2025 ICD-10-CM code K45.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Hernia - Other specified abdominal hernia Diseases of the digestive system (K00-K95) Feed
Other specified abdominal hernia with gangrene.
Medical necessity for treatment of a gangrenous hernia is based on the presence of life-threatening complications such as bowel ischemia, peritonitis, or sepsis.Prompt surgical intervention is typically required to prevent further complications and preserve life.
The clinical responsibility for this code involves the diagnosis and management of the hernia and the associated gangrene. This may include surgical intervention, medication management (e.g., antibiotics), and monitoring for complications.The physician or surgeon is responsible for making the diagnosis, determining the appropriate treatment plan, and following the patient's progress.
In simple words: This code is for a type of hernia where part of the intestine bulges out through a weak spot in the abdominal wall, and the protruding part has died due to lack of blood flow.
This ICD-10-CM code classifies other specified abdominal hernias complicated by gangrene.An abdominal hernia is a protrusion of abdominal contents through a weakened area of the abdominal wall.Gangrene indicates necrosis (tissue death) due to compromised blood supply to the herniated tissue.
Example 1: A 70-year-old male presents with a painful, irreducible right inguinal hernia with signs of strangulation (severe pain, tenderness, fever, and leukocytosis).Physical examination reveals a palpable, tender mass with overlying erythema and skin discoloration, indicative of gangrene. This would be coded as K45.1., A 55-year-old female with a history of ventral hernia repair presents with increasing pain and swelling at the surgical site.Examination reveals a tender, dusky mass with signs of necrosis, confirming gangrene.This situation would also be coded as K45.1., A 60-year-old male with a known umbilical hernia reports sudden onset of severe abdominal pain, nausea, and vomiting.Examination shows a tense, irreducible umbilical hernia with signs of bowel ischemia (lack of blood flow to the intestines). Surgical exploration reveals gangrenous bowel, necessitating resection and anastomosis (surgical removal and reconnection of the bowel).The appropriate code remains K45.1
Detailed history and physical examination documenting the presence of the hernia, its location, and the clinical findings suggestive of gangrene (e.g., pain, tenderness, erythema, skin discoloration, signs of strangulation).Relevant laboratory findings (e.g., leukocytosis, elevated inflammatory markers). Radiological imaging (e.g., ultrasound, CT scan) may be necessary to confirm the diagnosis and assess the extent of gangrene.Operative reports, if surgery is performed, should document the findings intraoperatively, including confirmation of gangrene and the surgical procedure performed.
** This code is highly dependent on clinical documentation supporting the presence of gangrene.Ambiguity in documentation may lead to coding inaccuracies.Always refer to the most up-to-date coding guidelines and official documentation for the most accurate coding practices.
- Payment Status: Active
- Specialties:General Surgery, Gastroenterology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center