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v1.0.0
ICD-10 Guide
DiagnosesAbdomen Wall Hernia

Abdomen Wall Hernia

ICD-10 Coding for Abdominal Wall Hernia(K43.2)

PRIMARY SPECIALTYGeneral Surgery
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Abdomen Wall Hernia?
Essential facts and insights about Abdominal Wall Hernia

Key Clinical Considerations:

  • Presence of a bulge in the abdominal wall that can be seen or felt
  • Pain or discomfort in the area, especially when lifting heavy objects
  • Feeling of fullness or pressure at the hernia site
  • Nausea, vomiting or both

Clinical Information

Clinical Criteria & Documentation Requirements

  • Detailed description of the hernia, including its location and size
  • Symptoms experienced by the patient
  • Any complications, such as strangulation or obstruction
  • Results of physical examination and any diagnostic tests

Coding Guidelines

Usage Guidelines & Examples

  • K43.2 is specifically for abdominal wall hernia without obstruction or gangrene
  • For abdominal hernia with obstruction but without gangrene, use K43.3
  • For abdominal hernia with both obstruction and gangrene, use K43.4

Code Exclusions

Important Exclusions

  • Inguinal hernia (K40.-)
  • Femoral hernia (K41.-)

Related ICD-10 Codes

Primary Codes
K43.2
Abdominal hernia without obstruction or gangrene
Ancillary Codes
11008
Differential Codes
K43.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

General Surgery

Specialty Applications

  • Patients presenting with a bulge in the abdominal wall without signs of obstruction or gangrene
  • Patients with a history of abdominal wall hernia who are asymptomatic

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Patient presents with a palpable bulge in the abdominal wall, consistent with a hernia.

Template 2

Physical examination reveals an abdominal wall hernia without signs of obstruction or gangrene.

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What is an abdominal wall hernia?

It is a condition where an organ or fatty tissue squeezes through a weak spot in the surrounding muscle or connective tissue.

When should K43.2 be used?

K43.2 should be used when the patient has an abdominal wall hernia without obstruction or gangrene.