Umblical Hernia ICD-10-CM Codes
Discover the precise ICD-10-CM codes for umbilical hernia, aiding accurate diagnosis and streamlined medical recordkeeping.
Fact Checked by Ericka Pingol.
What ICD-10 Codes are Used for Umbilical Hernia
An umbilical hernia is a common condition characterized by the protrusion of abdominal contents through a weak area in the abdominal wall near the navel. Accurate coding of umbilical hernia is essential for medical documentation and billing purposes. The ICD-10-CM coding system provides specific codes for umbilical hernia, allowing for precise identification and classification of the condition.
Here are six commonly used umbilical hernia ICD-10-CM codes, along with their clinical descriptions:
K42.0 - Umbilical hernia with obstruction, without gangrene:
This code is used when an umbilical hernia is present, causing a partial or complete blockage of the intestine or other abdominal contents. Still, there is no tissue death (gangrene).
K42.1 - Umbilical hernia with gangrene:
When an umbilical hernia leads to the death of the tissue (gangrene) within the hernia sac, this code is assigned.
K42.9 - Umbilical hernia without obstruction or gangrene:
This code is used when there is a diagnosed umbilical hernia, but it is not causing any obstruction or tissue death.
K42.83 - Umbilical hernia with gangrene and obstruction:
This code is used when an umbilical hernia is present and both obstruction and gangrene of the hernia sac are documented.
K42.89 - Other umbilical hernia with gangrene:
This code is assigned when an umbilical hernia is associated with gangrene, but the specific type of hernia or the presence of obstruction is not specified.
K42.91 - Unilateral inguinal hernia, without gangrene or obstruction:
This code is used for documenting an inguinal hernia, which occurs in the groin area when it is unilateral (affecting one side) and does not involve gangrene or obstruction.
Which Umbilical Hernia ICD codes are Billable:
Here is a breakdown of commonly used umbilical hernia ICD-10 codes and whether they are billable or not, along with brief explanations:
K42.0 - Umbilical hernia with obstruction, without gangrene:
Yes, this code is billable. It identifies an umbilical hernia with partial or complete intestinal obstruction, requiring medical attention and treatment.
K42.1 - Umbilical hernia with gangrene:
Yes, this code is billable. It indicates an umbilical hernia complicated by tissue death (gangrene), necessitating immediate medical intervention.
K42.9 - Umbilical hernia without obstruction or gangrene:
Yes, this code is billable. It represents a diagnosed umbilical hernia without any associated obstruction or tissue death complications.
K42.83 - Umbilical hernia with gangrene and obstruction:
Yes, this code is billable. It denotes an umbilical hernia complicated by gangrene and intestinal obstruction, requiring urgent medical attention.
K42.89 - Other umbilical hernia with gangrene:
Yes, this code is billable. It encompasses cases of umbilical hernias with gangrene, where specific types of hernias or the presence of obstruction are not further specified.
K42.91 - Unilateral inguinal hernia, without gangrene or obstruction:
No, this code is not billable for umbilical hernias. Although it is a valid code, it specifically pertains to unilateral inguinal hernias, a different type of hernia located in the groin area, and not umbilical hernias.
Clinical Information
- An umbilical hernia is a common condition characterized by the protrusion of abdominal contents through a weak area near the navel.
- It typically occurs in infants but can also affect adults, particularly those who are overweight or have a history of abdominal surgery.
- Umbilical hernias are often painless and appear as bulges or swelling near the belly button.
- The hernia may become more noticeable when the person coughs, strains, or stands for extended periods.
- Complications such as obstruction or gangrene can occur if the hernia becomes trapped and the blood supply to the herniated tissue is compromised.
- An umbilical hernia is usually diagnosed through a physical examination, where the healthcare provider can feel the protrusion.
- Imaging tests like ultrasound or MRI may be used to evaluate further or rule out other conditions.
- Treatment options include watchful waiting, hernia belts or trusses, and surgical repair.
- Surgery is typically recommended for symptomatic or larger hernias, as well as for hernias in infants or adults at risk of complications.
- Recovery from umbilical hernia surgery is generally quick, with most individuals able to resume their normal activities within a few weeks.
Synonyms Include:
- Navel hernia
- Belly button hernia
- Paraumbilical hernia
- Periumbilical hernia
- Ventral hernia (if located in the umbilical region)
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Commonly asked questions
ICD codes specific to umbilical hernia help healthcare providers accurately document and classify the condition. They are crucial for medical recordkeeping, insurance claims, statistical analysis, research, and ensuring proper reimbursement for healthcare services.
When documenting an umbilical hernia, healthcare providers should assign the appropriate ICD code that best describes the characteristics and complications of the hernia based on the clinical documentation.
Yes, in some cases, multiple codes may be used to capture the complete clinical picture of an umbilical hernia, especially when there are associated complications like obstruction or gangrene.
