K42.1

K42.1: Umbilical hernia with gangrene

Billable / specific codeICD-10-CM

K42.1 is a billable, specific ICD-10-CM code for umbilical hernia with gangrene. It is valid for submission on a claim.

Check K42.1 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Gangrenous umbilical hernia

Excludes1 inherited from the categories above K42.1

A category’s note binds every code beneath it.

Written on K42: Umbilical hernia

omphalocele (Q79.2)

Other codes that can never be billed with K42.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

I96Gangrene, not elsewhere classified
Q79.2Exomphalos
Q79.5Other congenital malformations of abdominal wall

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

K42.1 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56421Billing and Coding: CT of the Abdomen and Pelvis

Alphabetic index entries that lead here

Incarceration, incarcerated›exomphalos›gangrenous
Incarceration, incarcerated›sarcoepiplomphalocele›with gangrene
Hernia, hernial›umbilicus, umbilical›with›gangrene(and obstruction)

Code history

Unchanged in every release from FY2024 to FY2027.