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2025 ICD-10-CM code K42.1

Umbilical hernia with gangrene.

Coding guidelines for ICD-10-CM should be followed.Always use the most specific code available that accurately reflects the patient's diagnosis.

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).

IMPORTANT:K42.0 (Umbilical hernia with obstruction, without gangrene) and K42.9 (Umbilical hernia without obstruction or gangrene) represent related conditions without gangrene.Omphalocele (Q79.2) is a congenital condition and should not be coded with K42.1.

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.

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