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ICD-10 Guide
ICD-10 CodesK41.91

K41.91

Billable

Unilateral femoral hernia, without obstruction or gangrene, recurrent

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

Code Description

ICD-10 K41.91 is a billable code used to indicate a diagnosis of unilateral femoral hernia, without obstruction or gangrene, recurrent.

Key Diagnostic Point:

A unilateral femoral hernia occurs when tissue protrudes through a weak spot in the femoral canal, which is located in the groin area. This condition is characterized by a bulge that may become more prominent when the patient is standing or straining. In cases of K41.91, the hernia is recurrent, meaning it has occurred previously and has reappeared after surgical repair. The absence of obstruction or gangrene indicates that the hernia is not currently causing severe complications, although it can lead to discomfort and potential future complications if left untreated. The anatomical structures involved include the femoral canal, which houses the femoral vein and artery, and surrounding connective tissues. Diagnosis typically involves a physical examination and imaging studies, such as ultrasound or CT scans, to confirm the presence of the hernia and assess its size and impact on surrounding structures. Clinicians must consider the patient's history of previous hernia repairs and any symptoms that may suggest 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 note recurrence.
  • Documentation gaps may arise if previous surgical history is not adequately recorded.
  • Billing challenges can occur if the recurrent nature of the hernia is not clearly documented, leading to potential denials.

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 K41.91 lies in its potential to cause discomfort and complications if not addressed. Population health impact includes the need for surgical intervention in recurrent cases, which can affect healthcare utilization patterns. Quality measures may focus on the rates of successful surgical repairs and the incidence of recurrence. Epidemiologically, femoral hernias are more common in certain populations, such as older adults and those with a history of heavy lifting or straining.

ICD-9 vs ICD-10

The clinical significance of K41.91 lies in its potential to cause discomfort and complications if not addressed. Population health impact includes the need for surgical intervention in recurrent cases, which can affect healthcare utilization patterns. Quality measures may focus on the rates of successful surgical repairs and the incidence of recurrence. Epidemiologically, femoral hernias are more common in certain populations, such as older adults and those with a history of heavy lifting or straining.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the procedure codes align with the diagnosis and that all relevant documentation is submitted to support the claim. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for surgical intervention. Best practices include maintaining thorough records of patient history and ensuring that coding reflects the most current clinical information.

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 K41.91?

K41.91 specifically covers unilateral femoral hernias that are recurrent and not currently obstructed or gangrenous. It is essential to document the recurrence and any previous surgical interventions.

When should K41.91 be used instead of related codes?

K41.91 should be used when the hernia is recurrent and unilateral, without obstruction or gangrene. If the hernia is new or bilateral, or if there are complications, different codes should be selected.

What documentation supports K41.91?

Documentation should include a detailed history of the patient's previous hernia repairs, current symptoms, physical examination findings, and any imaging studies that confirm the diagnosis of a recurrent unilateral femoral hernia.