with a bulge in the groin area, which may be accompanied by discomfort or pain, especially during activities that increase intra-abdominal pressure, such as lifting or straining. The hernia is classified as 'without obstruction or gangrene' when there are no signs of bowel obstruction or compromised blood supply to the herniated tissue. Disease progression can lead to complications if left untreated, including incarceration or strangulation, which necessitates surgical intervention. Diagnostic considerations include a thorough physical examination and imaging studies, such as ultrasound or CT scans, to confirm the presence of the hernia and assess its characteristics. Accurate diagnosis is crucial for appropriate management and to prevent 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 include misclassifying the hernia type or failing to document the absence of obstruction or gangrene.
  • Documentation gaps may arise if the clinical notes do not clearly indicate the absence of complications.
  • Billing challenges can occur if the procedure performed is not adequately supported by the 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

The clinical significance of K41.90 lies in its potential to lead to serious complications if not addressed. Population health impact includes the prevalence of hernias in the general population, with a notable incidence in older adults and females. Quality measures may focus on timely surgical intervention and patient outcomes post-repair. Understanding healthcare utilization patterns related to femoral hernias can aid in resource allocation and preventive strategies, while epidemiological considerations highlight the need for awareness and education regarding hernia management.

ICD-9 vs ICD-10

The clinical significance of K41.90 lies in its potential to lead to serious complications if not addressed. Population health impact includes the prevalence of hernias in the general population, with a notable incidence in older adults and females. Quality measures may focus on timely surgical intervention and patient outcomes post-repair. Understanding healthcare utilization patterns related to femoral hernias can aid in resource allocation and preventive strategies, while epidemiological considerations highlight the need for awareness and education regarding hernia management.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for surgical repair if indicated. Common denials may arise from insufficient documentation or coding errors, particularly if the hernia's characteristics are not well-defined. Best practices include thorough documentation of the clinical findings, imaging results, and the rationale for the selected surgical procedure, if applicable, to support the claim.

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 K41.90?

K41.90 specifically covers unilateral femoral hernias that are not obstructed or gangrenous and are not specified as recurrent. This includes cases where the hernia is symptomatic or asymptomatic but does not involve complications.

When should K41.90 be used instead of related codes?

K41.90 should be used when a unilateral femoral hernia is diagnosed without obstruction or gangrene. If the hernia is recurrent or involves complications, other codes such as K41.91 or K41.00 should be selected.

What documentation supports K41.90?

Documentation should include a clear diagnosis of a unilateral femoral hernia, notes on the absence of obstruction or gangrene, and any relevant imaging studies that confirm the diagnosis.