2025 ICD-10-CM code K40
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Hernia Diseases of the digestive system Feed
Inguinal hernia, including bubonocele, direct, double, indirect, oblique, and unspecified inguinal hernias, and scrotal hernia.
Modifiers may apply depending on the type of procedure performed and the circumstances of the service, like the laterality of the hernia.
Medical necessity for treatment would depend on the presence of symptoms, size of the hernia, risk of complications (incarceration, strangulation), and patient's overall health.A large, symptomatic hernia is generally considered medically necessary for repair.
The clinical responsibility for K40 would typically involve a surgeon or general practitioner.The physician's duty includes evaluating the patient's symptoms, performing a physical examination, potentially ordering imaging studies (ultrasound, CT scan), and determining the appropriate management strategy, which could range from conservative treatment (observation, supportive measures) to surgical repair.
In simple words: This code describes an inguinal hernia, which is a bulge in the groin area caused by a part of the intestine pushing through a weak spot in the abdominal muscles.
K40 is an ICD-10-CM code that represents an inguinal hernia.This includes various types of inguinal hernias such as bubonocele, direct inguinal hernia, double inguinal hernia, indirect inguinal hernia, oblique inguinal hernia, and scrotal hernia.It also encompasses unspecified inguinal hernias where the specific type is not identified.
Example 1: A 60-year-old male patient presents with a right groin bulge that increases in size with straining.Physical examination confirms a right inguinal hernia.The patient undergoes a surgical repair (herniorrhaphy)., A 25-year-old female patient reports intermittent discomfort in her left groin.Physical exam reveals a small, asymptomatic left inguinal hernia.The patient is advised to monitor the hernia and scheduled for a follow-up appointment., A 70-year-old male presents with a large, painful, irreducible inguinal hernia with signs of bowel obstruction. The patient requires emergency surgery.
Detailed patient history, including onset, duration, and characteristics of symptoms, physical examination findings (location, size, reducibility of hernia), imaging studies if performed, and operative report if surgery is conducted.
** Always consult the latest ICD-10-CM coding guidelines and payer-specific rules for accurate coding and reimbursement.
- Payment Status: Active
- Modifier TC rule: May apply based on the circumstances of the procedure and whether the technical component is separate from the professional component.Refer to specific payer guidelines.
- Specialties:General Surgery, Gastroenterology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center