2025 ICD-10-CM code K42.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Hernia - Hernia (K40-K46) Diseases of the digestive system (K00-K95) Feed
Umbilical hernia with gangrene.
Modifiers are not applicable to ICD-10 codes.Modifiers are used with CPT and HCPCS codes to provide additional information about the service rendered.
Medical necessity for treatment is established by the presence of gangrene, which is a life-threatening condition that necessitates prompt surgical intervention to prevent further tissue damage, sepsis, and potential mortality.
The clinical responsibility will depend on the healthcare setting and the patient's presentation. It may involve surgeons, gastroenterologists, or primary care physicians for diagnosis, management, and surgical intervention (if needed).
- Diseases of the digestive system (K00-K95)
- K42.1 falls under the broader category of K42 (Umbilical hernia), which is part of the K40-K46 (Hernia) subcategory within the K00-K95 (Diseases of the digestive system) chapter of ICD-10-CM.
In simple words: This code describes a belly button hernia where part of the intestine is sticking out and the tissue is dying due to lack of blood flow. This is a serious problem and needs immediate medical care.
This code classifies an umbilical hernia complicated by gangrene.An umbilical hernia is a protrusion of abdominal contents through the umbilical ring. Gangrene represents necrosis of the affected tissue due to compromised blood supply.This condition requires urgent medical attention.
Example 1: A 60-year-old male presents with a painful, swollen umbilical hernia with signs of necrosis (darkened, discolored skin)., A 2-month-old infant is admitted with a gangrenous umbilical hernia causing bowel obstruction and systemic signs of infection., A 45-year-old female with a long history of an umbilical hernia experiences sudden, severe pain and discoloration around the hernia site.
Thorough physical examination documentation, including description of hernia size, location, presence of necrosis, and signs of infection or obstruction.Include laboratory results (e.g., complete blood count, inflammatory markers), imaging studies (e.g., ultrasound, CT scan), and surgical notes (if applicable).
** This is a serious condition requiring immediate medical attention.Early diagnosis and treatment are crucial to minimize complications and improve patient outcomes.
- Revenue Code: Revenue codes will vary depending on the services provided and the payer.Consult your payer's guidelines and internal coding policies.
- RVU: RVUs are not directly associated with ICD-10 codes.RVUs are used for CPT and HCPCS codes to determine reimbursement amounts for procedures and services.
- Global Days: Not applicable to ICD-10 codes.Global surgical days are associated with CPT codes for surgical procedures.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes. Fee schedules apply to CPT and HCPCS codes.
- Specialties:General surgery, pediatric surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital, Ambulatory Surgical Center