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ICD-10 Guide
ICD-10 CodesK41.9

K41.9

Non-billable

Unilateral femoral hernia, without obstruction or gangrene

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

Code Description

ICD-10 K41.9 is a used to indicate a diagnosis of unilateral femoral hernia, without obstruction or gangrene.

Key Diagnostic Point:

K41.9 refers to a unilateral femoral hernia without obstruction or gangrene, which occurs when tissue, such as part of the intestine, protrudes through a weak spot in the femoral canal. 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 can be diagnosed through physical examination and imaging studies, such as ultrasound or CT scans, which help confirm the presence of the hernia and rule out complications. Disease progression can lead to incarceration or strangulation if left untreated, although K41.9 specifically denotes cases without these complications. Treatment typically involves surgical intervention to repair the hernia, which can be performed via open or laparoscopic techniques. Early diagnosis and management are crucial to prevent complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as imaging may be required for confirmation.
  • Treatment complexity: Moderate, with surgical options varying in technique.
  • Documentation requirements: Requires clear documentation of symptoms and diagnostic findings.
  • Coding specificity: Specific to unilateral femoral hernia without complications.

Audit Risk Factors

  • Common coding errors: Misclassification with other hernia types.
  • Documentation gaps: Insufficient detail on symptoms or imaging results.
  • Billing challenges: Denials may occur if the documentation does not clearly support the diagnosis.

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

The clinical significance of K41.9 lies in its potential to progress to more severe complications if untreated. Understanding the epidemiology of femoral hernias helps in identifying at-risk populations, particularly females. Quality measures may include tracking surgical outcomes and complication rates, which can inform healthcare utilization patterns and improve patient care strategies.

ICD-9 vs ICD-10

The clinical significance of K41.9 lies in its potential to progress to more severe complications if untreated. Understanding the epidemiology of femoral hernias helps in identifying at-risk populations, particularly females. Quality measures may include tracking surgical outcomes and complication rates, which can inform healthcare utilization patterns and improve patient care strategies.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the surgical approach taken, whether open or laparoscopic. Common denials can arise from insufficient documentation or misclassification of the hernia type. Coders should ensure that all relevant clinical information is included in the medical record, such as imaging results and the rationale for surgical intervention, to support the claim and minimize the risk of denial.

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 K41.9?

K41.9 specifically covers unilateral femoral hernias that are not obstructed or gangrenous. It does not include bilateral hernias or those with complications such as incarceration or strangulation.

When should K41.9 be used instead of related codes?

K41.9 should be used when a patient presents with a unilateral femoral hernia that is confirmed through examination or imaging, and there are no signs of obstruction or gangrene. If complications are present, other codes should be considered.

What documentation supports K41.9?

Documentation should include a detailed history of symptoms, physical examination findings, imaging results confirming the diagnosis, and a treatment plan outlining the surgical intervention if applicable.