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ICD-10 Guide
ICD-10 CodesK41.4

K41.4

Non-billable

Unilateral femoral hernia, with gangrene

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

Code Description

ICD-10 K41.4 is a used to indicate a diagnosis of unilateral femoral hernia, with gangrene.

Key Diagnostic Point:

K41.4 refers to a unilateral femoral hernia that has progressed to gangrene, a serious condition where the tissue dies due to a lack of blood supply. Clinically, patients may present with severe groin pain, swelling, and signs of bowel obstruction, including nausea and vomiting. The anatomy involved includes the femoral canal, which is located just below the inguinal ligament, where abdominal contents can protrude. The progression of this condition can lead to incarceration, where the herniated tissue becomes trapped, and subsequently strangulation, where blood supply is compromised, resulting in gangrene. Diagnostic considerations include physical examination, imaging studies such as ultrasound or CT scans, and laboratory tests to assess for signs of infection or systemic illness. Prompt diagnosis and intervention are critical to prevent further complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough assessment to differentiate from other types of hernias and complications.
  • Treatment complexity: Surgical intervention is often necessary, with potential for emergency surgery due to gangrene.
  • Documentation requirements: Detailed clinical notes and imaging results are essential for accurate coding.
  • Coding specificity: Requires precise coding to reflect the severity and complications of the hernia.

Audit Risk Factors

  • Common coding errors: Misclassification of the hernia type or severity.
  • Documentation gaps: Incomplete clinical notes regarding the patient's condition and treatment.
  • Billing challenges: Potential denials if the documentation does not clearly support the diagnosis of gangrene.

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 K41.4 lies in its potential for serious complications, including sepsis and bowel necrosis, which can lead to increased morbidity and mortality. The population health impact is notable, as femoral hernias are more common in certain demographics, such as older adults and women. Quality measures may include timely surgical intervention and postoperative outcomes. Understanding the epidemiology of this condition can help healthcare providers improve prevention strategies and resource allocation.

ICD-9 vs ICD-10

The clinical significance of K41.4 lies in its potential for serious complications, including sepsis and bowel necrosis, which can lead to increased morbidity and mortality. The population health impact is notable, as femoral hernias are more common in certain demographics, such as older adults and women. Quality measures may include timely surgical intervention and postoperative outcomes. Understanding the epidemiology of this condition can help healthcare providers improve prevention strategies and resource allocation.

Reimbursement & Billing Impact

Reimbursement may be affected by the severity of the condition and the urgency of the surgical intervention. Common denials can occur if the documentation does not clearly establish the presence of gangrene or if the surgical procedure is not adequately justified. Best practices include ensuring that all clinical notes, imaging studies, and operative reports are complete and accurately reflect the patient's condition and the rationale for surgery.

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 K41.4?

K41.4 specifically covers unilateral femoral hernias that have become gangrenous. This includes cases where the hernia is incarcerated or strangulated, leading to tissue necrosis.

When should K41.4 be used instead of related codes?

K41.4 should be used when there is clear evidence of gangrene associated with a unilateral femoral hernia. If the hernia is uncomplicated or only incarcerated without gangrene, other codes such as K41.0 should be used.

What documentation supports K41.4?

Documentation must include clinical findings of the hernia, imaging results indicating the presence of gangrene, and any surgical notes detailing the intervention performed.