Inguinal Hernia ICD-10-CM Codes

Read our comprehensive guide to ICD-10-CM codes for diagnosing inguinal hernias, a common condition affecting the groin area, in 2023.

By Ashleigh Knowles on Feb 29, 2024.

Fact Checked by RJ Gumban.

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Inguinal Hernia ICD-10-CM Codes

What ICD-10 Codes are Used for Inguinal Hernia?

Inguinal hernias occur when tissue, such as a part of the intestine, protrudes through a weak spot in the abdominal muscles near the groin area. Accurate coding is essential for diagnosis, treatment, and billing. 

ICD-10-CM codes standardize the classification of this condition, providing a common language for healthcare providers to diagnose and treat inguinal hernias effectively.

Here are some commonly used ICD-10-CM codes for inguinal hernia:

K40.90: Unilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent

This code is used for a single inguinal hernia that is not obstructed or gangrenous and has not recurred.

K40.20: Bilateral inguinal hernia, without obstruction or gangrene

This code describes a situation where inguinal hernias are present on both sides without obstruction or gangrene.

K40.4: Bilateral inguinal hernia, with gangrene

This code is used when inguinal hernias on both sides have led to gangrene.

K40.3: Unilateral inguinal hernia, with gangrene

This code is for a single inguinal hernia that has led to gangrene.

K40.12: Bilateral inguinal hernia, with obstruction, without gangrene

This code is used when both sides have an obstructed inguinal hernia but not gangrenous.

Which Inguinal Hernia ICD Codes are Billable:

  • K40.90: Yes
  • K40.20: Yes
  • K40.4: Yes
  • K40.3: Yes
  • K40.12: Yes

Clinical Information

  • Inguinal hernias are most common in men but can also occur in women.
  • Symptoms often include pain or discomfort, especially when bending, coughing, or lifting.
  • Diagnosis usually involves a physical examination and may include imaging studies like ultrasound.
  • Treatment options range from lifestyle changes for mild cases to surgical intervention for severe or complicated cases.
  • Postoperative care is essential to monitor for complications such as infection or recurrence.

Synonyms Include

  • Groin hernia
  • Unilateral hernia of the groin
  • Bilateral hernia of the groin
  • Hernia with obstruction
  • Hernia with gangrene
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Commonly asked questions

When to use an Inguinal Hernia ICD code?

ICD-10-CM codes for inguinal hernia should be used during medical documentation for diagnosis, treatment planning, and billing. They help standardize the condition for effective medical care and data collection.

What are the common treatments for Inguinal Hernia Diagnosis Codes?

Common treatments usually involve surgical repair, known as herniorrhaphy or hernioplasty. Milder cases may be managed with lifestyle changes such as weight management and avoiding heavy lifting.

What does a diagnosis code for Inguinal Hernia mean?

A diagnosis code for inguinal hernia categorizes the condition based on factors such as the presence of obstruction or gangrene, and whether it is unilateral or bilateral. This standardization is crucial for determining the appropriate treatment plan and is also used for billing and insurance claims.

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