K42.0 — Umbilical hernia with obstruction, without gangrene
K42.0 is a billable, specific ICD-10-CM code for umbilical hernia with obstruction, without gangrene. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Umbilical hernia causing obstruction, without gangrene
- Incarcerated umbilical hernia, without gangrene
- Irreducible umbilical hernia, without gangrene
- Strangulated umbilical hernia, without gangrene
Risk adjustment
K42.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
K42.0 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
How K42.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K42.0.
- Incarceration, incarcerated›exomphalos
- Incarceration, incarcerated›omphalocele
- Incarceration, incarcerated›sarcoepiplomphalocele
- Hernia, hernial›umbilicus, umbilical›with›obstruction
Related codes at this level
Codes that share K42. If K42.0 is not quite right, the correct code is usually one of these.
Questions about K42.0
- Is K42.0 a billable ICD-10-CM code?
- Yes. K42.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K42.0 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Hernia (K40-K46).