K43.6

K43.6: Other and unspecified ventral hernia with obstruction, without gangrene

Billable / specific codeICD-10-CM

K43.6 is a billable, specific ICD-10-CM code for other and unspecified ventral hernia with obstruction, without gangrene. It is valid for submission on a claim.

Check K43.6 with the rest of the claim: free scrubber

Inclusion terms

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

Epigastric hernia causing obstruction, without gangrene
Hypogastric hernia causing obstruction, without gangrene
Incarcerated epigastric hernia without gangrene
Incarcerated hypogastric hernia without gangrene
Incarcerated midline hernia without gangrene
Incarcerated spigelian hernia without gangrene
Incarcerated subxiphoid hernia without gangrene
Irreducible epigastric hernia without gangrene
Irreducible hypogastric hernia without gangrene
Irreducible midline hernia without gangrene
Irreducible spigelian hernia without gangrene
Irreducible subxiphoid hernia without gangrene
Midline hernia causing obstruction, without gangrene
Spigelian hernia causing obstruction, without gangrene
Strangulated epigastric hernia without gangrene
Strangulated hypogastric hernia without gangrene
Strangulated midline hernia without gangrene
Strangulated spigelian hernia without gangrene
Strangulated subxiphoid hernia without gangrene
Subxiphoid hernia causing obstruction, without gangrene

Risk adjustment

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

Medicare coverage

K43.6 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56421Billing and Coding: CT of the Abdomen and Pelvis
A56658Billing and Coding: Cosmetic and Reconstructive Surgery

Alphabetic index entries that lead here

Hernia, hernial›ventral›with›obstruction
Hernia, hernial›ventral›specified NEC›with›obstruction

Code history

Unchanged in every release from FY2024 to FY2027.