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    v1.0.28
    OpenPayerBilling CodesHerniaICD-10-CM k43-ventral-hernia
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    ICD-10-CM Code For Ventral Hernia: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group K43 includes ventral hernias such as incisional, umbilical, and other anterior abdominal wall hernias, and distinguishes by presence of obstruction or gangrene. These ICD-10-CM diagnosis codes are used to document clinical scenarios involving abdominal wall defects, associated complications like obstruction or gangrene, and procedural history such as previous repairs with mesh. Accurate coding within the ICD-10-CM K43 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM K43: Ventral Hernia Overview

    The diagnoses in this group represent defects or protrusions of abdominal wall contents through the ventral abdominal wall, including incisional and umbilical hernias. They target the abdominal wall and related soft tissues and can involve bowel or omental contents with or without obstruction or gangrene. Accurate coding matters for proper clinical documentation and reimbursement because specificity about location, presence of a mesh, and complications affects claim adjudication and resource allocation.

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    When to Use

    Use a code from this group when documentation identifies a ventral abdominal wall hernia and specifies the anatomic site, presence of obstruction or gangrene, or history of mesh repair. Select the most specific code that reflects the current clinical status and documented complications to support accurate claims and records.

    ICD-10-CM Codes

    9 rows

    ICD-10-CM CodeDescription
    K43.0Incisional hernia with obstruction, without gangrene
    K43.1Incisional hernia with gangrene
    K43.2Incisional hernia without obstruction or gangrene
    K43.3Parastomal hernia with obstruction, without gangrene
    K43.4Parastomal hernia with gangrene
    K43.5Parastomal hernia without obstruction or gangrene
    K43.6Other and unspecified ventral hernia with obstruction, without gangrene
    K43.7Other and unspecified ventral hernia with gangrene
    K43.9Ventral hernia without obstruction or gangrene

    DRG Codes

    5 rows

    DRG CodeDescription
    393Other Digestive System Diagnoses with MCC
    394Other Digestive System Diagnoses with CC
    395Other Digestive System Diagnoses without CC/MCC
    791Prematurity with Major Problems
    793Full Term Neonate with Major Problems

    Related Codes

    K40-INGUINAL-HERNIA

    ICD-10-CM Code For Inguinal Hernia: Group Overview

    K41-FEMORAL-HERNIA

    ICD-10-CM Code For Femoral Hernia: Group Overview

    K42-UMBILICAL-HERNIA

    ICD-10-CM Code For Umbilical Hernia: Group Overview

    K44-DIAPHRAGMATIC-HERNIA

    ICD-10-CM Code For Diaphragmatic Hernia: Group Overview

    K45-OTHER-ABDOMINAL-HERNIA

    ICD-10-CM Code For Other Abdominal Hernia: Group Overview

    K46-UNSPECIFIED-ABDOMINAL-HERNIA

    ICD-10-CM Code For Unspecified Abdominal Hernia: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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